No. I just want to say this was well put together. It gave us a lot of food for thought. Do not mistake the lack of questions for lack of interest. But it was well put, and it gives us some starting points on how we should encourage the Task Force -- and I hope they're still here -- to see some of the things. You've done a lot of the legwork, groundwork and gives us a good beginning point. So thank you. And I've already instructed my staff to tackle you on the way out so that we can stay in touch.
Thank you. 106 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Certainly the information is very helpful to us as we deal with housing issues. New ideas can flow to other organizations that are doing it. We have this Affordable Housing Trust Fund. So that information can flow to them in terms of how they look at elderly populations. So we may not have a lot of questions, but we're gathering a lot of information. So thank you.
Thank you. Thank you for the opportunity to address the Council hearing. I want to share what I've learned in the last two decades as a teacher, a consultant and an advocate for conscious aging and for creating communities for elders and specifically 107 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 about elder co-housing, which is an additional model to what has been just presented. I also live, Councilman Jones, in your district, the Fourth District. So I'm pleased to be here. " I'm not going to read it. It's a background for what I shall be speaking about, and I hope that it might inform your decision-making. I want to focus on three aspects that I touched on in this document. One is what I mean by an elder-friendly community, the importance of the elder years, and what co-housing can offer as one model for creating positive elder communities. When I speak of an elder-friendly community, I am focused on the social interactions and meaningful 108 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 activities which engage older persons' minds, hearts and spirits, in addition to the needed services that are provided to care for them. I am looking at what really forms community and what makes the community a place for people to actively remain engaged and have neighbors and have social contacts. This expands the idea of Aging in Place that was referred to in the resolution to Aging in Community, which is now being seen nationally as very important, and then goes even further to focus on creating opportunities for engagement, inclusion and reciprocity. This means building interdependent relationships with others, which is the basis of what meaningful activities are really about. So I am moving a little bit away from the service model and encouraging us when we talk about creating an elder-friendly community to think about beyond just providing 109 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 services. When I think you asked earlier what would be the cost of providing services, I think it's difficult to assess that cost now, and I think it's going to be really impossible in the future when this growing age wave is much larger. And I say that not with fear of the growing age wave, but with an idea of looking at it differently. I've listed some values of what I see as an elder-friendly community, and that's on the bottom of your first page. They're gleaned from my research. There's many other cities and regions that are exploring the same issues, and the World Health Organization issued a document a year ago called Age Friendly Cities that looked at many of these same questions. And I looked at not only providing services, transportation, housing, social services, medical services, but also looked at what helps people to be included, what provides respect for individuals, what provides 110 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 ongoing educational opportunities. It's a rather extensive list, but if we're going to undertake the creation of an elder-friendly community, why not be bold. Why not ask for all that would make such an initiative truly exciting and challenging. That would make an elder-friendly community not only good for elders, but it would make it good for the whole City. I call your attention to the fourth value. This is exploration that is focused on the development of purpose and meaning within one's life, along with the exploration of spirituality. This does come from the Conscious Aging movement. The elder years are now called the third age by gerontologists. It's a specific time of life that has unique opportunities and purposes. Part of it is to review and assess one's life, to naturally reflect on what has been and what still needs doing. When you referred to your 111 12/2/08 - PUBLIC HEALTH & HOUSING - RES.
080735 mother going back and becoming a teacher's aide because she was bored, she was probably bored, but she might have had a desire to work with children or might have been something that said, now that I don't have to do what I've been doing, I want to do something different. For whatever reason that desire rose in her. And what did it give to her as a sense of satisfaction or usefulness or did she transmit to other people, what does it serve not only as a model for yourself and other family members. That's part of the process of growing older, where have we been and where are we going. Part of it is harvesting wisdom, creating legacies that are borne of desire and passion and interest, from skills learned and acquired through a lifetime. Elders are amazing resources. They have unique experiences and assets that they are able to offer to individuals and to their communities. 112 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 This contradicts the typical model of old age being a time of decline and uselessness, of elders being a drain on our economy and on our lives. It just is not so. There is a lot of information out now about positive aging, about positive -- about successful aging and about all that elders can give back. I've referred to some of that in the document in front of you and some of the studies that are being done. How do we best encourage ourselves -- and as I look around this room -- and elders to engage in these activities of growing older? How do we best affirm who they are and provide them with the opportunities to grow into who they still want to be? How do we use this vast age wave, not to fear the age wave but to build a better Philadelphia? Creating an elder-friendly community is one means to open up to these opportunities. So I take it very seriously about what you mean as an 113 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 elder-friendly community. Another is to provide innovative options that will allow elders to flourish and to grow in supportive environments. And I think you pointed to many of them in your open presentation, and I was really interested in the one from England. Elder co-housing developments are one such option, and they do come from Denmark. Elder co-housing is a new housing model which offers older adults new opportunities to live in communities that are safe, affordable and socially, intellectually and spiritually engaging. Co-housing residents are consciously committed to living as a community. The physical design encourage both social and counter and individual space. Private homes contain all the features of a conventional home, but residents also have access to extensive common facilities, such as open space, courtyards, perhaps playgrounds and 114 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 definitely a common house. Co-housing integrates the values of an elder-friendly community. People help each other out. There is reciprocity. People work together to build, maintain and manage their homes. There is engagement. There are structured and unstructured opportunities for socializing, learning new skills and exploring interests. When a person needs assistance, the community can help, or a service provider is called to provide what is beyond the scope of the community. Co-housing has developed the concept of what builds community. It's a model for intentional living. It's useful in retrofitted settings, in new construction, and I believe that the principles of co-housing, of how to live together, can be used in retrofitting existing living arrangements such as apartment buildings. 115 12/2/08 - PUBLIC HEALTH & HOUSING - RES.
080735 I hope that as the Council moves forward and adopts the concept of an elder-friendly community for the City of Philadelphia, it will also intentionally focus on co-housing and other innovative models for how elders and all citizens can live in communities that revive and embrace the values of social connection, interdependence and healthy living. Thank you.
No. Just an additional comment, that your concept of not just aging in place, I think I get it, that we need to just be more inclusive in our design of regular communities and not just batch together services and walkability and engagement and other non-deliverables but yet important concepts need to be inculcated into the design. 116 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
Exactly. And also I think that we need to look at aging as not something that begins when someone is debilitated or in need of services and frail, but aging is a process that begins when somebody is quite younger, maybe at 50 or 60, and are beginning to think, how do I want to live my years as I get older, and then how to build ties within a neighborhood, how to build the kind of connections that will help to support them and sustain them, not only physically but socially and emotionally and spiritually, as we have meaningful engagement and connections with other people.
Is there a juxtaposition to your issue of the amount of senior assisted living in a community? You had a formula of 20, 30 percent, not more than, if I recall.
I mean, again, I personally think that intergenerational models are really powerful and that 117 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 warehousing seniors in large communities by themselves is not -- at least not the way I think my generation wants to age. There's some -- I didn't talk about this, because it wasn't part of the study, but there's something called Generations of Hope, which is an intergenerational model in Illinois where they have families who are adopting children from the foster care system living with seniors, and the seniors provides six hours of volunteer service a week in return for reduced rent. And not a single person, senior, from that community has ever gone to a nursing home, because they take care of them there, and they take care of the kids when they come home from school if the parents are working and so forth. So that model -- the houses are interspersed. It's not like a big senior building somewhere. They're right next door to the families. So I think those kinds of 118 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 models are elder-friendly communities.
Right. I was a single mother until my son was 17. So I spent many years raising a child by myself. Many times I wished that there was somebody that could just come on over for a few hours and play cards while I ran out and did grocery shopping or just got off by myself for a while. How do we -- and I would have been more than pleased for myself or my son to go pull their trash cans out to the street or change their light bulbs or hang their picture on the wall or whatever it is. How do we build this kind of reciprocity, understanding that even a frail person can be engaged with people in their neighborhoods, and that brings meaning to their own lives.
It's amazing that other cultures get it, and we tend to have the opposite perspective on aging as many of them do. As people progress, they become elders in society and valued 119 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 for their resource and longevity and knowledge base, and we kind of tend to move them towards obsoletion -- obsoletion --
I think the key is to foster those interactions, and I think that's what Lynn is talking about, and some of these housing models by being in the community do that.
In my neighborhood and a lot of neighborhoods in Philadelphia, it would take a lot of support, agency support or community organization support, to foster that kind of interaction, because most of the people live in their homes. I live in a neighborhood that's aging. And so who takes the lead to provide that service to that community? It's just not that easy 120 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 to -- I mean, it is a need and as I sit here and I think about how can I engage someone or some group in my neighborhood to begin to develop activities and programs for the seniors, there is the recreation center, there is the Senior Citizen Center, but everybody does not go. And there are seniors in their homes who probably would like to have something to do, but it takes a lot more organizing to do that. When you think of the urban area, it's different than maybe the suburban area in trying to foster these relationships. I mean, there are a lot of issues around just the relationships. We don't even see people talking to each other anymore in the neighborhood. Not just senior citizens, but anybody. In the old days, people were out, they were walking, they were talking. So you may have a neighbor who is in trouble and you don't know it, because there's no communication. How do 121 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 we foster that communication to build a support system for those neighbors who need it. I have neighbors who are losing their homes who don't talk to anybody, and you find out they've lost their home in foreclosure because they don't feel comfortable talking to anybody about it to get the help that they need. So as I listen to your models, I think they're fine. How do we take your models and try to incorporate them in an urban setting?
I think you're raising really excellent points, but I think it was going to require like a real major paradigm shift in thinking, and that support may be needed at first, but I think once the culture changes, our whole expectations are different. But once those things start to happen, those linkages occur, the interactions occur, I think they take on a life of its own, and the outside professional support, so to 122 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 speak, can draw back. There's a lot of good things showing circles of support for people with developmental disabilities, where at first you may have a professional, but then they develop supports, friendships in the community and so forth, and over time the professionals step back. So with those kind of supports that you're suggesting, I think it might happen. The interventions might be necessary in the beginning, but I think over time there's culture shift.
I don't want to seem doom and gloom, but we went from that neighborliness and the caring for the people in the neighborhood to being behind closed doors because the increase in crime and drugs.
So you may trust the mother or you may trust the next-door neighbor, but the son may not be trustworthy or the daughter may not or 123 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 the uncle or somebody in that household may not be trustworthy. How do you know that? Just because of the influences of the drugs in our community.
Those are realities we have to face as we work. It doesn't mean that we don't try. So I'm not saying that we won't try, but we may have to find another model that fits the inner city.
I agree with you completely and I agree with Diana. I think that we need to find another model. I think you're pointing out the important questions. We need to create a new vision of what it's like to live in an urban community. The questions of safety can only be addressed by people taking care of each other and watching out for each other. So if we're going to say safety is about buying bigger locks and having thicker doors, that's not going to work. 124 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 The question of safety is only about knowing your neighbors and being able to get together and point to the people that are causing the disruption. The question of taking care of each other can only be done collectively. We are just not going to have enough people or enough financial resources to take care of all the needs of people as they grow older, and yet we can take care of each other. There's no reason we can't live in a shared housing situation. There's no reason you can't have people in an apartment building that are understanding that they want to care for each other and agree to bring somebody breakfast who needs a little bit of help for a while. That doesn't mean that you do their personal care or do their laundry or do their cleansing, but it does mean that there are things that we can do for each other, and in doing so -- what was it I learned as a child? It's better to give than to receive. We all 125 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 get that feeling of, I like doing this. How do we open up those opportunities to do for each other so that we are building a stronger community? Not just a better system for delivering services. And that system does need to exist and we do need to have a good system, but with that, we need to have the supports that go along with this so we can care for each other.
