It is clear there are holes in the safety net. In 2011, Social Security kept 21.4 million people out of poverty, including 14.5 million seniors, according to the Census Bureau Report, Income, Poverty, and Health Insurance Coverage in the United States: 2011 (PDF | 2.2 MB). Without social security, the senior poverty rate would have been five times as high. The question becomes how best to help those who have or might yet fall through those holes.
Since 1991, Senior and Disability Action (SDA) has conducted Senior and Disability Survival School (SDSS), with classes on how to navigate social service agencies to obtain needed benefits or, when relevant, to navigate life on the streets. The program (and its predecessor, Planning for Elders in the Central City) is funded by the city of San Francisco and the classes are held four to five times per year in neighborhoods throughout the city.
“Typically, the class is four days, four topics,” said Sarah Jarmon, who has run the Survival School classes since 2009. “We bring in speakers from different city agencies to cover such topics as transportation; community health issues; federal benefits like social security disability, Medicare and Medicaid; and housing issues. We want to show them how to get around the city safely and operate within the city service structure to access services in their own language. Then we will have panels where participants can ask questions. We can tailor the curriculum to meet specific neighborhoods’ needs, and we will provide translators for different languages so people understand what is going on.”
SDSS has held classes in a variety of languages such as Spanish, Chinese, Russian, Tagalog, Vietnamese, Italian, and Korean. There have been classes specifically aimed at seniors experiencing homelessness, and classes aimed specifically at the lesbian, gay, bisexual, and transgender (LGBT) community. “Often, LGBT people have no family or support network to rely upon. We provide information about hospice care, end-of-life issues, point them to LGBT-friendly housing,” Jarmon said.
The relatively small size of San Francisco, situated on a peninsula, and the historical importance of neighborhoods in that city allows SDA to customize their classes to meet the needs of specific groups. But structuring this service as a class serves several purposes. “We want to thoroughly cover, and make sure people know about and can manage access to all the relevant services,” said Jarmon. "We want to give them tools.” Also, presenting the service as a class allows for a certain degree of self-selection by participants. They attend the class because they have an issue that needs attention. They are there to receive relevant information about that issue.
“It is really about problem solving. We bring in people who can meet with participants one-on-one to help them with a health care issue, or perhaps get them hooked up with case management services for mental health problems, or steer them in the right direction on a housing issue, always a big issue in a very expensive city like San Francisco,” said Jarmon.
“We get the word around a neighborhood that we are doing a class at the local shelter, or a community center or church. People show up and we offer them lunch or snacks, we give them some information and then we start tackling specific problems for specific people. It is a very effective way to establish a connection to people and provide them with the answers and services they need.”
SDSS has trained many seniors and adults with disabilities, and has reached people throughout the city. It is a pioneering approach that gives San Francisco’s elders comprehensive information about services available to them. SSDS’ mission is to increase the physical, emotional, intellectual, social, and spiritual well-being of seniors who choose to attend survival classes so they can remain independent, active, and engaged. SDSS goes even further by creating a community through programs and activities so that people are connected.
Learn how SAMHSA’s programs, initiatives, and resources work to improve the behavioral health of older adults.
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