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As more Bay Area seniors face hunger, California’s Master Plan for Aging could help

on December 17, 2019

Leonard Humphreys knows Oakland. He grew up here, and has lived here all his life. His knowledge of the city helps him when it comes to planning his driving route, as he delivers food for Project Open Hand, a medically-tailored meal service that provides food for people who are ill. Project Open Hand delivers food to Bay Area seniors who are living with medical conditions, including HIV and diabetes. Starting from Project Open Hand’s office on San Pablo Avenue, Leonard has to hit each pocket of the city, from East Oakland to Lake Merritt to the border of Berkeley. 

“If you don’t know Oakland, you have Google, you have all those things,” Humphreys says. “But I was raised in this area, so I pretty much know this area.” During the two-hour trip around the city, he points out places his relatives have lived and provides a steady stream of observations about Oakland and how it’s changed. And in the process, he checks on, and chats with, each client, many of whom he treats like friends.

The first stop, Wood Street in West Oakland, is brief. An older black man who has been getting meals with Project Open Hand for years greets Humphreys, who gives him large frozen portions of rice, vegetables, meat and fish, packaged individually by meal, for him to eat over the next three days. All he’ll have to do is pop each meal in the microwave, and he’ll have a seasoned, nutritionist-selected, chef-made meal. The man says that he swears by the meals. “Give them a good review!” he says, noticing the reporter who is following Humpreys around.

The second stop is at a hotel—the Extended Stay America—where another long-term client lives. Humphreys knows this man doesn’t pick up the phone, so he walks inside to ask the woman working at the lobby front desk to ring the man’s room. After he takes the elevator up a few floors and walks down the empty hallway, he’s at the room of a heavyset white man. The man takes his meal, thanks Humphreys, but doesn’t want to chat. 

Although food insecurity—the formal term for being unable to reliably access and afford nutritious food—is on the decline in California, it’s on the rise for senior citizens. According to the UCLA Center for Health Policy Research, nearly 40 percent of low-income Californians over the age of 60 are food insecure, which represents a 21 percent increase over the last 15 years. And the senior population is booming in California—set to grow by 8.6 million by the year 2030. 

According to Kim McCoy Wade, the director of the California Department on Aging, the current governmental food assistance programs don’t reach as many people as they should. “We’ve got great community-based programs like Meals on Wheels, but I think folks who are on the front lines would tell you, ‘No,’ they are not connected in the way that the numbers and the experiences tell us we need,” McCoy Wade said. “It is still too hard for people to find the services.” 

Right now, California is ranked by the United States Department of Agriculture as one of the worst states at enrolling seniors in the state’s nutrition assistance program. The federal parent program is called SNAP, which stands for Supplemental Nutrition Assistance Program. Within California, it is dubbed CalFresh. Many people still colloquially refer to it as “food stamps,” even though nowadays, people get their monthly benefit credit pre-loaded onto an electronic card, rather than using stamps. 

At California Food Policy Advocates, an organization which researches food policy, senior advocate Melissa Cannon says CalFresh is the chief program people rely on if they need food. And for seniors, finding the program and enrolling people can pose particular challenges. “There’s a number of counties in California where you actually have to go in person in order to apply for CalFresh,” said Cannon. “So, for older adults, people with disabilities, that’s a particular challenge, especially given the social isolation, the mobility challenges, the transportation challenges that exist.”

Project Open Hand, a non-profit based in Oakland and San Francisco, is one of the local organizations tackling the problem of senior hunger. They aim to improve the quality of life of elderly and ill clients by preparing 2,500 meals and grocery bags every day. The food is specific to clients’ dietary restrictions and preferences—vegetarian, pescetarian and low-salt meals are all available. Because many of their clients are unable to walk, drive and move around with ease, many of the meals are delivered. That’s why Humphreys fills a critical need.

Humphreys said he thinks that each meal, and the fact that a person is knocking on the client’s door to deliver it, makes clients feel taken care of. “Because you might be the only one they see that day. You’re going to see how they’re doing… You’re going to learn about them, you’re going to ask them about things that they have mentioned to you, that they would have thought you wouldn’t have remembered,” he says. “It’s delivery with a personal touch, right? Meals with love. That’s who we are.”