I just want to say thank you and that you added an important component and ingredient to the topic today, and, that is, the kind of thing that binds -- the ties that bind, and it isn't locks and it isn't just services. It is caring for one another as neighbors.
Our next panel, Cathy Brewington, Charles Day, Robert Abdullah and Tania Rorke. I hope I got all those names correct. 126 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 (Witnesses approached witness table.)
Who is going to speak first? Are you part of this presentation?
Okay. Who is here who is going to make the PowerPoint presentation?
Oh, okay. We'll let you testify first. You start. We'll let him start and make the PowerPoint presentation and then we'll move forward. Mr. Day.
Thank you. Good 127 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 afternoon, Councilmembers and visitors. I'm Charles Day, a resident of East Falls and Chair of the East Falls Village Steering Committee of the East Falls Community Council. We're exploring the possibility of creating a non-profit organization to serve the needs of residents of East Falls who are age 50 and above. We envision being able to meet a wide range of needs, a one-stop shopping approach, which would facilitate aging in place in the community, essentially a bottom-up effort, accomplishing as much of this as possible through the participation of volunteers from the community. We're talking about a grassroots effort arising within the community which finds leadership and membership in the community, raises most of its operating funds from members in the form of dues or contributions, has minimal staffing and makes good use of volunteers. It should be affordable to a wide range of incomes 128 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 and it should have a way of assisting membership for people with limited incomes. We understand this kind of organization works well in communities where there is a strong sense of neighborhood identity, coupled with a strong desire on the part of residents to stay in their homes and/or in the community at large as they age. We believe that East Falls meets these qualifications. We've adopted the name "Village" in our committee's title because it reflects the key idea that we are about building a community, not simply providing services. Further, we've learned from the experience of other projects that many older people resist participating because they don't like being labeled old. In a sense, you might say they're ageist. I reluctantly include myself among them. References to elders, seniors, aging, retirement and 129 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 similar words fail to convey this sense of community and may actually turn away the healthy, vigorous component of older individuals needed to energize such a community. What is needed is to develop a sense of community appealing to the many older persons who are healthy and vigorous and thereby to energize the community while providing a lifeline for those who may be in need of it. The benefits of this approach are a better chance to retain in the City people with moderate or middle incomes and above, to maintain the City's economic base and tax base, and provide citizens with a better choice than the active adult communities and continuing care retirement communities that are springing up in the suburbs. As part of our exploration, we conducted a community survey in October, and I'd like to just share some of the results with you. 130 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 This was a low-budget effort, paid for by committee members out of their own pockets, aimed at getting enough replies back to paint a picture of community concerns. Using the services of student volunteers from Philadelphia University, we distributed several thousand questionnaires door to door throughout the neighborhood, asking respondents to mail them back or drop them off at the library. We received 134 replies. All but eight were from ages 50 or older. Here's a summary of what they told us: 79 percent plan to stay in their own homes, plus another five percent said they were unsure, and here are their current needs to stay safe and comfortable. These are in priority order. They told us they need assistance with yard work; help with handyman kinds of chores; healthy life-style programs; help with heavy cleaning; a referral list for professional services and contractor 131 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 services, featuring providers who have earned the community's trust; help with wills, living wills, estate planning, tax preparation and similar items.
Here's what they anticipate needing, also in priority order: Transportation within the community and to shops and other services; shopping assistance; meals; laundry and housekeeping; home modification for safety and physical factors; personal care assistance and case management; handyman and heavy cleaning services again; and organized activities. " The need for walkability and safe streets came up frequently; desire for shuttle transportation around the neighborhood, including the SEPTA station; parking at the train station and in the business district; the need for occasional organized trips to museums, sports 132 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 events, restaurants, et cetera; and concern that disability payments are not keeping pace with rising taxes, cost of living and medical costs. In East Falls now we're turning our attention to conducting a feasibility study to determine whether and how to proceed. There are many things that government might be doing to facilitate aging in community. Some of them cost a lot of money; some not so much. Here are some of the "not so much" recommendations for your consideration: Support development of models for aging in community that can be replicated. And I know you're working on that today. Provide technical assistance, information share and workshops about what is learned; provide awards and recognition for successful community organization efforts for businesses that are supportive, for hospitals and for non-profits; promote caregiving both as a 133 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 profession and as a form of volunteer service, something to be proud of, take pride in; ensure neighborhoods are accessible, curb cuts, sidewalks, signage, traffic controls, snow and trash removal; increase transportation options for older people, for example, by adjusting bus routes to promote access to neighborhood facilities; facilitate restoration of buildings that could be used for multi-family residences. We've heard more about that already today. Work to enhance safety in our neighborhoods and our gathering places. Interestingly today, I have a news release from the Philadelphia Police Department talking about a safer seniors public education campaign which is about to begin. And promote a major strength of Philadelphia; namely, its wonderful neighborhoods. In summary, in a period of financial shortages, use the powers of government that do not cost a lot of 134 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 money and harness the energies of its residents and businesses in this important effort. Thank you.
Thank you very much for your testimony. You're doing just what Ms. Iser talked about in terms of moving your community to dealing with the seniors in the community. We thank you for your testimony. We'll hold the questions until we finish. Ms. Brewington, would you come forward since I asked the East Falls group to go before you. Thank you.
Good afternoon. My name is Cathy Brewington. I'm here representing Haddington Multi-Services for Older Adults. Ms. Geneva A. Black, our Executive Director, she's unable to be here today, so she asked me to come in her stead. I am here today to represent the elderly population we serve. Our 135 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 service area is both North and Southwest Philadelphia. The membership of our agency is about 5,000 members and more. We operate a senior center where we serve seniors age 60 and over. We offer congregate meals, socialization, recreation, counseling and education, transportation. We have an in-home support unit where we coordinate services for homebound seniors, such as chore services. We have information and referral services, minor repairs we may do and accessibility of railings, hot water heaters, and we assist seniors with delinquent energy bills through discretionary funds that we receive through the Philadelphia Corporation for Aging. We have another program known as the Survival of Caregivers. It's short abbreviated SOC. This program was designed to educate caregivers on how to access available resources and assist 136 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 seniors through the maze of caregiving. All of these programs and services are designed to assist the elderly to remain in their own homes, in their own environment, versus going into a caring facility where it is a known fact that the elderly deteriorate faster if they are living in unfamiliar surroundings. And the City can help by doing -- Ms. Black has written down several suggestions that we feel as though would benefit the seniors. If the City could assist with home repairs in a more expedient way. In a lot of cases seniors do expire as a result of waiting for City services. We would like to suggest cutting the bureaucracy. We assume that certain questions and certain eligibility requirements are not necessary. We also must remember also that we're dealing with seniors. We suggest that more accessibility to energy assistance 137 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 hotlines might be a little bit more created in such a way that there's no 4 waiting and no listening to busy signals and waiting long periods of times listening to the computerized messages and the computerized prompts, which is very confusing for seniors. We believe that a better relationship with the senior programs in centers in the City of Philadelphia and a better understanding of services that we provide. The City should establish a partnership with senior centers and senior programs. Ms. Black -- and she stated this -- that some of you in City Council are age eligible for services or will be, and she says you ought to think about how you could improve City services to the elderly. Thank you.
She's taking advantage of knowing us for so many years. And she's right, and that's 138 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 why we're here. Thank you so much for your testimony. I have a question for you, but we're going to let everybody testify and I'll come back with the questions. So don't leave.
Next? Who is next? Young lady, you may move over here. Are you going to testify?
My name is Robert Abdullah. I'm with A Place Like Home Adult Daycare Center. First of all, I'd like to say I'm very excited to be here, and thank you very much for having a setting where we can talk about some of the issues in our community. We believe that A Place Like Home Adult Daycare Center can be one of the solutions to strengthen Philadelphia neighborhoods by providing healthcare and 139 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 support services to seniors who desire to age and live with dignity in the comforts of their own homes. I'm not sure that a lot of people understand what adult daycares are, so the question is, what is an adult daycare center? An adult daycare center is a medical facility where activities-of-daily-living services are provided to guests or consumers five to eight hours per day. These services include nursing, medical care -- sorry; personal care, nutrition, education, social and recreational activities. An adult daycare center is also licensed and inspected annually by the Pennsylvania Department of Aging. Who attends the adult daycare centers? Typically those seniors over 62 who are nursing home eligible or dependent on others due to mental and/or physical disabilities, seniors who can no 24 longer be left alone at home, seniors who have been discharged from the hospital or 140 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 need nursing care, seniors who need stimulation through socializing with others, and young adults that may have had a stroke and have some form of dementia. Some of the benefits that I think -- since we're here talking about crime in the neighborhoods, I'm going to share my testimony with Carmen Martinez, who is part of our Caregivers Program and whose mother attends our center. We believe that if seniors are more aware, if they receive adequate healthcare and -- well, I'll just read it. Attendance of adult daycare centers can greatly reduce crime and a number of illnesses faced by seniors. For example, seniors who attend three to five times per week is far likely less to become a victim of crime, because they're not at home as often, so it limits the opportunity of a crime. They change their daily routine. They're not just 141 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 sitting at home or maybe just going out to the corner and going back home. See, I also believe that because we do understand that home healthcare is important, but I also believe that home healthcare or home care or healthcare should not just be restricted to the home. Our adult daycare center is "a place like home" where they can come and they can receive those type of services in a community-type setting. More people know their whereabouts. Our seniors are educated about the pros, about the cons and scams. We talk about white-collar crimes, and we offer a safe environment. The health benefits is daily health monitoring, because we have a nurse on staff and we have a facility doctor, nutritional meals, and they get to socialize with their peers. I know this year with the presidential election, it gave us a lot to talk about. We talk about not just 142 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 the presidential election, but what's going on in your house, in your community, what's going on with your home, because we have someone who is not a licensed social worker, but is like a social worker there, so we can address a lot of issues and concerns that the seniors have at home. Also, there's heat in the winter and there's cool in the summer, and we all know that's a problem too with our seniors that live at home. And a lot of our seniors don't come out because they're afraid. They're afraid of the crime, or a lot of our seniors have a lot of pride. They might not ask for help. When you're in a setting, such as I believe like A Place Like Home, you talk to people, you talk to your peers, you talk to like our administrator, who is Janet Glenn, who is a block parent from the community.
