Igal Jellinek's Speech on Senior Services

REMARKS FOR ALZHEIMER’S ASSOCIATION OF STATEN ISLAND
MAY 14, 2009



Thank you for the opportunity to speak with you today. I have been asked to share with you what I see the future of senior services to be, looking at it in May 2009. As the Executive Director of Council of Senior Centers and Services, we have been doing a lot of soul searching on just this topic and I am delighted to bring to you what we have been wrestling with as our world has changed drastically.

When I was first invited to speak, my reaction was to say “no.” Like many people, Alzheimer’s has hit close to home but I am far from an expert on the subject. However, I was assured that my role was to address the issues of senior services – and that is a subject in which I can claim some familiarity, possibly even expertise. I have been living it and breathing it for more than 30 years and have seen evolutionary changes take place. Now we are standing on the brink of revolutionary change.

Here’s what I mean. In 1979, CSCS was born out of the vision of Elly Guggenheimer at her kitchen table. She believed that senior centers needed an organization that would advocate for them and so the Council of Senior Centers was born. Notice the name: Council of Senior Centers. Over the course of time, agencies that provided services such as case management and meals on wheels to seniors wanted to join and so our name was changed to include them. Thus, the name became Council of Senior Centers and Services and signified a move to a wider umbrella that would encompass other types of organization that served seniors. We have seen our membership continue to evolve with Naturally Occurring Retirement Communities or NORCS, housing, adult day service providers, multi-service and special populations now represented. Our member agencies serve more than 300,000 of New York City’s elderly.

Let me begin by telling you what we do. We advocate for seniors on the federal, state and city level. We build capacity for our member organizations through training in group settings, one-on-one technical assistance and sponsor a major conference on aging in New York City. We provide opportunities to network and we offer training for new directors to prepare them for their very complex and complicated job. For them, the most important thing we do is let them know they are not alone.

Part of our mission is to identify emerging trends in aging. That has led to incubating programs at CSCS, giving good ideas a home while testing and refining them. Let me give you a snapshot of a few of those cutting edge programs. The New York City Family Caregiver Coalition is a CSCS program that was created to bring together caregivers of all ages, circumstances and relationships. Under the guidance of Gregory Johnson and James O’Neal, the Coalition has begun working in the areas of advocacy, education, information and public awareness as it establishes itself as a valuable vehicle for communication about caregiving. If you wish to join, see our website, www.cscs-ny.org.

Another program is the Marketplace @ CSCS. It is a group purchasing program that harnesses the buying power of the senior network to effect cost savings on agency purchases. We were excited to learn that just this week, Mayor Bloomberg told a session at the Council on Foundations that the city is testing a group purchasing program for organizations that get city contracts as a major part of a three-part program to help nonprofit groups struggling because of the poor economy. Our members who are participating in the Marketplace @ CSCS can testify to the savings they are reaping. Those savings can be reinvested in programming, more services, meals, capital improvements – empowering and important in this time of budget cuts. The Marketplace started with food and now knows no bounds! Insurance, vans, office supplies, furniture, printing services – the list is limited only by your imagination. If you are interested in learning more about what the Marketplace can do for you, let me know.

Speaking of budget cuts, let’s take a look at what is at stake. In FY10, $800,000 in Borough President discretionary funds for aging is targeted, which fund meals, transportation, case management services, elder abuse prevention programs, social adult day care, caregiver support programs, and enhancements for a variety of other senior services. We also strongly advocate that the full $7.5 million in Borough President funding remain within their control to keep funds close to home.

The second program is HIV/AIDS training for senior agency staff and for seniors. We have partnered with ACRIA, which stands for AIDS Community Research Initiative of America, the trailblazing research group that found the fastest growing cohort in terms of the HIV virus is age 50+. They have documented that 34% of people living with the HIV virus are over the age of 50. We did not see this one coming so imagine our surprise when presented with the data. It was, however, an opportunity in that ACRIA needed help reaching seniors; they had no experience in the field and this was a sensitive topic. After a successful first year, I can report we are ready, willing and able to deliver training throughout the city and have been amazed to find that seniors are listening and stepping forward to be tested. Yes, tested.

The next program I want to tell you about is one that I believe has extraordinary potential and relevance to you as an organization and to the caregivers who are here today. It is the Volunteer Bill Payer Program. We have collaborated with the AARP Foundation and with Reserve in a new model to provide seniors with a free service that provides help in paying their bills on time. While the program serves Manhattan, Brooklyn and Queens, you should know that where we can recruit volunteers to carry out the direct service aspect of the program, we will serve that population, matching volunteers to seniors in their own communities and would welcome the chance to come to Staten Island.

Now let’s step back and take a look at the big picture. I have given you examples of how CSCS has adapted to and accommodated change. What is on the horizon? We have been hearing about the impact of baby boomers since they first arrived in 1946 – and I am one of them. Now 63 years later, they are about to impact the senior services network. What will we see?

  • With lower birth rates, we are witnessing a shrinking workforce and fewer caregivers.
  • An outflow of well and wealthy older adults and an influx of frail and poor older adults.
  • The boomers will begin to confront serious disability within the next five years.
  • The boomers’ retirement income will be less likely to be based on fixed pensions and they will be more subject to fluctuations in the economy. We are seeing the savings rate increase from 0% to 4% and predictions are that the age of “living beyond one’s means” is over.

For senior services, their influence will be felt as the network is asked to be transparent and provide choice and information about choice where the consumer understands all the available service options.

All of this is now being played against a backdrop of diminished resources. Here on Staten Island, adult day service programs have been closed or reduced because of budget cutbacks and today’s sponsoring agency, the Alzheimer’s Foundation could lose funding. Your seniors will continue to get older and frailer. Their needs for community based services that will allow them to stay in their homes will grow. CSCS is vigorously supporting new SNAP legislation to provide funds that will eliminate the waiting lists for meals-on-wheels.

CSCS believes strongly that an essential element of the future of senior services is the reform of long term care. It has been documented that people want to remain in their community. For that to happen, there is a need for community-based support services. For most of their day, frail persons are likely to need support with things such as meals; transferring (e.g.,from bed to chair); maintaining a clean, comfortable environment; bathing; transportation to doctor’s appointments, socialization, etc. and related social service supports. For the majority of frail individuals, skilled nursing care and other health care services are needed only intermittently. There must be a shift from a medical model of delivering care to persons at home to a balanced model of community-based care. The delivery of care should be more closely aligned with what the consumers’ daily needs are, which are in most cases non-medical services with health care as adjunct services and quality of life considerations. Doctors’ orders and nursing assessments make sense in delivering needed health care. They do not make sense for delivering non-medical support. A system that is driven by a medical model, whether or not in home care, or in a nursing home, is expensive and predisposed to the limiting of a person’s self determination. On the other hand, a continuum of community-based services that includes senior centers, meals-on-wheels, transportation, friendly visiting, telephone reassurance, home care, mental health and socialization can deliver a wide range of services that contain costs while protecting an individual’s self-determination. That is the future of senior services. It is the bottom line.

To make it happen will require a concerted and collaborative effort among all of us who work with seniors. That effort is called advocacy. It is the type of effort that resulted in 20,000 letters from seniors being delivered to City Hall when senior centers were being threatened with closing. It is the type of effort that brought 3000 seniors from every corner of the city to a rally against budget cuts. The future of senior services needs all of us to be passionate about what we do and to be willing to speak out. We do it for today’s seniors and we do it for tomorrow’s seniors.

And that is you and me which certainly raises our stake in our success.

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