John Griffin, a retired teacher and Oakland resident, is one of Humphreys’ regular clients. Griffin, who receives dialysis treatment a few times a week, says he was struggling to make ends meet after he retired, and was living on a fixed disability income. After people at the dialysis center noticed he had lost a significant amount of weight, someone asked him if he would be embarrassed to get meals from Project Open Hand. Griffin was not embarrassed, and says that the meals have been a blessing. He says that he knows many people who are also disabled and also struggle to make sure they have enough to eat.

Before he got help, he says, he wasn’t eating nutritious food, and what he could afford was extremely limited—he’d have about $10 to spend at a time. “I would buy some hot dogs and then you get the Top Ramen, like, ten for a dollar,” Griffin said. “And, you know, that was it.” 

Project Open Hand is predominantly funded by donors, but also receives money from government agencies. “I pray that the government, state, will keep funding the program,” Griffin says. “Because for every one like me, there are ten worse off.”

One of the last stops on Humphreys’ route is The Altenheim, a senior housing center in Oakland, which houses over 200 residents in apartments. It looks like a towering, white hotel from the outside. Inside, the decor is more muted, and the quiet of the hallways is striking. Three people in this building are clients of Project Open Hand. Today, Humphreys is bringing three days’ worth of meals to a woman who lives alone in a studio apartment.

The housing here is is offered below market-rate, but caretaking is not provided. Those who live here might take advantage of community activities, but mostly, people live on their own. And since people are living independently, says Kendra Lewis, the resident senior services coordinator, residents often struggle with getting enough food.

“Hunger is huge,” says Lewis. “Seniors citizens are already on a fixed income. We’re very thankful that the federal government opened food stamps for everyone, but you still have to qualify. So there are certain seniors that don’t qualify for the food stamps, and food is challenging to fit in their budget. And it’s a necessity—no one should be hungry.”

Lewis says that The Altenheim staff is currently looking into starting a food assistance program in January, in conjunction with the Alameda County Community Food Bank, to provide fresh fruits, vegetables and other foods. “People are on fixed incomes and they should not have to choose paying their rent or buying food,” she says.

After chatting with Lewis, Humphreys hops back into his van, heading for a final stop near Lake Merritt before his rounds are finished for the day.


******

On June 10, Governor Gavin Newsom signed an executive order to create a statewide Master Plan for Aging, meant to help advocates and government officials plan for the booming aging population. The order states that the aging population is becoming more ethnically diverse, and that people are more likely to be single or childless and live alone, while working longer and having lower income and retirement savings.

“All older adults, and those with disabilities, should be able to choose to remain in their communities as they age, and whereas meaningful choice requires access to a broad range of public and private programs, resources, and supports, including health, homecare, food and nutrition, human services, housing and transportation,” the order states. 

The plan, which is set to be finished by October 1, 2020, will be managed by the California Health and Human Services Agency as well as a committee of advisors. While such a broad focus might seem daunting, some food policy advocates think this could be a policy window for improving access to current programs for seniors, and for filling the growing need for fresh, affordable food. “From our perspective, as anti-hunger advocates, we know that food insecurity is growing amongst older adults,” said Cannon. “And the Master Plan for Aging provides a platform to really highlight that issue and to call attention to the need for solutions and for really timely solution, because a lot of older adults, they can’t afford to wait.”

McCoy Wade said that the main driver for hunger is poverty. And since senior poverty is increasing, the pressure of ineffective care programs, combined with increasing housing and healthcare costs, has created a population of seniors that is not sufficiently served right now.  

McCoy Wade said that often, people don’t turn to state services until a crisis happens, such as a fall or a medical issue. And right now, she said it’s hard to find services—and there’s often a waiting list if you do. 

She envisions using the state’s new plan to create a better system that would be better at assisting people before they got to the crisis stage. “The Master Plan isn’t just about doing more—although the numbers certainly suggest that—but it’s also about imagining a true person-centered, coordinated care system that really helps people as they as they journey through age,” said McCoy Wade. 

She said that in November, together with staff from California Food Policy Advocates, the Department on Aging convened representatives from nutrition programs and partners in California—including food banks, CalFresh, adult day care food programs, the senior farmer’s market coupon program, and medically tailored meal programs like Project Open Hand—to look at how the programs fit together, and how they might need to expand or change.

