When San Francisco officials adopted a groundbreaking LGBT aging policy plan five years ago, local advocates worried it would be shelved somewhere inside City Hall like so many reports of the past. A similar report issued in 2003 suffered just such a fate.
Yet, within a year of the issuance of the 2014 report, a number of its recommendations had already either been put into place or received pledges from city leaders that they would work to implement them, as the Bay Area Reporter noted in a June 2015 article. The LGBT aging issues highlighted in the report ran the gamut from social support and health services to legal assistance and access to affordable housing.
Four years later, even more strides have been made toward ensuring LGBT seniors can age comfortably in the City by the Bay. In fact, according to the city's Department of Aging and Adult Services, it has made considerable progress toward addressing 11 of the 13 areas of concern listed in the 120-page document, titled "LGBT Aging at the Golden Gate: San Francisco Policy Issues and Recommendations."
The city has implemented many of the 40 specific steps the report suggested be taken to benefit its LGBT senior population, estimated to now number nearly 25,000 residents age 60 or older. The areas of focus have included helping connect LGBT seniors to such things as benefits counseling and health insurance, Alzheimer's and dementia care, financial literacy programs, and eviction protections.
"I feel really proud of the fact we've done that with 11 of the 13 policy areas," said Shireen McSpadden, 54, who is bisexual and executive director of the city's aging department. "Having the recommendations at our fingertips is very helpful, so we don't have to start from scratch. These recommendations came from San Francisco residents living with these issues."
When gay state Senator Scott Wiener (D-San Francisco) served as the District 8 supervisor, he worked with gay former District 9 Supervisor David Campos and bisexual former District 5 Supervisor Christina Olague to push for the creation of the LGBT Aging Policy Task Force in 2012. In a recent editorial board meeting with the B.A.R., Wiener said he was "pleased" with the progress that has been made in seeing that its policy prescriptions became reality.
"My sense is the agencies took the report and legislation from the board very seriously and are committed to doing better for LGBT seniors," said Wiener, whose push for an LGBT seniors' bill of rights at both the local and state level came out of the aging report.
The ultimate goal, recalled Wiener, was to bring to the forefront the unique needs of LGBT seniors so that the city could no longer overlook them.
"There is more work to do, but I am happy with the progress," said Wiener.
Gustavo Serina, a gay man who is president of the San Francisco Aging and Adult Services Commission, noted that, due to the passage of the city's Dignity Fund by voters in 2016, there is $50 million in funding in the 2019-2020 fiscal year for myriad senior services. By 2026, the pool of dedicated funding for senior services in the city is set to increase to $71 million. DAAS estimates that nearly $6.8 million of the Dignity Fund allocation is earmarked for services directed at, or inclusive of, LGBT seniors.
"I think the needs are being identified and programs are being developed and implemented to address those concerns and needs," said Serina, who has served on the oversight body since 2004. "I think it is a huge need, but it is being addressed and being met little by little."
Having the LGBT aging policy report has been crucial in being able to seek funding from mayoral administrations and the Board of Supervisors, noted McSpadden, who took over leading DAAS in 2016.
"We could follow the script in saying, 'As long as we have funding for X, Y, and Z, we can do it.' It is easy to go to the mayor for funding and the board because it was all here," she said.
Remaining issues
The remaining two policy areas in the report still to be addressed, improving the living conditions of the city's single-room-occupancy hotels, which many LGBT seniors call home, and ensuring the city's shelters are LGBT-friendly, are priorities for Mayor London Breed, as the B.A.R. reported last month. Talks are underway with the city's Department of Building Inspection on how best to inspect the SROs, while a shelter set aside for seniors is being looked at, said McSpadden, that would be welcoming to LGBT older adults.
"We have talked with the CEOs of the shelters. They seem very interested in having a senior shelter but not necessarily carving one out for LGBT seniors," she said.
Michael G. Pappas, a gay man who serves on the city's aging commission, told the B.A.R. he has been impressed with city staff's "diligence and really trying to see the implementation of the measures" included in the report.
Executive director of the San Francisco Interfaith Council, Pappas had chaired the LGBT advisory committee at the San Francisco Human Rights Commission in 2012 when it called on the city to form the special task force to look into the aging needs of the LGBT community.
"It has been kind of fun to watch it incubate and be on the DAAS side of it to see the implementation," said Pappas, who was appointed to the agency's oversight body in December 2017 by the late mayor Ed Lee.
Despite the progress DAAS and the service providers it contracts with have made toward providing services to LGBTQ seniors in recent years, getting those older adults through the doors of agencies and senior community centers remains a challenge. As DAAS noted in a report last year on how it has worked to meet the requirement that it collect sexual orientation and gender identity demographic data of its clients, another recommendation made by the LGBT aging policy panel adopted by the city, LGBT seniors underutilize the services that are available to them compared to their heterosexual counterparts.
"We still want to work on that, making sure all of our organizations are affirming and inviting of LGBTQ people," said McSpadden.
One consequence for LGBT seniors living alone in the city and not connected to services is they are more prone to becoming isolated, as the B.A.R. noted in a recent series on the end-of-life issues LGBT seniors confront. And that can lead to issues with loneliness, depression, and an inability to remain living in their homes when they experience a health care crisis due to their lacking social and familial support.
