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The Honolulu Advertiser

Posted on: Tuesday, July 16, 2002

Vision is needed for our elders

By Oscar Kurren
Professor Emeritus at the University of Hawai'i

The July 6 issue had an article headlined "Aging-in-place programs in demand," by Christie Wilson. She described the growing inability and concern for the elderly to obtain affordable supportive housing that would enable them to "age in place."

Hawai'i and the nation need the passage of federal and state legislation for the elderly that has the equivalent impact of the No Child Left Behind Act. Under the provision of the federal education act, low-income students from high-poverty, low-performing schools in Hawai'i and the nation will be given top priority for transfers to higher-performing schools.

Top priority for the elderly, particularly the low-income elderly, is to link with housing supportive services — personal care, meals, transportation. Surely this is not an impossible goal.

Yet here we are in the year 2002 without a national housing program for the elderly, and with state administrative and operational responsibilities for housing for the elderly designed only for independent living. No supportive services are provided.

The community maze of fragmented, uncoordinated elderly services can only be navigated successfully by the elderly with the help of professional case managers. Medicaid's Title 19, the federal program that provides the bulk of skilled nursing home care financing, approximately $106 billion annually, allocates minuscule funds for supportive care for the elderly who desire to "age in place."

Our elder-care system is broken and requires a major overhaul, structurally as well as financially.

Following World War II, European nations, faced with enormous catastrophic social problems, created a social services system that suggests feasible alternatives for our country. They established the principle of local decision-making capability in partnership with the national government.

The national social service structure provided the basic standards and major financing systems for social services. The local authority structures established the priorities for their respective communities and populations in need.

Obviously, there is no "magic silver bullet" solution for achieving "aging in place." Equivalent legislation for the elderly that has the vision of the No Child Left Behind Act could lead to the creation of federal, state, local and private partnerships that assure the elderly can age in place with dignity, privacy and a meaningful life.