September 15, 2020 by stephenshubert
Response to Tom Eversole’s Open Letter to the County Council District 2 Candidates.
• The majority of voters on the island are likely to be seniors. What issues and needs of seniors must be addressed, and what will you do about them that is not already being done if you are elected?
We are in a nationwide crisis for Long Term Care and Aging in Place. We are forecast to have the largest shortage ever of RN’s in 2020. With so many baby boomer nurses retiring and 10,000 seniors retiring every day we are expected to fall approximately 220,000 nurses short of the need. We have large numbers of seniors entering their “golden years,” which are frequently their sickest years, and we will spend more health care dollars in this last chapter of our lives than at any other time.
In the face of that reality, we face our own struggle to provide our seniors with the ability to age in place. To do that we need home healthcare (medical), home care (assistance with daily living issues), affordable housing, access to transportation and assistance with home maintenance and repair. The problem is that all of these are notoriously difficult to provide adequately and well in small, rural communities. We currently provide some of these services, to some degree, on some of the islands but nowhere are all of the services readily available.
I think the county council has a role to play in addressing these problems but not the primary role. We have a county board of health and we now have public hospital districts on the three main islands. Those are the bodies, working together, that are best equipped to take the lead. Public health is their focus. The council can and should facilitate and assist them in every way it can.
• What do you know about the following issues as they relate to seniors, and what will you do about them if they elect you: Home Healthcare and Home Care (they are different), affordable access to home maintenance and repair, healthy aging in place, public transportation that is accessible to seniors and people with disabilities?
In basic terms, Home Healthcare deals with in-home medical services, everything from wound care to medication management. Home Care is about daily needs, errands, shopping, cleaning and food preparation and things like home safety, accessibility and sanitation. Together they are what is needed to allow seniors to age in place. Community Paramedicine programs, like the very good one on San Juan Island, tend to address both of these but primarily identify problems and refer them to others for resolution.
Efforts to address transportation for seniors, like the efforts to address other aging in place issues, have developed in a patchwork fashion. There is a state funded Transportation Voucher Program that provides $300 every two years to defray transportation costs for eligible seniors, but that can be inadequate for low income seniors. Transportation options vary from island to island. Friday Harbor has the RoundTowner discount taxi service and regular commercial taxis. Orcas has Lahari’s Door2Door program to connect volunteer drivers with seniors in their own neighborhood and regular taxi services. Lopez has volunteer drivers through Senior Services and Lopez Hospice that will help seniors to appointments and errands, but these haven’t been offered during the pandemic. The RoundTowner non-profit has recently expanded to Lopez with an electric car and is looking for funding streams to offer a low or no cost rides programs that can expand to all three islands. Also, each of the three senior centers has a single wheelchair accessible van and programs to help transport seniors to medical appointments on the mainland, but again, this is not happening during the pandemic.
Home maintenance and repair may present the most intractable problem. To date, it has largely fallen to local volunteers. There is a program to certify contractors, but the paperwork is onerous and the maximum wages are low. There are no island contractors in the program and mainland contractors won’t come out here. Plus, with local contractors fully employed they have little incentive to get into such a program. (There are subsidized programs for weatherization for seniors and also home modifications for safety and accessibility, e.g., wheelchair ramps, but they don’t address regular upkeep). There are promising programs to begin rethinking housing for seniors to get folks into shared housing so they can share costs or live with younger roommates who can provide continuing care for properties. But, again, it’s a patchwork.
The good news is that the San Juan County LTC Coordination Network just received a grant from the federal Health Resources and Services Administration (HRSA) that will provide $250,000 per year for three years to address these problems in a comprehensive, county-wide approach. I think the county council could be most helpful by reaching out to the various entities and offering to coordinate some of the many conversations that will need to take place in this process and assist with advocacy at a state level to address barriers to services for our isolated, ferry-dependent communities as they arise.
• Tourism may not be a sustainable enterprise on Orcas as currently undertaken and managed. What other businesses do you believe represent growth industries for the island, and what do you commit to doing that will help foster them? How could you promote family wage jobs in those fields?
We have an educated population, a need for trades people, a deadline to get off fossil fuels, a resurging agricultural community, and many retirees hoping to age in place. Each of these presents an opportunity to diversify our economy and create jobs. Critical to supporting those jobs is affordable housing. How do we attract and retain the people to fill the jobs in those fields, to say nothing of our teachers, medical service workers and law enforcement personnel, if they can’t find an affordable place to live? The need for affordable housing, itself, presents job creation opportunities. We need to think much more creatively about public-private collaboration to create jobs in those fields.
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