"The next big step is to get the word out to LGBT seniors that they could apply for various services. That is our next task," said Martha Knutzen, 62, a lesbian who joined the aging commission last fall. "People don't realize how much they could get, and I want to make sure we get the word out to our community."
Knutzen worked to highlight the needs of the city's LGBT seniors as a member of the San Francisco Human Rights Commission in the late 1990s and early 2000s when its LGBT advisory committee, which she at one point co-chaired, issued the first city report on the needs of older LGBT adults. What has been key, said Knutzen, is the inclusion of language in city contracts with providers of aging services that LGBT seniors be a priority population of theirs.
"That is a huge kind of accomplishment," she said.
But a major misnomer among LGBT seniors, noted Knutzen, is that the city's senior programs are only for low-income older adults. While that is true in terms of applying for affordable senior housing, it isn't always the case with a vast array of services DAAS offers and contracts for with local nonprofits, such as the congregant meal programs at community centers.
"Anyone over 60 qualifies for them. It is not based on income," said Knutzen of the meals.
Housing a major focus
One of the more pressing needs for the city's LGBT seniors is housing assistance, whether it is support to age in place in their current homes or access to affordable housing units. In fact, the bulk of the LGBT Aging Policy Task Force's recommendations are ideas for how the city can lessen the impact of skyrocketing housing costs for LGBT seniors.
"It is a very expensive city and housing is a challenge," acknowledged McSpadden.
The suggestions in the aging report run the gamut from building more affordable housing for LGBT seniors and increasing eviction protections for them to providing rental and homeowner assistance and legal services to help them maintain their housing. The city helped fund the 24-bed LGBT adult homeless shelter Jazzie's Place, something the LGBT aging panel supported in its report.
It also assisted with the financing of the affordable senior housing complex on Laguna Street near Market that is aimed primarily at LGBT older adults. The residents of a new building containing several dozen rental units are expected to move in this April.
"Housing is a key concern," said Roberta "Bertie" Brouhard, 72, a transgender woman and former Openhouse board member. "If they were building 9,000 units it would be too few."
In response to the aging policy report, DAAS several years ago designated Openhouse, a nonprofit provider of LGBT senior services, as an aging and disabilities resource center. It also beefed up its funding to assist LGBT seniors seeking affordable housing opportunities in the city, not just at the 110 units in the Laguna Street buildings.
The new building, at 95 Laguna, will include two floors of community space for Openhouse. It aims to host programs and events for both the residents of the Laguna Street complex and the larger community.
"We are not building Openhouse as a closet for LGBTQ seniors. If this is a place where only seniors come, then we have missed the fucking point," said Openhouse Executive Director Karyn Skultety, Ph.D., who is bisexual. "We want people to come here to experience the vibrancy and energy from seniors. We are excited to have a space where the entire LGBTQ community is coming to because, on balance, LGBTQ seniors should be a vital part of our world."
Openhouse and DAAS have worked hard to provide cultural competency training to service providers and operators of senior housing about the needs of LGBT older adults, another recommendation of the aging policy report. But issues remain in ensuring that LGBT seniors feel welcome.
Brouhard recounted how, at one senior living center in the city that she toured when looking for a place to live following her divorce from her ex-wife, the marketing manager not so subtlety told her to look elsewhere.
"She didn't think it would be a good fit for me, and that is here in San Francisco," said Brouhard. "Overall, the city has some wonderful services but it rewards rich people better than poor people. If I am 80 and have no money, I would leave San Francisco overnight and go to the Midwest. I think the poor queer old are at the bottom of the food chain."
Nonetheless, most agree that San Francisco is an ideal place for LGBT seniors to live and has only gotten better so as city leaders have worked to address their needs over the past five years.
"I couldn't imagine any place better to be an LGBT senior," said Tom Nolan, 73, a gay man who is manager of special projects at DAAS and staffed the LGBT Aging Policy Task Force.
Bill Ambrunn, who chaired the task force, credited Nolan with helping to ensure the LGBT aging report remained a priority even after leadership changes at DAAS and three mayors over the last five years.
"He is very committed to our work not becoming a dusty report," said Ambrunn, who now lives in San Mateo. "My impression, having kept in touch with Tom, is the city still has the issue of LGBTQ seniors on its list of things to address."
DAAS will hold a town hall from 10 a.m. to noon Saturday, March 9, in the Rainbow Room of the LGBT Community Center, 1800 Market Street, to discuss its accomplishments to date in implementing the LGBT aging policy plan and what next steps it intends to take.
To download a copy of the full report, visit https://sf-hrc.org/lgbt-aging-policy-task-force-lgbtaptf.
To read Matthew S. Bajko's recent articles on end-of-life issues for LGBT seniors, go to https://www.ebar.com/news/news/270988 and https://www.ebar.com/news/news/269128.
Contact the reporter at [email protected].
UPDATED 1/24/2019 Clarified Martha Knutzen's comments regarding the income eligibility criteria for certain programs offered to seniors.