“With seniors, you also have additional issues of getting to the grocery store, cooking and cleaning, food prep work. Even if the resources are there, the assistance is needed,” she said. “And I think that’s where I’m most excited about the opportunity the Master Plan presents.”

She said that when considering all these resources in conjunction, it’s also critical to consider how the population is changing. The state is becoming more racially  and ethnically diverse, and the population represents people with varying needs and abilities. Then, she said, they will “try to match up what supports we have” and address any gaps in between. 

After the plan is released next October, McCoy Wade said there will be a follow-up report on statewide progress delivered to the legislature every year. But it’s still not clear which oversight body will be tasked with implementing the plan.


*****

Every weekday around noon at the Downtown Oakland Senior Center, elderly people who want a nutritious meal can come get one in the cafeteria for $3.75, or however much they can afford. The lunches are brought to the center by volunteers and staff members from Spectrum Community Services, a nonprofit which assists low-income families and seniors. Around 20 people will come to any given meal, and there are a lot of regulars, according to Juan Sosa, who checks people in at the meals. Sosa says that earlier in the week, a man who comes regularly turned 100, and everyone enjoyed a birthday cake.

Sosa's photo, displayed on his iPhone, of the 100-year old man on his birthday at the Downtown Oakland Senior Center meal, with his plates of finished food in front of him.
Sosa’s photo of the 100-year old man on his birthday at the Downtown Oakland Senior Center meal, with his plates of finished food in front of him.

Each meal is planned by a registered dietician, and includes foods like tomato Florentine soup, Brussels sprouts, whole wheat pasta and salmon in a lemon caper sauce. Each meal comes with milk, and there’s always a chef salad (even a vegetarian version) if people don’t want the meal of the day. 

On a recent Friday, a table of regulars, some of whom know each other from playing bridge on afternoons during the week, are eating a Moroccan chicken dish with brown rice, salad and pineapple. They are happy to chat. “I like the meals because I think they’re good for us,” says Jean Mundy. “They have protein, carbohydrates and minerals.”

“There’s something about cooking for one person,” she continues. “It’s hard to cook well for one person. This helps us—it’s social eating with other people.”

The table of regulars. From left, Clair Styve, Marge Black and Jean Mundy. They sit with finished plates of food in front of them.
The table of regulars. From left, Clair Styve, Marge Black and Jean Mundy.

Clair Styve, who is 95 and comes to the meal every day, echoed this thought about the lunch health benefits. “The food is good for us because it’s low-fat, low-salt,” he says. When he’s not eating at the center, he says that he mostly eats prepared foods, like TV dinners. 

Juan, seated, checks people in for lunch at the Downtown Oakland Senior Center.
Juan checks people in for lunch at the Downtown Oakland Senior Center.

“I think the food is handy,” says Marge Black, who lives in Oakland. “I live alone and it’s nice to come out and have a meal prepared.”

The senior center’s program is unique, because it attacks two problems at once: hunger and social isolation among seniors. Cannon said that over the past year, she and her colleagues have spent a lot of time talking to older adults about hunger, and that it can be just one of many issues tied to living alone. “We hear all the time about the social isolation of older adults,” Cannon said. “And there’s a number of reasons for that, but as people get older, they may lose some of the support that they’ve developed throughout their lifetime.” The loss of social connections mean fewer people to bring them food, or help them access state programs like CalFresh.

Additionally, a lot of seniors have mobility challenges, which make it difficult to not only use public transportation, but also to grocery shop and cook—especially when you don’t live with other people who can help out. And then, of course, there is the problem of money. “From a lot of seniors that we spoke with, they just told us there’s not enough money,” Cannon said. “‘We have fixed incomes.’ And on top of that, they’re facing rising costs of living with those fixed incomes. So their their housing costs are going up through the roof, but yet they’re only getting a set amount per month.”

And while living alone can cause problems for seniors, so can living with dependent family members. According to a 2017 study titled “The State of Senior Hunger” from Feeding America, a nationwide network of food banks, a contributing cause of food insecurity is multi-generational households—that is, ones that must host more children and grandchildren than the elder’s income can support with consistent and nutritious food. The study concludes that 1 in 5 Americans live in a multi-generational household.

