Marin needs to prioritize services for older residents, study says

Feb. 15—A new study designed to improve services for older residents in Marin recommends that the county create a division focused on aging and disability.

The $125,000 study conducted by Githens & Associates was commissioned by Marin County supervisors last year. Githens was tasked with reviewing the county's services and programs and determining what changes might best improve them.

The top recommendation is the creation of a new division of aging within the Department of Health and Human Services. Its director would join the department's executive team, which includes Marin's public health officer and the heads of three divisions focused on social services, behavioral health and homelessness.

"Because of aging and adult services' position in the administrative hierarchy, it is harder to advance an aging lens across the county," said Rod Githens, the founder of Githens & Associates, told supervisors at a meeting on Feb. 7. "It is currently at a pretty low level in the organizational chart under social services within Health and Human Services."

Githens said that besides the sheer size of Marin's senior population, there are several compelling reasons for the county to rethink how it delivers services to older adults. The first is the number of Marin residents projected to develop Alzheimer's disease or other forms of age-related dementia.

A University of California at San Francisco study cited in the report estimates that among baby boomers who live to be 65, one in six will develop Alzheimer's disease and one in five will develop dementia. UCSF researchers estimate that 14,205 Marin residents born between 1946 and 1964 will develop dementia during their lifetimes.

"There are really severe implications for how Marin is going to be positioned to provide safety net services," Githens said.

According to the study, another big change on the way is the racial makeup of Marin's older adult population. The number of Latino older adults is projected to increase 518% between 2010 and 2040. White residents have a per capita income that is 288% of the income of Latino residents. So Marin's future senior population will have fewer financial resources from which to draw.

The study states that even today many seniors in Marin are struggling financially.

"There is a stereotype that older adults are wealthy in Marin County," Githens said. "That is not true and it has implications for decisions that are made on the ground. A little known fact is that 25% of the current older adult population in Marin is low income."

Teri Dowling, who heads the steering committee of Marin's Aging Action Initiative, urged county supervisors to embrace the recommendations. Dowling said that 29% of the county's residents are over the age of 60 and by 2030 that number will increase to 38%. The biggest increase will occur among those over age 85.

Many of the findings in the study were echoed by others.

"Low-income seniors are an invisible group in Marin," said Meredith Parnell, director of homelessness prevention for St. Vincent de Paul Society of Marin. "The fact is that low-income seniors are falling into homelessness every day in Marin."

Parnell said the county's "point in time" count conducted in February 2022 reported 280 adults ages 60 and over experiencing homelessness, 80% of whom were unsheltered.

"At St. Vincent's, we know of at least 100 older residents who are living in their cars," Parnell said.

In addition to elevating the status of aging services within the Department of Health and Human Services, the study recommends four other major changes.

It suggests paying a premium of 15% for aging services provided in rural Marin because of staffing challenges, challenges in securing volunteers and the distances between clients. The study also recommends prioritizing two or three organizational changes to enhance the well-being of older adults each year and the hiring of a permanent staff member to spearhead the effort.

The study advocates for the county to improve its navigation system for guiding residents to all types of social services provided by the county, including those for older adults. It also recommends that the county develop more consistent messaging about its various change initiatives underway.

While these were the study's top recommendations, other lower-ranked options included. For example, one involved addressing discrimination against people based on their age or disability.

"It is essential that you move forward to address ageism," said Diane Lopez, who heads Marin's Commission on Aging. "It is a socially accepted form of prejudice, the most pernicious but least acknowledged."

Several supervisors mentioned the need to evaluate the costs of implementing any of the recommendations.

"I'd like the discussion about the division to be examined a little further," said Supervisor Dennis Rodoni. "I think we need to untangle the funding sources and the programs that are associated with creating a division. I do think it is important that we try not to commit the general fund ongoing to support this division change."

Supervisor Katie Rice said, "I think we really need to understand where funding is coming from and what the specific funding mandates are."

Supervisor Eric Lucan also said he is concerned about the potential costs.

Supervisor Mary Sackett said she is interested in giving aging services a seat at the Department of Health and Human Services executive table for a six- to 12-month pilot trial.

Benita McLarin, director of the department, did not comment during the meeting.

In an email, McLarin said, "We will also be evaluating the recommendation for structural change to ensure that any change we make improves our ability to provide services and maintains state and federal revenues for vital county services."

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