Our people are all from the community in our neighborhood. We like to think that our adult daycare 143 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 center is not just a medical facility but a community center. And I invite any of you. I know, of course, Councilman Jones has been there plenty of times, but I invite any of you to come out and see the facility. I did throw some pictures in the statement just so you can have an idea of what the center looks like. But it also provides peace of mind for the caregivers, and it prevents premature nursing placement. And just a quick fact. When Councilman Jones spoke about money that goes on along with care, and from the resolution, we see that for assisted living, our annual fee for one person could be about, I think it was, $32,400, and for nursing home care, $84,000. For someone to attend an adult daycare for a month, it's about a thousand dollars, and that's five days a week. And if you look at the savings for ten people over a period of one month for adult daycare, 144 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 you will pay $10,000. For assisted living you would pay 26,000. For a nursing home you would pay 75,000. Over a six-month period, 60,000 for adult day, 159,000 for assisted living, and 450,000 for a nursing home. And then since we always know that money is always an issue, especially for healthcare, especially for our seniors, and we know that there's roughly 250,000 seniors in the City of Philadelphia, which is a large number, one of the largest, if not the largest in the State of Pennsylvania, and I believe any study and any professional will tell you that most seniors over the age of 65 have some type of disability. I'll use a conservative number. Forty percent. I've read studies that were higher than that, but we'll go at the low end, 40 percent. And if adult daycare is preventive healthcare, even if you delay someone from going to a nursing home or to assisted living, you're saving over a 145 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 six-month period of time -- say if my mom, we can delay the process of her going into assisted living for six months and say we have -- I'll take another number, say a round number. If we have 250,000 people and we'll take a thousand people out of 250,000 over the age of 65 and say we can delay them from going into an assisted-living facility, we save the State close to $16 million in six months. And if you're talking about nursing homes, you're talking about $39 million in six months of a savings that you can give to the City or to the State. And as Councilman Jones says -- and we all know this to be a fact -- our district is one of the highest senior population districts in the City. We have over 10,000 people over the age of 65 and 4,500 people over the age of 75, with just two adult daycare centers in our district. In my center, we have, I believe, 30 people in my center. Something is missing there. 146 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 But I can say this before I let Carmen speak: I'm a community-based person. I've worked in community development, community centers pretty much my professional life and my entire professional life. My center -- I've opened my doors up to anyone who wants to do anything positive in our community, not just for seniors. I don't know where the answers are as far as the funding source, but my center is open. Any way we can be of assistance to the City -- let me change that. Any way we can be of assistance to the seniors in our community and to the City to do the things that you're trying to do, my doors are always open. Carmen.
Good afternoon. My name is Carmen Martinez-Skinner and I'm the Vice-President of the Caregivers 147 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Association for A Place Like Home Daycare. Our address is 5610 Lancaster Avenue. So you're more than welcome to come. Also, we have some representation today from our center, some of our seniors and some of our families and our caregivers.
Could they please stand. Could our family stand. (Applause.)
Okay. Thank you. I'm going to just talk a little bit about the features and benefits of adult daycare and what it's like at A Place Like Home. They need a voice, and some of us kind of are the voices for them, for those who can't explain everything they want to say. So I'm going to try to do some of that for you. Adult daycare provides a safe 148 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 facility from five to eight hours per day and on the weekends to give our loved ones a place away from home to be able to socialize with their peers. Adult daycare allows them to be medically treated with trained personnel that can look after their medicines and make sure they are properly being administered. Also, find out if they are up to date on their shots, doctors' appointments and if they're in need of any additional medical assistance, a facility that looks good and has a friendly environment so seniors can get the individualized attention that they need most of the time. Adult daycare provides seniors with not having to be bothered with people who prey on the elderly for money and because they can. This type of facility allows them to get a nourishing breakfast and lunch every day. In some cases, they are not eating at all. The facility gives our loved ones an opportunity to talk, discuss and listen 149 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 to their peers who have traveled the world, who have been to war to their peers -- I'm sorry; who have been to war, who have been executives and anything else most of them can remember and share about themselves. With the assistance of Para-Transportation, they're able to come and return back home safely every day. The Para-Transportation system has trained personnel that become friends to our loved ones and are very caring and concerned about them. Those of us who have to work can be assured that our loved ones are being cared for in a facility that is safe, clean and friendly. It won't be for everybody, but the elderly that we care for should be given the opportunity to have a place in their neighborhood or near their neighborhood that provides them with a safe environment and peace of mind for the family or caregiver. 150 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Most important, it gives them something to look forward to. If not every day, maybe a couple days a week, that they can go to a place where they will be able to paint, dance, play pinochle, listen to Nat King Cole, sing gospel and even help someone else at the center that might need some assistance. Our loved ones still have something to give and share. This is the benefit of adult daycare. Thank you.
Thank you very much. Could I just ask you -- I was going to ask you about transportation, but then you said the transportation service picks them up.
How many adult daycare centers? Do you have any idea how many are in the City?
Total, in 151 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 the entire City?
There are 4 adult daycare centers in the City, but 5 from the funding, the funding source for 6 adult daycare that I'm aware of from the 7 2007 budget from PCA, is about $978,000, 8 which is a minimum amount for the number 9 of seniors that we have in the City and 10 which I believe could benefit from the 11 services of adult daycare. 12
A lot of the 15 people that attend my center pay out of 16 pocket. I would say about half of the 17 people that we have pay out of pocket and 18 the rest are covered probably by PCA through Medicaid.
The fee is -- Janet, correct me if I'm wrong -- for a 152 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 full day $52 and for a half day $31.
Right. Okay. As you were talking about seniors and being preyed upon, I think we have to go back to the "just say no." Anyone ask you anything, just say no. 8
You won't get into trouble. Don't let me think about it. I don't want to be bothered. Just say no. 13 Thank you so much for your testimony, and it seems that you must have a good daycare center. Curtis Jones here represents you. Okay. Next. Thank you.
My name is Tania Rorke and I would like to thank you for allowing me this opportunity to speak to you today on behalf of Penn's Village. Penn's Village is an innovative, non-profit organization 153 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 founded to enhance the lives of residents in Old City, Queen Village and Society Hill as they grow older or have special needs. We provide support, services and programs that enable our members to live healthy and meaningful lives in their own home. We are a true Aging in Community organization. " Penn's Village began offering services in June of 2008. We have a growing menu of services, all member driven. Our members' needs determine the services that we provide. These services include, but are not limited to, transportation, including rides to the doctor's office, grocery store, senior centers, cultural events, airport and other local destinations; household and convenience services, such as picking up prescriptions, groceries or laundry; running errands; mailing packages; 154 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 watering plants; taking out trash; walking or caring for pets on short absences; computer problem solving and in-home computer training; home repair and adaptation; home maintenance; meal preparation and delivery; paperwork; bill 8 paying; sweeping or shoveling of sidewalks; lifting of heavy items and changing light bulbs. We provide information and events, such as trips, activities, educational seminars, programs, dining groups, book clubs, medical discussions and support groups. For health services we have timely access at both Pennsylvania and Thomas Jefferson University Hospitals; referrals to preferred nursing and home care agencies; companion care; explanations of medical benefits; information on prescriptions; spiritual healing; advocacy; exercise classes and personal training. We offer volunteer opportunities to our members and others 155 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 in the community through Penn's Village or other volunteer organizations. We provide information services so that if a member has a question, a problem, needs information, we'll help locate that answer or solve their problem. We provide peace of mind. We do regular check-ins or look-ins for those with distant relatives or those who live alone in this area. We provide companionship and also advocacy. All of these services can be accessed by calling one number. Our goal is to provide the highest level of customer service and satisfaction. Penn's Village is a "volunteer first" organization. We provide all of the above services using talented and carefully screened volunteers. Services provided by the volunteers are at no 23 additional charge to a member. However, when a volunteer is not available, arrangements are made for services to be 156 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 provided by carefully vetted providers. Services will be completed by these providers often at specially negotiated rates. If a member prefers to use only providers and not volunteers, we will happily set that up. Our members' wish is our priority. Following a visit from any volunteer or provider, members are called to check on their satisfaction, and any follow-up is performed, if necessary. Penn's Village offers three types of memberships. We offer charter memberships available at $2,000 for a household and $1,300 for an individual. That is a two-year membership, and it also includes a tax-deductible donation. We have regular memberships available for $750 for a household and $500 for an individual. In the near future -- and we are currently doing this now on a limited basis -- we hope to offer a membership assistance program for those residents who want to join Penn's 157 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Village, need its services but cannot afford the full membership.
We have one member who is 96 years old, and when you think of $500 for a membership fee, if you divided that into an hourly cost and the cost of transportation, she would only be able to get approximately 9 trips to the grocery store. We've taken 10 her every week to the grocery store since 11 she's become a member, all for her $500. 12 Penn's Village has established strong strategic partnerships with both Pennsylvania Hospital and Thomas Jefferson University Hospitals. As strategic partners, the hospitals provide a liaison to Penn's Village to facilitate appointment scheduling, billing issues and act as an advocate for Penn's Village members should problems arise or should they find themselves in the ER or hospitalized at either institution. The hospitals also provide health education programs and sponsor special events. We recently, in November, 158 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 offered two free flu shots in our communities, all donated by Thomas Jefferson University Hospital and sponsored by Penn's Village. How did all of this begin? On February 9th of 2006, residents from Society Hill read an article titled "Aging At Home: For a Lucky Few, A Wish Come True" in the New York Times. This article was about a wonderful new organization at that time in Boston called Beacon Hill Village. Beacon Hill Village is a membership organization founded in 2001 by a group of long-time Beacon Hill residents as an alternative to moving to retirement or assisted-living communities. In response to all the calls Beacon Hill Village received as a result of that article, they created a manual on how to create your own village. Residents from Society Hill were among those who called Beacon Hill, and residents from Old City, Queen Village and Society Hill formed a 159 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 steering committee and met to discuss the concept and in June of 2006 purchased Beacon Hill's manual. " We then surveyed our communities to see if there was interest in a village and to find out what services people would be interested in. In early October, we visited Capitol Hill Village, another village located in Washington, DC, to learn what they were doing. On October 30, 2007, we incorporated and became Penn's Village. The rest is our history. Today, Penn's Village has been providing services for six months. We have growing membership. We have 39 members at this time averaging an age from 40 to 96. We have 29 volunteers. Our members have a financial diversity ranging from or bringing in less than $700 a month to over $100,000 a year. We 160 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 now receive an average of 97 requests a month for services from our members. Ninety-eight percent of those have been completed by volunteers. We have collected over $25,000 in membership fees and donations and have received grants and other donations totalling over $75,000. We have applied for 501(c)(3) status from the IRS, but more importantly, we have made a significant and meaningful difference in the lives of the members of our community and their loved ones. We are grateful to Beacon Hill Village for creating this model. There are now more than Villages across the 18 country and the world. The first thing 19 that one learns when looking at villages 20 is that no two villages are the same. Every village is a reflection of the community it serves. Penn's Village is no different. We do not think of ourselves as an Aging in Place organization. We truly think of 161 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 ourselves as Aging in the Community organization. While Penn's Village currently serves primarily Old City, Queen Village and Society Hill, we do accept members from outside of these communities. We are in discussions over the possibility of expanding our geographic boundaries to include all or most of Center City.
We look forward to working with the City of Philadelphia, the Philadelphia Corporation for Aging, the Philadelphia Senior Center, AARP and any other interested individuals looking to create a village in their area to enhance the lives of the aging in our communities. After all, it takes a village. The heart of Penn's Village is a neighbor-to-neighbor endeavor, and we so appreciate your interest and the opportunity to testify here today.
Thank you very much. That certainly is a great 162 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 idea, and it kind of picks up on what Ms. Iser said about the neighborhood. And I'm going to take this and give it to my CDC and tell them to start something like this in my area, one of my areas, because some of the services you provide are certainly services that the seniors who are living in their homes could provide. It's very -- it sounds very exciting. Any questions?