Study co-author Professor Craig Gunderson, the director of undergraduate studies in the Department of Agricultural and Consumer Economics at the University of Illinois, said that all things being equal, households that include grandchildren have higher rates of food insecurity. He said part of the reason is that these households have more mouths to feed, but that’s not the entire picture. “Another issue with this is, oftentimes, this was not planned,” Gunderson said. “In other words, these grandparents hadn’t expected to be raising grandchildren.”

Additionally, he said, governmental assistance programs are not set up to accommodate grandparents as primary caregivers. “Oftentimes, with respect to a program like SNAP, is it could be the parents are actually the ones who are listed as the caregiver for the children, even though the grandparents are providing the models of care. So…they’re not able to get extra SNAP benefits,” he said.

According to the Feeding America study, Social Security, which is a major source of income for most seniors, provides an income only slightly higher than the federal poverty line. For a single-person household in 2019, the poverty line is $12,490.

The study also points out that minority communities are much more affected by senior hunger than others. Co-author Professor James P. Ziliak, of the Center for Poverty Research at the University of Kentucky, said that controlling for income and education differences, a black person is much more likely to experience food insecurity than a white person. Their study found that food insecurity is greatest among those who are racial or ethnic minorities, those with lower incomes, younger seniors (those ages 60-69), and those who are renters.

In a letter to Governor Newsom about the Master Plan for Aging, advocates from California Food Policy Advocates made a similar point. “California’s older adults are becoming more racially and ethnically diverse and food insecurity is correlated with race and ethnicity,” their letter states. “White Americans have the lowest rates of food insecurity followed by other ethnic minorities, Latinx, and Black Americans. These communities face systemic injustices such as punitive policing, patterns of racial/ethnic segregation, and employment and earnings gaps that impact their ability to achieve wealth, prosperity, and food security.”

“I worry about it, because we’re a wealthy country,” Ziliak said. “And yet we have many people, seniors, children, adults, who are food insecure, and it just doesn’t really compute. It doesn’t make sense, right? In a country like ours, that there are so many people who are struggling with the uncertainty of whether or not they’ll have enough money to buy food for themselves and their loved ones. So, I do think it’s a substantial policy issue and one of the largest public health threats in the country.”

Part of the reason it’s a public health threat is because there are documented, significant health risks with seniors who are food insecure. 

“Those health threats are actually greatest among the senior population,” he said. “You know, they’re at greater risk of experiencing depression, heart disease, inadequate nutrition intakes, asthma.”

*****

There are already state and federal programs designed to ease hunger, but many of them are strained and not always easy for seniors to use.

One of the most important of them is CalFresh, California’s branch of SNAP, an aid program run by the federal government. SNAP provides a small food budget to recipients via an electronic benefits transfer card that functions like a debit card. It can be used at grocery stores, corner stores, farmers’ markets and other food retailers. SNAP benefits can be used for any unprepared food, or seeds and plants to grow food. However, they cannot be used to purchase any hot food or restaurant food. This represents an additional hurdle for elderly people who may lack the necessary access to a kitchen, or the mobility to prepare foods that they enjoy and wish to eat.

For seniors, using the online or mobile forms can be a barrier to enrolling, said Cannon. And, if they have trouble enrolling online, the paper form is 18 pages long, which also deters people. Making the process more accessible to seniors, and helping them enroll, is a goal, she said.

Cannon said that the existing programs are also currently under attack by the Trump administration. “So in the last year alone, the Trump administration has come out with three proposals to cut Americans and Californians off from the food assistance that’s made available through SNAP,” she said. “And there are at least two of those three proposals that would directly harm older adults and people with disabilities.”

The most recent change, proposed in October, could change how SNAP eligibility is calculated, specifically the limits that determine how much a recipient can spend on their utilities bill. A person’s benefit level is currently calculated by factoring in their household’s income and housing costs, among other variables. A change affecting this calculation could potentially cut access to one quarter of Californians

Another recently-proposed rule, introduced in July, would remove what’s called “categorical eligibility.” As the rule stands, people who are eligible for Temporary Assistance for Needy Families (TANF)—a grant program that provides time-limited funds for families who are struggling to pay for basic needs—automatically receive SNAP benefits. This rule would remove their access to SNAP.

A third change, which was introduced in December, 2018, proposed increasing the job requirement. Able-bodied adults without children or dependents who cannot find and keep part-time work will no longer be able to use SNAP. The rule would revoke a time limit waiver for getting a job, which previously existed in regions where unemployment is over 10 percent, or where there are not a sufficient number of jobs.

