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Saturday, February 11, 2006 | Once a month, aides to then-Mayor Maureen O’Connor served lunch to the low-income elderly persons who shuffled into the Senior Community Centers for a hot dish. Paul Downey was on that mayoral staff, which was one of the many groups who files into the cream, stucco building on Broadway to scoop up meals for the thousands of impoverished seniors who live in San Diego’s urban core.
Since becoming president and CEO of Senior Community Centers 11 years ago, Downey serves old-timers more than steamed carrots and applesauce. In addition to overseeing the more than 1,000 meals are served everyday, the 46-year-old lifelong San Diegan supervises all other aspects of the nonprofit. These include the organization’s housing facilities, health and psychological services and social work.
This year, the first baby boomers turn 60. Downey sat down to shed some light on what’s new with the older crowds.
How would you rate the state of the seniors in San Diego and compare that to what you see 20 years down the line?
Right now, we’re not meeting the needs of seniors in San Diego, but fortunately there are some elected officials out there who recognize the problem. In terms of housing, health care, food – we’re not meeting those needs today.
The big issue is that in 20 years, with the demographics, is that we aren’t going to meet their needs unless we grow. The one guarantee we have is demographics. By 2030, a third of the country will be over the age of 60. We know that’s going to happen, so we have an opportunity to go out there and implement the procedures and the financing for all the things we need to build infrastructure that we need to deal with the baby boom bulge. We’ve got to start doing it now. We’re starting from a point where we’re not even meeting the needs today.
Housing prices downtown have multiplied, so where do those low-income seniors who used to be the mainstay there go?
That really is the worry, because SROs (single-resident occupancies) are becoming an endangered species downtown as market-rate projects come in and are torn down and the SROs we do have are converted into market-rate hotels. Pickwick [at First Avenue and Broadway] is the latest example of that.
Where will low-income seniors go? That’s who has traditionally inhabited downtown SROs. You throw in demographics: We’re going to see more seniors, more low-income seniors and fewer places for them to live because there aren’t any places in San Diego County where you’re going to find a place for $600 or less. And you’re certainly not going to find a place that’s near a bus line, health care or stores – the types of things seniors need.
Both the city and the county need to continue finding affordable housing locations and, from my standpoint, it doesn’t necessarily need to be downtown. I understand that when land is $400 or $500 a square foot, building affordable housing isn’t necessarily the best use, but we need to understand that if we lose 150 units at the Pickwick we need to identify somewhere else to replace those units while adding more.
You talked about the need for seniors to be close to public transportation, but is our mass transit system working for seniors?
If you live within a block or less of a bus stop or trolley station, then yes, it’s fine. The problem for many seniors is they use canes, walkers, wheelchairs or just have limited mobility. If you don’t have housing convenient to the bus stop, for a senior, that doesn’t work.
Some of it could be better, but I think most of it is adequate for seniors.
What’s the typical situation an elderly person is in when they come to Senior Community Centers?
Over 90 percent of the seniors we see here live below the poverty level, which means they’re living on less than $750 a month. That’s usually social security maybe [supplemental security income], maybe a small pension if they’re lucky. They’re trying to get by on $750, when rents for the SROs where they live are $600. These are folks who are trying to get by on $150 – if they’re lucky, $200 – for all their other needs, so they come to us needing food, shelter, health care, mental health care.
There is a whole array of services that, in a “normal” situation, a family might be providing. In their cases they don’t have a family, and that’s where we step in. Out of all our centers, about 8,000 come through on an annual basis.
The Medicare Prescription Drug Benefit took effect last month, what are your early observations about how the program is working?
It’s a complete fiasco. It may go down in history as one of the worst government programs ever. There is massive confusion and massive disarray.
The biggest concern, I think, is that there are seniors out there who don’t even know they have a problem, and are going to find that out at the end of March. What happened is that many pharmacists who had seniors who are dual eligible – Medicare and Medi-Cal – gave their patients three months of supplies in December. Now these folks are going to run out in March and they’re going to discover that they were placed by Medicare into some sort of program that may or may not cover the medications that they’re taking.
We had a lady whose total monthly income is $800, and she got put into a program by Medicare that would have cost her $500 a month. Fortunately our nurse caught it and was able to find her a plan for about $25 that would meet her needs, but there was no rhyme or reason to how dual-eligibles got placed into programs.
We’ve also had major problems where a senior switches to another plan. They go in to the pharmacist and their card doesn’t work. They can’t get their medication and so a lot of pharmacists have had to step in and kind of front some of the money and hope that the State of California is kicking in some dollars.
Medicare has said, finally, that they may reimburse as well, but the fundamental flaw in the program is that Medicare is specifically prohibited from negotiating drug prices. An HMO, a PPO, the [Department of Veterans Affairs] – they all negotiate drug prices. If you let Medicare negotiate, you’re going to reduce costs substantially for the government. Right now, there is no check and balance, other than competition, and expecting seniors to figure out what the best deal is.
How common is it for seniors in San Diego to cross the border to find cheaper medications?
We have some seniors who take the trolley down to the border, and there are some who will order drugs online from Canada, but a lot of people just can’t do that. They’re either afraid to do it, or physically hiking across the border is not something they’re able to do.
We have lots of cases, though, where seniors will cut their pills in half, take pills every other day because they can’t afford it. Ultimately what happens is that you end up spending more money on the back end because they are hospitalized. They go into long-term care facilities, nursing homes and it turns out to be one of those pennywise-and-pound-foolish things.
Elder abuse seems to be playing out more often in headlines. What are your concerns about the issue and has this hit the radar screens of elected officials and law enforcement in San Diego?
Yes. In San Diego, we have one of the foremost experts in elder abuse with Paul Greenwood, a deputy district attorney. In terms of prosecution, he’s aggressive, and fortunately he’s outstanding.
From a broader perspective, elder abuse comes in many forms. A lot of it, unfortunately, comes from family members who take advantage of elderly parents and grandparents. For instance, at our Potiker Family Senior Residence [in East Village], we have security there who, around the first of the month, will refer to a list of children and grandchildren of residents who are not allowed in because they show up to try to hit up their parent or grandparent for cash. That’s a milder form.
Other types are flat-out fraud – where family members raid checking accounts – to physical abuse by caretakers. Another one, which has been stopped a little bit by the Do Not Call List, are the telemarketers who berate seniors into doing things they wouldn’t normally do. It’s a horrible situation and something everyone should be vigilant about.
– Interview by EVAN McLAUGHLIN