Yeah. I just want to say thank you to everyone, because it gives me hope for the future. And Geneva is right, eventually we all are going to need these services at some point in time. A couple of things, though. What are impediments that you see that we can address? The Chair was wise to put you in groups of service providers versus administration. Even though we're not against them, it's a separate panel. And I want to know, can we help you with marketing? Is it across-the-board fair 163 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 process by way of marketing what your services are, and is that a problem that we can address, and, if so, tell us what's going on with you in your realities.
I think one of the obstacles for adult day is a lot of citizens, whether they are social workers or they're administrators in senior housing complexes, understand what adult daycare is. And I addressed this -- of course, as you know, I spoke to the PCA President, Mr. Williams, and I have also reached out on the State level, because for someone to be in an adult daycare center, they have to be nursing home eligible, but they also -- the second part of that, or clinically disabled, that they have a tendency to forget about that part. One of the great things about adult daycare is, the new Secretary of Aging, Michael Hall, he wants to focus on dom care and adult daycare. He wants to 164 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 transition people out of the nursing homes and back into the communities. So education is probably one of the biggest hurdles. Advertisement, as you know, is probably something that we need to do better with. But A Place Like Home is a center. We are a for-profit. And I say that to say that as a for-profit, that means that all the money to develop that center, I raised that money. I raised it through people that invest in the community. I didn't want to be a not-for-profit or a non-profit because I wanted to take the money and distribute it the way that I wanted to, and the way that I wanted to do it was to pour it back into the community, at least a percentage. When I raised the money, I asked my investors to take a portion of it and put it back into the community, because healthcare in our community is not just for seniors, it's for all of us. Like, for example, I figure that the money you can generate through adult 165 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 daycare, you can put back into the communities and create nurses or doctors, find students who -- we got Overbrook High School right next to us. Students who want to be involved in healthcare, let them come and volunteer at the center. They have a passion for healthcare? Well, A Place Like Home or -- A Place Like Home is part of a human interest group whose stated mission is to help in the underserved communities and health and wellness. If we can take that money and provide a scholarship to someone that's going to medical school or to nursing school or even home health, that's what we're all about. So money is an issue. Advertising is an issue. And without the money, you can't advertise properly. So it's like the chicken and the egg dilemma for us.
We have to work on that, because don't your participants have to be referred or do 166 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 they -- they volunteer to be a part of your program, and if they don't know about it, then they don't take advantage of it, and it's kind of the chicken or the egg concept. You have to let people know about it in order for them to make a conscious decision to participate.
They have to know about it, then they have to be referred by their doctor or PCA, and then you have to be eligible for the funding. We get plenty of people -- and Janet could be my witness to this. We get plenty of people who walk through the doors who want the service, who need the service, who can't afford the service.
Are you a part of any task force the City has put together, any of you? (All witnesses shaking head no.)
Well, okay. Let me put a note and pin in that, because if you're not a part of the Task 167 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Force, what is the task and who is the force?
I'm surprised that Haddington is not. Certainly not to belittle or say that you're not, but they've been in business for a hundred years or more.
At least I know Ms. Black for a hundred years. You tell her that. But Haddington has been around a long time, and I just wanted to ask you a question. As a result of the programs you run in Haddington and you provide services in the homes of the senior citizens, do you see a lot of the senior citizens staying in the neighborhood out there?
Yes. A lot of our seniors do remain in the neighborhood. We have had a lot of death recently, but everybody basically is stable. It's like a family, a community 168 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 kind of setting where people just enjoy being in that environment, being in that surrounding. So we do offer a lot of services, but our biggest problem and our biggest concern is our transportation. We have lots of seniors who would like to do and go places, like visit some of the museums and cultural centers in the City. We're funded by the Philadelphia Corporation for the Aging. We receive our transportation allotments from PCA. But we limit our transportation to medical emergencies, seniors who are having financial difficulties and can't afford to pay for transportation themselves. We also -- transportation is also connected with CCT also. We have seniors who are members of CCT, so they have -- they can get their transportation. We provide some of their transportation and costs, and they 169 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 provide a small, a very minimal fee, like $1, towards their transportation. And if we had more funding so that they could go to their different social, cultural activities, that would be really great. That would improve their environment and their living. And also we have seniors who sing, we have a choir, and they would like to go and sing more often than they do, but they're unable because of the problem with transportation. So there's a lot of things that we need in our senior center, but, again, the finances are not always there, even though we are funded, but we're not funded enough. That's why we do fundraising. We do fundraising, and we have volunteers who help us out a whole lot. And task force, that's something that we need to investigate, because I'm sure if there was a task force, I'm sure we would know about it or would want to know about it or want to 170 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 participate in it. I'm not familiar with that, so I would like to know more about that.
Well, certainly this Task Force comes out of the City's Commission on the Aging and Celeste --
Public Health. Well, we need to incorporate some of these providers and certainly to get some information.
Right. So certainly should be inclusive of some of these agencies who have testified here today so that they can have input in terms of their interaction with senior citizens in their communities. Okay. Well, thank you all so much. Oh, yes. I'm sorry, 171 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Councilman.
Thank you, Madam Chair. Just quickly. Two quick ones. Ms. Brewington, in your statement I know you said these are Ms. Black's points about how the City can help, but you might be able to answer this. In number two where you say cut the bureaucracy, trust me, we all have that problem. We have that problem in our offices. But you say you assume some of the questions and requirements are not necessary. Do you have one or two quick examples, particularly of requirements that would not be -- that particularly come to seniors or don't seem to make sense to you?
Well, you have a whole lot of requirements, especially if you're going to apply for oil or if you're going to use the Heater Hotline and you need to buy or purchase a hot water heater, you have income 172 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 requirements in order for seniors to be eligible for these things. If they didn't have to go through so much of that eligibility requirement, maybe they can get help, because that's why they're calling. Even though they might have family members living in the household, sometimes there are problems where some of the family members aren't able to help that senior. Sometimes their income might interfere with their eligibility for some of those services. So some of those questions, I know you ask them and I know that they might seem to be important, but sometimes they do cause that senior to be ineligible for services.
But they need it. But there's no help in the family. Even know they have a whole house full of people living with them, there's still no 25 help and the heater is still broke. 173 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
I guess I understand that, and I'm not trying to defend the City in this, but I guess as far as income requirements, there probably has to be something. I mean, it would be great if we didn't have to have any, but we probably have to have some, because there's only so much money to go around. So I guess as far as the income requirements, they're probably hard not to ask for. Now, maybe they should be a little broader and maybe take in more things. I can understand that. But as far as income requirements, I think that would be tough to do away with, if you will.
Well, you have not only income, you have health requirements also. There could be a whole series, depending on what the need is or what the request for service is. So that's a general statement, because I would have to be a little bit more specific in terms of what is it that 174 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 you're applying for and then what questions.
That's the kind of thing I was trying to get, because I'm sure there are those things, but that's something we might be able to help with, if maybe you can get back to the Chair.
And then those hotlines are really horrible. You know, you call and you try to get some services on those hotlines and you get a prompt to --
You don't like those where you have to push 6 and then push 3?
Nobody likes them. Nobody likes those. No, you're right, but I'm sure it's more frustrating.
You got to call security and you got to go through 175 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 all of that, and you never get anybody on the line. You get an operator that's a computerized source.
No. I agree, and I'm sure they're frustrating for everybody, but I'm sure they're more frustrating for seniors. I understand what you're saying. Okay. Thank you. Thank you, Madam Chair.
Thank you. I am going to call Panel 4, but I ask you to excuse me. I have a meeting in my office, and I will come back as soon as that meeting is over, but Councilman Jones is going to continue. Panel 4, Robert J. Groves and Renee Cunningham Ginchereau. (Witnesses approached witness table.)
My name is Robert 176 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 J. Groves. I'm the CEO of the Philadelphia Senior Center.
It's heartening and timely that City Council should focus on aging in place within Philadelphia. As one of the State's largest and its oldest senior center, Philadelphia Senior Center, or PSC, and the thousands of older adults we serve have a vital stake in this, and in 2009, we celebrate our 60th year of service. We consider ourselves a senior-serving organization. We have three physical centers and we have three major community and home-based programs. We serve over 5,000 adults and their families each year. And it's a very diverse group, I can assure you. In the short time I have here today, I'd like to make three major points. And you do have my full testimony and I'm kind of summarizing it. 177 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 The first is the importance of reducing senior isolation. The second is the value of services that occur in senior centers, and the third is to suggest some supports and services that can help seniors right in their home. When considering the importance of aging in place, I urge you to purge from your minds any singular vision that may be there of older adults just happily sitting around in their living room or at a dinner table surrounded by a loving and smiling family and friends. While this can be one element of good aging in place, there's far more to it, as you've heard and you know. For example, we know that many thousands live alone in the City and see friends or relatives less than once a week, if at all. In fact, over 100,000 seniors 60 and over in Philadelphia live alone. I also ask you to purge from your minds another narrow image, one in which an older person is just sitting at 178 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 home and this array of services is being brought to them while they sit there. Again, this can be one element of good aging in place, but it is also limited. These two narrow visions really leave out a crucial factor, an older person's need for purpose, community and structure in their lives. And I fear that the critical importance of these things is often left out of the aging in place discussion. S. Constitution. After awhile the answer became very obvious. Most of us need to have personal goals to have fulfilling lives, no matter what our age. We like to be working towards something, and the Senior Center's classes in any area, language, computers, fitness, foreign 179 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 language, art, all of which we have, provide participants with something to work toward, a personal goal that makes getting up each day worthwhile. By providing over 70 activities each week, Philadelphia Senior Center, like all other senior centers, enables thousands of older adults to have a real community and structure for their day and purpose. Through our social services, which I won't describe in length here, we are a gateway to all other benefits and community services seniors might need. Because of what I see each day in our centers, I often say I work for a depression-prevention machine that offers people many opportunities for purpose, community and structure. And we have a sideline product too as it turns out in stroke rehabilitation and knee surgery recovery. That's because a major part of the rehabilitation and recovery often takes place when seniors who have recently had these problems come to our 180 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 centers and are helped by others and get through the day not in isolation but within the context of all that goes on there and among their friends. So there are many stories that could be told about their lives that relate to these factors. Without senior centers, Philadelphia would immediately find itself with over 22,000 very isolated, inactive, older adults on the fast track to depression and ill health, who will need more expensive care and face earlier death.