Beyond CalFresh, there are other federal programs to assist seniors facing food insecurity. These include The California Department of Aging’s Congregate Nutrition Program, which funds sites to hold communal meals, and their Home-Delivered Nutrition Program, which provides funding for food delivery to homebound seniors. 

The Senior Farmers Market Nutrition program, while praised by experts for existing, only provides $20 a year—38 cents per week—for seniors to spend at local markets.

Ziliak said that he sees increasing SNAP benefits as a solution to senior hunger. “The most important thing that I would recommend would be to make SNAP benefits more generous,” Ziliak said. “You know, really increase that benefit levels, which will have implications for seniors, of course, but also have implications for the broader population. And so given that SNAP is such a successful program, by building on that success, rather than creating something brand new, is really the most effective way to do this.”

Gunderson agreed that increasing SNAP—and expanding its participation rates—is a solution. He said that thinking about how the benefit can be tailored to seniors is also important, including potentially allowing it to be used for food delivery. “That could be really valuable to seniors, right? Because they might be able to cook for themselves, but getting to the grocery could be a real challenge,” he said. 

*****

On a Friday afternoon in the basement of the Mercy Care and Retirement Center in Oakland, dozens of elderly volunteers are packing tomatoes, celery, and canned goods into brown paper bags. They hand these bags, one at a time, to the people who have lined up at the basement’s entrance. The line has over 50 people, and wraps all around the building. A balding man in his 80s with a scruffy grey beard sits at the end of the line with a wooden walking stick—he’s a dedicated volunteer serving line control duty today, and he’s happy to help these people get their food.

Krista Lucchesi, the Brown Bag Program coordinator at the retirement center, walks around to check in with the baggers. For the past 13 years, she has coordinated senior volunteers to package bags of groceries containing fresh fruit and vegetables, along with other canned foods and dry goods, for other seniors to pick up from Mercy. She cheerfully greets the volunteers and people in line, many of whom she has known for over a decade. 

The food that Mercy packages and hands off comes from both the Alameda County Community Food Bank and private donors. In addition to serving people at the retirement center, they also do food deliveries and host distribution events around the Bay Area.

“Our motto is ‘seniors helping seniors,’ and, honestly, the volunteering is probably just as beneficial to their health as the grocery and the nutrition piece,” Lucchesi says. She points out that many of her volunteers have been doing it for more than a decade. In fact, she says, “We’ve had people that volunteered for over 30 years, which is crazy, because they were already retired when they started and they still just keep going.”

Lucchesi said that she thinks of their program as one of the “three legs of a stool” that support hungry seniors: the delivery service Meals on Wheels, communal meals like the one at the Downtown Oakland Senior Center, and directly providing groceries, which is what the brown bag program does. During her time here, she said that the demand for food has skyrocketed. When she started, she was providing food for 2,200 people per month. Now, it’s nearly 6,000 people.

When asked about why more Oakland seniors are experiencing hunger, she said, “Gentrification is a big piece of it. So that has pushed the prices of housing up. And just the cost of living in general, of course, that they are making decisions about ‘Should I take my meds or eat?’ And if the meds say you have to do it with food, what are you going to do? Because either way you’re going to get sick.”

One volunteer at Mercy is Hope, who is 95 and has been volunteering for 25 years. On that day, she was packing bags with tomatoes. Hope was born in China and she said that when she was growing up there, her family was very poor, and couldn’t afford food. “We only had soups,” she said. “And just bread.”

Hope seated in the basement of the Mercy center. Behind her are boxes of tomatoes.
Hope seated in the basement of the Mercy center. Behind her are boxes of tomatoes.

She says that now that her own children are grown and off at work, she has no more responsibilities and that she loves helping other people have food. “I’m enjoying doing everything,” she says.

After Hope completes her shift packing bags, she sticks around in the basement. She looks over the bags she had packed with delight. Then she walks away for a moment. When she returns, she has a handful of Slim Jims. She places one in each bag—an extra treat for someone.

Rose packs a Slim Jim into brown bags in the basement of the Mercy Retirement and Care Center.
Hope packs a Slim Jim into brown bags in the basement of the Mercy Retirement and Care Center.

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