The following testimony was given on Tuesday, May 24th, 2016 at a Public Hearing on the Pennsylvania State Plan on Aging for 2016-2020. Under the Older Americans Act, the Pennsylvania Department of Aging is required to develop and implement a strategic plan every four years that outlines how the department will serve the Commonwealth’s older adult population. The implementation of the upcoming state plan will begin on October 1, 2016 and be carried out until September 30, 2020. Read the draft of the 2016-2020 State Plan on Aging here.
May 24, 2016
Drexel University, Bossone Engineering Building
3126 Market St., Philadelphia, PA 19104
Good morning. Madame Secretary, thank you to you and your staff for holding this public hearing and for the opportunity to share comments with you here this morning.
My name is David Griffith. I am the Director of Programs and Outreach for the LGBT Elder Initiative. As a small, community-driven non-profit here in Philadelphia, the LGBT Elder Initiative is dedicated to helping LGBT older adults to age successfully. Our work seeks to educate, empower and advocate for LGBT elders, building bridges between Aging and LGBT service and community organizations through advocacy, information, education and referral.
We would like to commend the Department of Aging on its commitment to diversity and dedication to providing services to a multicultural population across the state. Throughout this draft, there are many instances where this commitment to diversity shines through – building partnerships with organizations representing diverse constituencies, redesigning publications to reach vulnerable populations, targeting outreach efforts to hard-to-reach segments of the population, and working to expand the cultural competence of volunteers working with multicultural populations. This commitment clearly recognizes the realities of our state in 2016 and the demographic shifts that have made the Commonwealth more diverse than ever before.
As this draft moves forward though, we would like to see more specifics regarding these services to diverse communities, including explicit mention of LGBT older adults and older adults living with HIV/AIDS. We want to ensure that sexual orientation and gender identity are included when we talk about diversity, and that LGBT older Pennsylvanians are recognized as a vulnerable population in our state, in need of targeted outreach, programming, funding, and support. We similarly want to see elders living with HIV to be prioritized as a constituency receiving specific attention and support from the Department of Aging and the aging services network.
We know from the work that we do, as well as from consistent research findings, that LGBT older adults and people living with HIV/AIDS face many unique challenges. The number of LGBT seniors in the United States is projected to double by 2030. Additionally, for the first time in history, the majority of people living with HIV/AIDS in the U.S. are now over the age of 50. The growth of these populations underscores the necessity of taking action to address the needs of these communities of older adults.
LGBT elders have systematically encountered obstacles to good health, and as a result, many face magnified health vulnerabilities, such as drug and alcohol use, HIV/AIDS, depression, and an increased risk of some cancers. Many have experienced discrimination in healthcare settings, resulting in a tendency to avoid or delay seeking medical care. Older adults living with HIV face additional health risks and co-morbid conditions resulting from both the virus and HIV medications. HIV+ older adults must also deal with the physical and social effects of stigmatization and discrimination based on both age and HIV status. LGBT older adults living with HIV are especially at risk for social isolation, contributing to high rates of depression and other mental health issues. This isolation often hinders HIV+ older adults’ ability to reliably access and maintain care.
We know that the vast majority of caregiving in the United States is provided by family members. LGBT people however, as a result of past definitions of marriage and family, are disproportionately likely to be single, childless, and living alone, leaving them with heightened reliance on community-based services. Yet LGBT elders report an almost universal fear and anxiety of care provision by strangers in assisted living and nursing care settings.
According to figures from SAGE, LGBT older adults are less likely than heterosexuals to utilize senior centers, meal programs, and other aging services out of a fear of discrimination and harassment. Fearful of the discrimination they could encounter in mainstream aging settings, many LGBT elders become isolated. This isolation and marginalization places LGBT elders at a higher risk for elder abuse, neglect, and various forms of exploitation, as well as compounding the physical and mental health concerns affecting this community.
There is great opportunity before us to significantly improve the level of services available to LGBT older Pennsylvanians.
With more targeted outreach to LGBT populations, the State will be able to connect more vulnerable LGBT older adults with the resources and services needed to age successfully with the necessary supports. This will include connecting LGBT elders with critical resources and services such as APPRISE counseling, PACE enrollment, preventative health programming, and other services provided by the Department of Aging. Targeted outreach, LGBT-inclusive promotions and marketing materials, and collaborations with LGBT community organizations will all help to meet these goals.
We also have the opportunity to strengthen the ways that the Department of Aging and AAAs across the state collect data on sexual orientation and gender identity. As you know, LGBT older adults are largely uncounted. We lack good data on how LGBT people are, or are not, accessing services. We don’t have data that we can use to inform funding decisions or service priorities. Additionally, improving data collection methods is an important step toward making agencies more welcoming and inclusive. For example, transgender seniors trying to access services still face intake forms on which they are forced into an “M” or an “F” check box. This may seem like an insignificant detail, but in reality it can be the difference between accessing services or forgoing them all together.
We also face the opportunity of improving the LGBT cultural competence of those who serve older adults, including volunteers, staff, and agency administrators. LGBT older adults live in every county across the Commonwealth, and receive services from all 52 AAAs. Encouraging AAAs to adopt policies and procedures that are inclusive of LGBT elders is an important step toward creating agency cultures where LGBT older adults are welcomed and supported.
All of these goals start with recognizing LGBT seniors and older adults living with HIV as vulnerable populations experiencing unique needs and requiring targeted outreach, resources, and services. Strategic documents such as this State Plan provide the opportunity to acknowledge and start to address the needs of communities who have largely been ignored for far too long.
In closing, I would like to thank you and your Department again for the commitment to diversity and prioritizing the improvement of services to diverse populations on Pennsylvanians. I would however urge that LGBT elders and older adults living with HIV are explicitly written into this State Plan when talking about the diversity of older Pennsylvanians and the Department of Aging’s goals to better reach diverse communities.
I and the rest of the LGBT Elder Initiative will gladly be a resource to you and your Department in working to improve the quality of services available to LGBT seniors across the Commonwealth.