The families of those seniors would also suffer, because they will have lost a critical resource that allows an older person in the family to be productively engaged each day while younger members work and deal with children and other responsibilities. And we are also incorporating a new paradigm in our senior center in our center culture, one in which sees seniors not only persons in need of service, but also as people who can serve the 181 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 community in return. Our burgeoning older population does not have to just be seen as people who need things and need services. They do need things, they do need services, but they also can be seen as a community resource when you're looking at the broad picture. At PSC, we're starting the Ready to Serve civic engagement program. We are beginning or starting some elements already, some such as training adults to mentor ex-offenders coming out prison or to be pen pals with people who are still in jail. We're starting a Green Team to deal with some environmental issues. And we are also having seniors who are computer savvy work with us in our financial management program, which I'll describe later, to help other seniors pay their bills from their homes. In a related and important vein, Laura Gitlin and colleagues at Thomas Jefferson University's Center for 182 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Applied Research on Aging and Health have done some work that shows clearly the many benefits older adults receive from the very type of activities they engage in at senior centers, and she mentioned six specific types. I've referenced this research at the end of my testimony, which I think you have, but it does give you a picture of the value of centers across the board in terms of physical and mental health. So I urge you in any strategy for promoting positive aging in place, please remember the reduction of isolation and its importance and affording adults opportunities for personal growth and community service that gives life meaning. In my remaining time, I'd like to switch gears and outline the importance of a couple of services we provide to folks in their homes, and I bring them up because I think they're replicable. 183 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 One service is unique to us, our financial management service. It's an extremely valuable resource to positive aging in place, because it enables needy seniors to manage their very often limited income in the most efficient and effective way. Services are provided to any senior in the City and the region. Older persons often living alone may have trouble staying within a budget on a fixed income, as well as keeping track of and paying their bills. This may be due to inability to get transportation to the bank, vision or health problems, periodic hospitalizations. Also involved may be some deterioration in their ability to understand bill notices and terminology, but these folks may be otherwise very well functioning, but actually face evictions from their apartments, foreclosures on their homes, shut off of utilities and even homelessness because 184 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 of issues around paying bills and keeping a budget with their limited means. Our program has looked at these challenges and serves about 100 seniors a year currently in their homes, and in our current state of the economy, these problems are being exacerbated by greatly escalating costs of just about everything. So for many low-income clients of financial management service, it's even more crucial that these funds be managed effectively. When we first meet many of our clients, about 50 percent of them have already received a shut-off notice for a utility when we first meet them. So what we do is, we get them set up in situations so that they can stay in their home, and I'll give you one example. Ms.
A is an 80-year-old double-leg amputee, one of our clients, living alone, who is referred to our financial management service by another organization because she had received 185 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 shut-off notices from the gas and electric company. When she started with the program in March 2008, she owed approximately $1,800 to PGW, 600 to PECO and 140 to Verizon. Once enrolled in the program, our counselor was able to prevent the termination of her services by interceding with these vendors and we were able to get her placed on the low income programs through PGW and PECO. Today her bills are current. She has an average of 600 available in her bank account at the end of the month. She has stated many times how grateful she is, and for the first time in many years, she was able to take $100 from her bank account and splurge for herself on her birthday. And, in fact, this was about the first time she had been able to put together a savings account, because we gave her that help. As noted earlier, we are now trying to expand that program. We can't afford to do it by just hiring more 186 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 staff. We are training seniors to work as the financial counselors to expand that program, and we'd like to do that in multiple languages ultimately as well. So we have six seniors signed up who are getting started in that right now. The second program I want to mention that we provide and is not unique to us but I think is important has somewhat been alluded to, but we call it SOS, Services on Site. We have social workers who coordinate and directly provide services under contract with 12 publicly subsidized senior apartment sites in Philadelphia. These sites have over 1,600 residents. Social workers act as counselors regarding public benefits, community services and personal issues. They intervene on behalf of tenants when they're in danger of eviction or have other issues with building management. They arrange for services, such as home and personal care, and connect seniors to PCA and other community supports. 187 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 So a key element that I'm recommending to you in any strategy for aging in place is the very simple fact of having the availability of service coordinators who can assist seniors in some way, as our SOS workers do. One place to start is to encourage all senior housing developments, subsidized or otherwise, to have social service coordinators available to residents so they can deal with their issues. In summary, I hope City Council can consider the full range of issues when considering successful aging in place. Any recommendations should incorporate the role of the more than 18 multi-purpose senior centers in 19 Philadelphia. We are experts in 20 collaborating and pursuing all available 21 resources. 22 Also, PSC and other centers 23 have been in dialogue with 24 representatives of the NORCs that you 25 have been talking with here today, and to 188 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 date, our experience is that they essentially need and want to implement many of the same social and community services we offer, and we're very happy and feel confident we can work with them. Thank you.
Good afternoon. My name is Renee Cunningham Ginchereau and I'm Associate Director at Center in the Park, a nationally accredited seniors community center in Northwest Philadelphia. On behalf of my center and the Board of Directors, the staff and the 6,000 members that we serve, it's my pleasure to thank City Council, especially the Committee Chairs and their staff and the members of the joint committees, for providing us the opportunity to speak today about a topic that's of critical importance to our participants, who range in age from 55 to 98. 189 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 In June 2006, a former City Managing Director was quoted in the Philadelphia Inquirer as saying that, quote, "Aging priorities were never on the radar at high-level meetings" in all his years in City government. We're happy to see what we hope is the beginning of a significant shift in the direction of support for community-based aging services and are happy to be afforded the opportunity to be a part of this process. Senior centers are often the point of entry to aging services in Philadelphia and across the Commonwealth and the country. We provide education, information, referrals, socialization, nutrition, opportunities for civil engagement, health promotion, fitness, chronic disease, self-management programs. Center in the Park's 40-year history of providing comprehensive programs and services in the areas of lifelong learning, arts and humanities, 190 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 health promotion and fitness, social services and housing, civic engagement, socialization and intergenerational programs is evidence of the importance of senior center activities and are supported by recent research, which has shown positive correlations between mastery and activities in meaningful social interactions and positive health outcomes. In 2006, the Creativity and Aging study conducted by the National Endowment for the Arts and George Washington University reported that older adults who participate in community-based cultural programs appear to be reducing the factors that drive the need for long-term care, as there is a positive correlation between participation and programs like ours and maintaining independence. Additionally, a 2003 study found statistically significant correlations between attending health 191 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 promotion programs and practicing healthy behavior and between spending time at a senior center and having a healthy mental outlook. As important as the quantitative data and outcomes are, and especially at Center in the Park where our mission dictates that we listen to the voices of our members, it is our members who really dictate the importance. "The Center has been a blessing for my loneliness and depression, and the people here have made me feel as if I found a home. " This is a quote from one of our members at our Thanksgiving luncheon last week. As a provider of home and community-based services to older adults, our mission also values and promotes the Aging in Place model and concept. People want to live in the communities that they call home. They want to live safely and independently in their own homes and in 192 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 their own neighborhoods. This is not an outlandish request and is a hope that most of us have. With adequate resources, flexible community-based supports and proper coordination, this is a more than achievable goal. In some respects, the Aging in Place model is already a reality. With additional resources, this model can be expanded and implemented citywide through existing channels like Center in the Park and other senior centers that have their fingers on the pulse of the older adults in their communities.
As an example, OHCD has recognized the critical role senior centers can play in addressing the complex housing needs of older adults by funding three senior centers, including Center in the Park and Philadelphia Senior Center, to provide housing counseling specifically for older adults. As you may be aware, 78 percent of older adults over the age of 60 own 193 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 their own home and percent are renters. Fifty-three percent of older adults in homes live in homes more than 60 years old, according to Philadelphia Health Management Corporation. And according to OHCD's Year 34 Preliminary Consolidated Plan, 46 percent of Philadelphia's elderly homeowners and 60 percent of elderly renters live on a low income. Older adults' housing needs are often complicated by issues including financial constraints, physical health issues, environmental factors, financial literacy, cognitive and psychological factors and the emotional significance of home. This has been amplified during the recent foreclosure crisis, as the senior center housing counseling agencies have been called upon to assist older adults facing foreclosure who are eligible to participate in the City's Foreclosure Diversion Program. Senior centers are uniquely 194 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 equipped to assist older adults with navigating through homeownership issues, tenant issues, and with providing financial literacy and consumer education to enable aging in place. In order to provide effective housing counseling for older adults, it's necessary to address the needs of the whole person and to take into account functional disabilities, cognitive deficits, credit and financial difficulties, family dynamics and then older persons' desire to age in community and stay in their own neighborhoods. CIP provides this specialized assistance by offering a holistic array of programs and services designed to serve the whole person and access to resources available within the aging system. However, there exists the critical need for increased affordable housing production, as the demand for subsidized senior housing units greatly exceeds the supply. Similarly, the demand from senior homeowners for 195 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 assistance with home repairs far exceeds the resources and scope of existing programs. In order for older adults to age in place safely and independently and within their limited financial means, they need access to information, increased affordable housing options, and assistance adapting and maintaining their current housing. Ben Franklin said an ounce of prevention is worth a pound of cure. If energy and resources can be committed to strengthening senior centers, there will be a reduction in long-term care waiting lists, increased utilization of short-term and preventative services and programs, and a healthier, more engaged older adult population in the City. As mentioned earlier, there's a growing evidence that participation in senior centers' activities has a positive measurable effect on the health and wellness of older adults, decreasing 196 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 depression and isolation and increasing their longevity and active participation in their communities. As community centers, we're a natural conduit for work to be done in the neighborhoods. Senior centers are a well-known, trusted and valuable resource in their communities. In many cases, we're the initial point of contact with the aging system for older adults and their families. Our numbers reflect this, as Center in the Park alone registers 40 new members every month. With the new generation of participants beginning to access aging services and programs, we have reached a critical juncture. If we are to meet the needs of this changing and growing population, we will need to work together towards our common goal.
We're ready to come to the table as significant contributors to the long-term care equation and look forward to working together to make Philadelphia a more hospitable place to age. 197 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Thank you for your time.
Thank you for your testimony. Two quick questions. Are either of you a part of the Task Force?
I am aware of it. I attended its first meeting in the summer, but I have not gone back to it. There has been a recent cancellation, I think, of one of the meetings.
Food for thought. I'm hearing so many inspiring issues coming from this community, and it has changed my thought and way of thinking. There are certain themes that I've kind of got now and that we -- yes, it's aging in place, but it's not just aging in place. It's aging within a designed community that allows us to age in place, and that the big issue also is isolation and preventing that and utilizing social engagements to find a 198 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 whole plethora of other issues that may be affecting a senior. You find out if he's eating or she is eating by virtue of the fact that they come out every day, that their health is being maintained because you see them, and those are interactions that are valuable. It reminds of a real good grandson or granddaughter if you can get them, but if not, this seems as a valuable substitute. One other thing, and I haven't heard this from any of the testimony, career options. Talk about people who have had valuable careers and enriching professional lives, but is there a placement for them part time, full time within your scope of services?
We actually have a very good relationship with the Mayor's Commission on Aging and also NCBA, National Caucus for Black Aged, and through those programs, we have been a training site for countless years, as long as probably we've been around, and 199 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 have been able to hire quite a few folks who are older adults into our workforce.
We currently have four employees who have retired from previous jobs as full-time or part-time employees. Also, our civic engagement work that we recently started, for instance, on the environment, people that -- one of the people leading it has their Master's degree in biology and has decided to get involved in this Green Team, and another gentleman who recently retired from Red Cross is involved in leading it. They're not being paid, but I guess what our civic engagement, the point is that when people can afford it, we are trying to provide them with volunteer opportunities that are truly longer term and in depth and have almost a professional substance to them if they want to get into it.
You 200 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 mentioned the foreclosure piece, and bells started ringing for me. How are your agencies interacting around the foreclosure issue with seniors? Have there been any problems with them accessing the same resources? We're going to be in the next three or four years making sure that we're being as aggressive as we can for prevention purposes and so forth. So what's the assessment so far and do we need to be doing other things?
So far what I would say, we've had quite a few clients go through the Diversion Program. We're part of the hotline as well, and so it's been -- we've actually had quite a few seniors come to us through the hotline that are not eligible for the Diversion Program.
Sometimes it 201 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 is an income piece. But what we have found, though, is that we're able to do a significant amount of housing counseling with folks who may not be eligible for the Diversion Program but that we may not have gotten access to otherwise.
Is that something that you're going to be looking in terms of in the future? Because I foresee this being a bigger issue with the economic crisis. So you currently don't get any funding for that type of housing counseling?
We have a housing counselor through a contract with OHCD, and for every one that we have, we could use two more.
I would just add to that, the small amount of money we've been getting from OHCD each year is crucial to keeping our housing counseling going, and if you are trying to help seniors get counseling in a City budget 202 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 crisis situation, you might consider thinking about protecting those small contracts that senior centers have that do housing counseling, because we really couldn't afford to do it without those OHCD contracts.
The Ralston Center, Neighborhood Interfaith Movement and Journey's Way, Interac.
While we are getting our next panel situated, we received information from the Pennsylvania Uniform Crime Reporting System, which states that in the category of 60 to 64 in Pennsylvania, there were 14,916 cases of crime against seniors. In the category 65 and older, there were 29,276 cases of crimes against seniors. In Philadelphia, in the category from 60 203 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 to 64, there were 2,486 crimes against seniors. In the category of 65 plus, there were 5,534 criminal acts against seniors. That says a lot about society when we pick on folk who are in their senior portion of life to utilize them as victims of crime.
Those are citywide numbers and juxtaposed against Commonwealth of Pennsylvania numbers. Thank you. State your name for the record.
Can you speak in the mike, pull it a little closer to you.
My name is Barbara Phillips. I'm Director of Development at Ralston Center. Many people are not aware of 204 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Ralston Center. It has been dealing with issues of aging for 192 years. I have not myself been at Ralston Center for quite that long. Sarah Ralston, our founder, was a very interesting woman. She was the daughter of a mayor of Philadelphia, Mr. Clarkson, who served five terms, from 1792 to 1796, and she was the wife of Robert Ralston, who was active in the China trade and an eminent citizen of Philadelphia around the 1800s. So I mention this just as a way of saying that Ralston Center has been dealing with issues of aging for quite a long time. I've given you written testimony, which you can read, so I'm just going to highlight a couple of the points out of that testimony that have not been covered by some of the other testimony this afternoon. A couple of years ago, the Ralston Board of Managers was looking for 205 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 a difficult project, and they landed on this notion of aging in place. And I was going to read you all of this testimony, but I won't since we've been here for such a long time this afternoon. In this book is demographic information on different demographic 9 indicators for 69 different neighborhoods 10 in Philadelphia clustered into 15 11 sectors. And we did that research with 12 an organization based in Exton called 13 Third Age, which is a national consulting 14 practice on issues of aging. And so 15 through them, we have had access not only 16 to some very smart people, but also 17 because of their national practice, we've 18 been able to gain familiarity with what's 19 going on around the country. 20 So early on when we looked at this notion of what is aging in place and what are the characteristics, the first thing that we noticed is that there is a very large component of any population that is what we've taken to calling in 206 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 shorthand the gap population, people whose incomes, household incomes, are maybe between $20,000 and $40,000. And if your income is below $20,000, you're eligible for PCA services. Everybody is eligible for PCA services, but there are certain income caps that we have heard people talk about. If your income is higher, you can access a variety of private services. You may not know exactly what those services are, but you can access those services because you can afford to pay for them. But then there are all these people in the gap, and what are they going to do? They need the same sorts of access to transportation and housekeeping and yard work and meal preparation, et cetera, et cetera, all the things that other people have listed, but where are they going to get them? So we decided that we would focus on the gap population. Secondly, in doing a series of 207 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 focus groups, one of the things that came to the fore very quickly is that it's very, very difficult to understand the realities of aging. I described the work that I was doing to my 85-year-old mother, who said, That's so interesting, dear. I would love to be involved in something like that when I'm old. You hear that over and over and over again. So services like Beacon Hill Village, one of the huge problems an organization that depends on membership for a portion of its operating income or the majority of its operating income, a big problem that they face is that, Because I don't understand when I'm going to be old, I can't make a decision about what day to begin paying for services or when I should move to an assisted-living facility. So I put it off and put it off and put it off. We heard in one of the focus groups from a woman who lives in Mount 208 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Airy. She's 96.
She lives alone in her own home, fabulous-looking woman, and when we pressed her a little bit on the question of what she might need, she thought and said, well, you know, now that she was 96, maybe she could use a little help with housecleaning. So, in fact, were there services available to her, she would avail herself of them. But as has been brought out by other people who have spoken this afternoon, where do you find somebody? How do you know that somebody's services are going to be the level of quality that you require, that you can trust them to come into your home, et cetera, et cetera? Another thing that we looked at in tackling the topic was that Philadelphia is hugely rich in services, and I think you've seen just a bit of it this afternoon. So there really is not a need for reinventing wheels, but there is a strong need for knitting things 209 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 together, coordination, catalysts around various issues, and because Ralston has been around so long, that catalyst role is one that we can take. And we have, unlike some organizations that have to run a complex program, what we're doing at the moment is sort of -- all the things are in their boxes and they're going along well, so that the Managing Director and I can spend a fair amount of our time sitting in a room thinking about how some of these problems would be solved. Out of the focus groups, a number of things that we discovered are that many of the programs that are currently available are not actually consumer focused. They're organization focused. And when you look at the characteristics of the soon-to-be seniors, you see that they're not really going to be quite as willing as some of the currently seniors or currently older people to take one size fits all. They 210 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 haven't been accustomed to one size fits all, and they don't want one size fits all, and, in fact, one size doesn't fit all. So that consumer focus is going to be important. It's also going to be critical that whatever gets knitted together is affordable, particularly to people in the gap population. Skipping over a lot of what we did, what we have now come to with our partners at NIM is, we're preparing to launch a pilot project in Germantown and Mount Airy. Those neighborhoods were selected because that is where there is the largest group of gap population seniors in an area that is highly diverse and where there are also existing services so that one really doesn't have to start from scratch. And we have a financial model that at least on paper looks like one can deliver to the seniors in those neighborhoods all the services that have been described by Penn's 211 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Village, for example, but with an initial investment of only $350,000, and there is a break-even point at to 36 months at 5 which the thing runs. It doesn't need 6 fundraising. It doesn't need more 7 contributed income. And that has been 8 really the big problem that organizations 9 like Beacon Hill Village have run into. 10 They cannot get enough memberships paying 11 enough money to run the program, so 12 they're subsidized memberships. And I 13 think the last time I looked, it was 14 somewhere between 55 and 60 percent of 15 their annual operating budget has to be 16 raised. And we're looking for something 17 that is going to be a different model. 18 The notion is that once this 19 project, this pilot project, is 20 successful, we would be able to replicate 21 it in other neighborhoods around 22 Philadelphia and around the country and 23 the world perhaps. 24 Thank you.
Thank you. 212 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 We will hold questions until all the panel testifies. Would you state your name and move the mike a little closer to you.
Oh, okay. That's wise. I need to tell that to my staff.
Well, I will actually be brief. I'm George Stern, the Director of Neighborhood Interfaith Movement, and I just want to emphasize that we changed our name from Northwest Interfaith Movement to Neighborhood Interfaith Movement a few years ago, and the reason was that we always operated as a very grassroots, neighborhood-based organization, and we have a history of bringing other organizations together in order to tackle community issues from as broad or as many perspectives as possible. So, I mean, for example, you'll 213 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 know of some of these. It is through NIM's auspices that Northwest Victim Services, Northwest Meals on Wheels, Central Germantown Council, Interfaith Housing on Chelten Avenue and Northwest Philadelphia Interfaith Hospitality Network got started, because we brought people together. And I want to emphasize the importance of looking at creating communities that are senior friendly, but in talking about looking at them neighborhood by neighborhood. I don't want to too closely define what a neighborhood is, but we heard before reference -- I think maybe you made it -- to trust. People trust organizations that they know that are in their neighborhoods. NIM, because we're also -- we are made up of about 60 religious organizations, Christian, Jewish, Muslim, Unitarian, a lot of people know who we are, they trust us. They will call us when they might not call another organization, and they would 214 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 also -- I also want to emphasize the importance of providing services to individuals by people, not by push buttons on a phone, particularly for senior citizens. We also have to realize that in our neighborhoods, there are not only people who can afford things, but people who cannot. They don't have access to computers. They can't look up things on the Internet. So we have always operated for 40 years on the assumption that it's important to create community, look at a community holistically and try to be as inclusive and as grassroots as possible. If you don't -- we actually brought folders that have our testimony in it, all of the details, but Linda Brunn, who is our Director of Adult Programs, will fill you in a little bit more on some specific things that we've been working on using the principles that I mentioned in serving older adults. 215 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
My name is Linda Brunn. I'm Director of Adult Programs at Neighborhood Interfaith Movement. And I'm just going to highlight a few things. When I came to NIM three years ago, NIM already had a tradition and a group that it was working with called Seniors Partnering Across the Northwest, and it started out as a group of consumers, as well as agencies that serve older people, who were just literally meeting, looking at issues, looking at ways to solve problems and ways to address issues that affected people as they were aging, and it was based on the idea of aging in community. One of the things that's come out in all the testimony that we've been hearing is that there are a lot of different ways to come about looking at aging in place, aging in community, and you can start here or start there and you still end up in the same place. 216 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 One of the things that this group became very sensitive to was this issue of how do people find what they need when they need it. And we have lots of help lines in the City. We have lots of organizations set up to give information, but somehow people do not necessarily find it helpful to start at the beginning of a bureaucracy and try to get through it to answer questions. We started with the idea that if we were going to set up a NORC or a way for people to age in place, that we would need to first address this issue of how do we find the resources and help people to find them. Again, the idea of not inventing the wheel, just because we live in a very rich environment in our Northwest community. We have a resource directory that just covers the Northwest, and it covers the City and State and federal programs as well. The importance of this is that it covers things that are 217 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 informal as well as formal. One of the things that we felt as we began a communication, consultation and information line was that it needed to include informal resources and knowledge at the neighborhood level. We recognized that informal connections and relationships which can be identified only at a neighborhood level can be as critical as formal services in making it possible for an individual to age in place. And one of the ways we came to this was out of our work with congregations, who themselves are communities that families and older persons draw on, and we wanted to build on the communities that they represent. The other thing we wanted to be sure was that people would receive a personalized response. When they call the Resources for Older Adult Living, our consultation line, they get a person. If they don't get a person, they get a call back within five minutes, if possible. 218 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Many times we don't know the right question to ask. An example would be we've had a caller, for instance, who called and said, I need help with fixing my roof, but I don't have money because my mortgage isn't paid, and it goes on. You peel the onion and you start to find out that it's a big set of issues and there's several places that the woman needs to be helped to find, and she needs coaching as well, because it's not easy to negotiate these resources in the community. The other thing that came out of this group that's been meeting for a long time was this idea that we needed to raise at a community-wide level this whole issue of what it means to age in a community. We worked with Nancy Henkin at Temple's Intergenerational Program, who calls it a community for all ages, where people are dialoguing across systems, all the stakeholders in a community and the citizens, about how 219 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 could this community support us all and how can we build community together.
And we had a forum last May where, again, our community partners that helped us to found ROAL and others that we invited came together and talked about for a whole day what would a community for all ages look like, with a heavy emphasis on what would it look like as we age, what do we want it to look like. There is a brochure about that in your packet. Many of the issues that were raised are citywide. Many of them are also peculiar to our neighborhood. But the concerns that were raised that can be addressed by City government or another level of government included accessible housing; zoning that is responsive to the needs of older adults, including the capacity to have shared housing, community housing, co-housing; reliable transportation and accessible social services. Specifics included -- again, the list you've been hearing from 220 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 everyone else is the same -- home maintenance, pedestrian-friendly sidewalks and traffic signals, safe indoor community/outdoor community gathering places. One of the things that people were reflecting on, that if you have a walkable neighborhood, one of the purposes of going out is to find other people to chat with, but you don't always want to stand up, you need a bench, and wouldn't it be nice if it's in a little pocket park or there's a coffeehouse that would welcome you and not have just rock and roll music on so you can hear each other talk. A lot of what we discovered was that although many of the things that were talked about cost money and needed really an overhaul in how we thought about it, that the other critical piece was, again, what Lynn Iser started introducing and that has been coming up over and over, is this issue of how you build interpersonal community and 221 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 support. And the thing that does come up when you hear about the programs like Penn's Village or the East Oak Lane project that's developing is the need for citizens to get together and begin to solve problems on their own and involve government and other resources as they're able. This doesn't happen just like magic. It takes leadership. It takes staffing. It takes people following through. It takes people making a hundred phone calls. And if you don't have some organization or entity in the community able to keep following up and holding the thing together and encouraging the leadership that does evolve, then it probably won't happen. And we need to think about how we can make that happen in communities where it's not already happening. One promising new program to meet unmet needs in our community is the one that Ralston Center and we are partnering again around, which talks to 222 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 the gap population. NIM is still very concerned about the folks that will not be able to even afford the gap population or who are awaiting the services that are addressed to the gap population or on waiting lists for PCA and have houses falling down around them. So we are looking at developing and beginning to develop a volunteer program to start to encourage neighbors to help one another. Our specific suggestions are these: This hearing is a good start on what should be an intense continued focus on how to harness the City's resources to create a city which will support its older citizens. We have been blessed with the Mayor's Commission on Aging, which works to connect resources overall and to educate the community about older adult needs. This Commission needs to be protected and funded so that it can strengthen its role in bringing about better coordination of City services for 223 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 our aging population. The Commission should be empowered to initiate planning for services not provided by the City or through the Philadelphia Corporation of Aging or other City departments and programs.
It should establish and oversee collaborative mechanisms to assure the right mix of quality community-based services available. That Commission should be charged with planning with the City departments a coordinated, cross-department approach to health, transportation, recreational, zoning, housing and environmental infrastructure. I was pleased to hear of the existence of this Task Force, but I think -- and it's probably a good start, but my guess is it's being attempted with departments that are already overstretched in terms of their current mandates. City Council members can 224 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 participate actively and take leadership in each of their districts to bring together knowledgeable citizens in private and public organizations that work with older adults and to identify neighborhood-specific needs which can be addressed by City departments and neighborhood organizations. Sometimes when the Mayor comes or one of the Councilpeople or a State legislator, the complaints and the issues come up and you see the legislator say, Take care of that, to somebody, and they get back to them. But we need systematic approaches. We don't need just that person being responded to. We need it really addressed systematically at a neighborhood level. And we welcome continuing to dialogue with you and others, and thank you for your time.
Thank you for your testimony. We want to try to -- we have one more panel after this. We're doing fairly well. 225 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 State your name for the record.
Good afternoon. My name is Sheila Eskin. I'm a volunteer peer counselor and on the Advisory Council for Journey's Way and for programs and services for people 55 and older. I'm reading remarks written by Cindy Wishkovsky, Director of Journey's Way, who is unable to be here today. I would like to commend Councilman Curtis Jones and his staff for initiating this dialogue and for City Council for holding this hearing. This is an important conversation about making our City's communities and neighborhoods places where people can age vitally. I appreciate having the opportunity to present testimony on aging in place in our community. This is a long dialogue, and I thought that I would try to cut it down because of time. In the Northwest area where Journey's Way is located, 20 percent of 226 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 our community is already over age 60. We have developed numerous service programs that address the needs of our aging community. Many of our specialty programs extend throughout Philadelphia. The services that are offered through Journey's Way include The Center, housing counseling, affordable housing development, adult day services and the geriatric counseling services, a nationally recognized mobile geriatric mental health service, and our new service, Neighbor to Neighbor program, that assists people aging in place. We have over 3,000 older adults and their families that were served by our agency this past year, and over 520 volunteers have assisted a small staff in meeting its mission to help older adults live life to the fullest as they age in their communities. A recent needs assessment by the Green Tree Community Health Foundation identified this area as one of 227 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 the Northwest Philadelphia neighborhoods with the greatest number of older people living alone and in poverty with an annual income of less than 10,000 a year. It was also identified as having high numbers of adults with disabilities who are no longer able to work. Sixty-four percent of the elders are women, and one quarter of all elderly live alone. Other communities served by Journey's Way include East Falls, Nicetown and the near area of Germantown, which also have high numbers of older adults living to maintain their independence in the community.
Because I read through it. It was eight pages. Everything will be on the record. You submitted it, so it will be on the record. 228 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
So speak from your experience a bit and as a counselor.
There is an adult daycare program for the seniors. There's a supportive environment for older adults. The senior volunteers work in people's houses as volunteers for many different services, like cleaning, putting up winterization projects, taking people on rides to the doctor's so that -- they use their own cars. This is their transportation, and there's no 17 charge to the client, to the elderly people. And the agency has made significant investment in having a Pensdale Village, which is a HUD 202 project. It was opened four years ago. And at this point, they're starting another project, HUD project, for elderly to increase affordable housing, and 229 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 unfortunately, we haven't gotten the funding that is needed to continue this project because of unexpected financial difficulties at this time. We also need good transportation. Journey's Way subsidizes anyone who is coming to the center with CCT Connect, and the clients come and pay a dollar each way and Journey's Way pays the rest of the charges. The ride is $4 and Journey's Way pays the rest. In summary, here's what the City can do to help people age vitally in our community: Advocate to rebalance public expenditures so that community-dwelling elders have more support in their neighborhoods. What Journey's Way hopes to do is to help senior citizens with many different kinds of supports and also to recognize that seniors give so much back to the community. So that's how I've summarized it, but I left a lot out. 230 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
Thank you so much. Does the panel have any questions for the witnesses?
Yeah, I did. On the proposed project by the Ralston Center around a self-funded project, have you guys come up with kind of a business plan of what the fee for services would be for some? I'd like you to submit that the Chair. I think it's something that is a great interest in terms of how you create a menu of options of kind of secured services. So I'd be interested in looking at that business plan, if you could submit it to the Chair.
Thank you. We have one more panel to come up. Will the Clerk read the names of the people providing testimony.
Judee Bavaria from 231 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Presby's Inspired Life and Angela Brown, Director of Public Relations, NewCourtland. (Witnesses approached witness table.)
Thank you for your patience. Please state your name for the record and provide your testimony.
Good afternoon. My name is Angela Brown. I'm the Director of Public Relations for NewCourtland, and I've actually invited my colleague, Jim Reilly, up. He is the Director of Telehealth Technology. So in the event you have some detailed questions that I'm not able to address as it relates to the ways that we are providing technology throughout the network, he could help me out. 232 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 So Shoshana told me to bring it on home. So everybody with me? NewCourtland is a non-profit provider. Many people don't know that we have more than a century of history here in Philadelphia providing services to a disadvantaged population. And then in 1995, we actually narrowed our services to specifically meet the needs of seniors in Philadelphia, specifically low-income seniors in Philadelphia, through community services, affordable housing, nursing homes and innovative programming, innovative programming like our Comfort and Joy intergenerational program, which has won all types of awards and enables seniors residing in skilled nursing facilities the opportunity to still play a role in the community, as well as our recently launched Living Well, Learning Well community education outreach where many of the organizations that were represented here today actually have provided great partnership for us to meet 233 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 the needs of seniors in Philadelphia that are living independently, not necessarily directly under our care, but we want to make sure that they have the resources in place now so that they do not end up in nursing homes, though we're proud to stand behind the nursing homes that we do have in our network. And I also wanted to thank you for providing this opportunity for us. I actually had a seat on that Task Force, went to two meetings and then it was disbanded, is my understanding. So I'm hoping that there's an opportunity for us to aggressively move the initiatives that were identified on that Task Force forward. NewCourtland is committed to caring for thousands of seniors that they meet the needs of today, but not just the seniors that we care for today, but the thousands more that we anticipate serving as Philadelphia's aging population continues to grow. 234 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 Also, on behalf of NewCourtland's President and CEO, Gail Kass, and its Board of Directors, all the seniors that we serve, I want to thank you for this opportunity to both hear and express some of the ways that we could empower seniors to age in place. I certainly have learned some things today. I'm going to leave out a lot of my testimony, because PCA covered a lot of it. Philadelphia's senior population absolutely is aging, which demands that those vested in their long-term care, and the way that that care is delivered, mature as well, and NewCourtland, along with many of its peers that were represented here today, has anticipated this growth, as well as its related challenges. And nonetheless, we maintain a commitment and are poised to meet the needs of Philadelphia's aging population. Since narrowing our mission in 235 12/2/08 - PUBLIC HEALTH & HOUSING - RES.
080735 1995 to meet the needs of this low-income Philadelphia, beginning with our venture into nursing homes when we salvaged a variety of nursing homes in Philadelphia that now 1,500 seniors now call home, NewCourtland has since witnessed the landscape of senior services evolve and, accordingly, has evolved with it, balancing its quality care delivered in institutional settings, such as the seven nursing homes in its network that employ nearly 2,000 people -- I don't think people know that either -- with home and community-based services, including Courtland at Home, which is our home healthcare agency certified, NewCourtland LIFE, and affordable housing, innovative long-term care that combined to meet the needs of more than 2,000 seniors in Philadelphia and is distinguished by blending the compassion of a highly trained staff with assistive technology -- that's the buzz word of the hour -- that anticipates and adapts to 236 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 the needs of today's seniors while providing them with a choice about how and where to receive the care they need. Two factors we envision contributing to this growth obviously is, people are living longer, thankfully, but to care for one of the nation's largest and faster growing populations, an enhanced focus on services for older adults is essential, if we are to effectively address the health and associated economic challenges of an aging society desiring to age in place, especially when the cost of providing healthcare for an older American is three to five times greater than the cost for someone younger than 65. And our current system is designed just to react to treatment, and NewCourtland, our nursing homes, 90 percent of them are reliant upon Medicaid in order to get this care that they need. Our NewCourtland LIFE program, which I'll talk briefly about, 100 percent of the participants are low 237 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 income, and they are solely reliant on Medicaid in order to get the care that they need. There are some challenges that we have getting some of the reimbursements that we need to deliver the care consistently, specifically in the realm of remote monitoring, and hopefully with your assistance, we'll be able to make some changes. Because we desire to continually remotely monitor specific populations, and we think that they should reimburse us for providing that type of service so that we can identify trends that if ignored could potentially lead to a more costly intervention and negative quality of life implications. Consequently, the solutions NewCourtland proposes to meet the growing needs of seniors is a dramatic increase in the availability of services for seniors in their own homes or communities, as well as affordable senior 238 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 housing, both supported by the fully reimbursable technology to enable seniors to live as independently as possible for as long as possible. An example of a home and community-based service that enables seniors in our network to age in place is the LIFE program. It's modeled after the nationally recognized PACE program. I don't know that all are familiar with that. In Pennsylvania it's actually known as LIFE, Living Independently for the Elderly. Community services like this actually offer seniors certified nursing home eligible the opportunity to live in their own home or community with the support of an interdisciplinary team that manages every aspect of their care, ranging from prescription coordination, transportation to and from their medical appointments, clinical care, physical therapy, recreation and home care support. It's only one of three LIFE providers here in Philadelphia, and it's 239 12/2/08 - PUBLIC HEALTH & HOUSING - RES.
080735 anchored by an adult day center that actually operates out of the Germantown House, a senior complex that's managed by Philadelphia Housing Authority, another great partner of NewCourtland, but it exclusively serves those adults that are 60 and older, deemed nursing home eligible, and they have to reside in a 10 zip code area, which NewCourtland LIFE 11 covers the Northwest. There are a host 12 of seniors in Northeast Philadelphia that do not have a LIFE provider, and we're hoping that we'll have the opportunity to change that. Additionally, NewCourtland LIFE participants benefit from an [m]Power system. It's actually an electronic cognitive fitness system employing touch-screen technology to stimulate the minds and enhance the memory of the users, as the majority of NewCourtland LIFE participants are diagnosed with some form of dementia. And that's a direct reflection of an aging population. 240 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 2 million people actually living with Alzheimer's, and approximately one in eight baby boomers they project -- that equates to about 6 million people -- are expected to develop 7 the disease in their lifetime. So that 8 has significant ramifications on Medicare 9 and Medicaid, the funding available to 10 the State to deliver those services here in Philadelphia. And as Pennsylvania forges ahead with its quest and need to rebalance long-term care by offering more home and community-based services, the City of Philadelphia and those committed to the seniors who reside here must address the lack of affordable and accessible housing with the appropriate support services to age in place. One quick testimony about a NewCourtland LIFE participant who actually benefits from the technology. Lives in her own apartment, actually is enrolled in the NewCourtland LIFE 241 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 program. The home care coordinator is her first point of contact in the event there's any medical emergencies. " That's one portion of the technology, but it's certainly evolved and is much more sophisticated than that. But on this particular occasion, she didn't have her pendant on to alert people in the event of an emergency. She went into her bathtub and was not able to get out of the bathtub. The NewCourtland LIFE home care coordinator was able to identify the lack of inactivity because of the sensor technology that she had employed in her home, went upstairs, knocked on her door, wasn't able to get in, was able to then go identify the property manager, who broke down the door, and they were able to rescue her out of her bathtub with the support of the NewCourtland LIFE program that's supplemented by that type of 242 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 sensor technology. Conversely, my husband's grandmother is residing in one of our nursing homes, and I'm proud of the fact that she's in one of our nursing homes, but had she been enrolled in the NewCourtland LIFE program and since we've learned she's actually in that zip code area, she would not have had the illness that she had. She would not have ended up in the hospital and stayed for the multiple days that she stayed there. She would not have been rushed and discharged to her home, where she certainly was not able to move about. Her bathroom was on the second floor. It was not a good situation. And so we had to put her in a nursing home, where she continues to remain, but had she been in the NewCourtland LIFE program with the support of sensor technology, we would have been able to not just respond, but we would have been able to anticipate and perhaps prevent a lot of that activity. 243 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 To broaden opportunities for seniors desiring to live as independently as possible, the NewCourtland network offers a variety of housing options with access to home and community-based services on every step of the continuum of care. HUD 811 we heard briefly talked about.
That's a way that family caregivers can live in the home of their loved one that perhaps has dementia or Alzheimer's, which is a form of dementia, and they could live there 24/7 and be compensated for providing care in a HUD 811 situation. We're proud of --
Yes, HUD 811. And we have a state-of-the-art campus in Germantown, and I would invite you to come and take a tour. Our HUD 202 Apartments, as well as the apartments on the historic campus of Kearsley Retirement Community -- 244 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 people don't know that that's actually part of the NewCourtland network. It's actually managed by Courtland Management Services. Those enable independent seniors to live on their own as well. These housing residents also benefit from the technology that NewCourtland employs, specifically sensor technology. And we're very big on evidence-based research. We have great partnerships with technology providers, and the University of Pennsylvania School of Nursing actually has named a center after us. So we've done lots and lots of pilots before we actually provide the service throughout our network, and to date, we actually are in a position to partner with other agencies so that we can take those pilots outside of our network. We know that they work, and now we can expand them and provide more services to seniors in Philadelphia so that we can monitor activities of daily living, vital signs, to manage and watch 245 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 for trends and chronic and acute conditions, while ensuring a sense of safety, who for those -- I'm sorry. Go ahead, Jim.
And medication management for those who benefit from this service. And we would appreciate the City of Philadelphia expressing its ongoing support it has in many ways for qualified senior housing developers -- and NewCourtland is one -- that are equally skilled in providing care for those. We're proud that we're getting ready to open NewCourtland Square, which is a partnership with DPW and the Nursing Home Transitions program that was testified about earlier today. NewCourtland Square is a transitional housing site that is going to accommodate seniors that are going to have 23 built-in support services, such as what 24 is offered at NewCourtland LIFE, and have 25 access to technology. 246 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
And another unique story is a couple, the wife was living in a nursing home and her husband was still out in the community. Now with this transition into NewCourtland Square, they're able to reunite and live together. So a great way for seniors to age in place. We seek the support of the State of Pennsylvania via tax credits. So hopefully you can help us with some letters of support so that we can do some additional development. Councilman Greenlee, I've been to his office bothering him about that, and I'm so grateful for the support that he's 247 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 demonstrated to us to date. In recent years, the State of Pennsylvania has really, really been very aggressive in the need to rebalance long-term care, and we've been working diligently to ensure that that happens. So we recognize that technology is solutions available now and successfully implemented throughout our network, not only offer great promise to improve quality of care, but are absolutely essential to respond to the quantity of care needed as the 65 and older population increases and the nursing workforce decreases. I didn't really hear anybody talk to the need for more nurses in Philadelphia's workforce. However, in the meantime, technology solutions can affordably allow for improved prevention through earlier detection of disease, assistance with adherence to a care plan, increased support for family and professional 248 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 caregivers, decreased hospital visits so seniors can continue to age in place the place that they call home, all at a fraction of the cost -- and we actually are willing to submit additional support that identify this -- all at a fraction of the cost of delivering care in an institutional setting. However, technology in our mind is just an extension of, not a replacement for, the aging services nursing workforce. Yet, in light of the increasing demands of the nation and Philadelphia's senior population, there is a decrease of educators in addition to nurses that are available to train qualified nurses. So there's a gap between the supply and the demand, and we only expect that it's going to widen. But because NewCourtland anticipates and meets the needs, we are planning to open an LPN school in 2009 on our Germantown campus. There is a 41,000 square foot community center that we now are going to 249 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 convert into an LPN school, and, again, we would love your support via letter to enable us to move forward. In conclusion, while technology is a much-needed resource to support seniors aging in place, NewCourtland embraces the responsibility to recruit and train a qualified nursing workforce by opening a state-of-the-art LPN school. We again solicit the partnership of the City of Philadelphia to assist us in developing the next generation of nurses to ensure the healthcare needs of Philadelphia seniors are met along every step of the continuum. Again, we thank you for the opportunity to testify today. We commend Councilman Curtis Jones and Councilwoman Jannie Blackwell, in her absence, the joint Committees on Housing, Neighborhood Development and the Homeless and Public Health and Human Services for their leadership and foresight to convene this public hearing today to identify the 250 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 appropriate support and services Philadelphia's deserving senior population needs in order to age in place. So we invite you to visit our website, hear more about how we are delivering services to seniors in Philadelphia, enabling them to age in place, and partnership, partnership, partnership. I don't know if that was five minutes.
Other than Ms. Rafferty, I don't know anybody who could speak in a consistent caveness that quickly and get through a text that fast other than you. If you are looking for a back-up job, you can do that.
I promise I had a voice before I came. 251 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
Do the members of the Committee have any questions? Councilman Greenlee.
Just a quick statement. I certainly back up what you just said, Mr. Chairman, and you can see why I became a supporter when Ms. Brown came in. But even more important, or just as important, let me say, is the -- we also have spoken to people who have partaken of the services, and they are maybe the greatest salespeople, because they have told us how important and how vital NewCourtland was to them. So I want to say congratulations on that.
And your Chief of Staff is also such a vital resource. She's constantly referring constituents to our office and we're steadily placing them.
She will do that, yes. 252 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735
I had a brief conversation with Shoshana and I heard the Councilwoman mention the homeless. Angela, we do -- and she is aware of this -- we have a relationship with the Bethesda Project in Philadelphia where we actually monitor five sites for them, provide nursing and high-tech monitoring for wellness for a group of a couple hundred men, which is really going well. We started in April of this past year, and we have given them the opportunity to monitor their own weights, blood pressures and such. The house monitors or house managers get to view it on a portal, gather data for their doctor visits or physician visits and get them hopefully on the right track. Also, I would like to add that Pennsylvania is one of the only states that has thrown their hat into the ring 253 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 from PDA, and now authorized last November reimbursement through PCA for these technologies that we employ today. NewCourtland has been working with some developers and some manufacturers for the last three years maturing devices that fit what the senior population needs. We are now ready and have operationalized this sometime ago and now are deploying this not only in our state but in other states. Utilizing our knowledge and our relationships in this industry, I think we can take this to a new stratosphere. There was a lot of great testimony today by some grassroots organizations. You heard the big numbers. We need scalable solutions that can wrap our arms around biggest pieces, biggest chunks first, and then tighten it up to address some of the other issues. The chronically ill, they say once you get to 50 years old -- I am a nurse, by the way. Once you get to 50 years old, you will have a chronic 254 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 disease or the beginnings of a chronic disease. Every ten years after that, you will get another one. Technology in medicine has allowed us to --
I just want to tell you, the technology in the last 11 years has allowed us to live longer. The 12 reasons we have these issues today -- 13
So wellness is 16 another issue. If I can implore this 17 Council anything that we do need, 18 connectivity to our technology is the 19 most crucial piece. We were working with 20 Philadelphia, the Internet company that was --
Yes, Wireless Philadelphia for a while trying to get 255 12/2/08 - PUBLIC HEALTH & HOUSING - RES. 080735 affordable realtime connections, because the faster we can connect, the better we can watch what's going on. If we do store and forward through phone lines, it's not very dependable and it's old information. So if I can say to you one thing that we all need, is the affordable access to connectivity at DSL speed or better.
For people who are going to view this later on, I think it's important to note that what we're talking about is the ability from your home to be monitored by a nurse, professional or a doctor and get your vitals, things like blood pressure and things like that right from the convenience of your home.