Myung Lee Provides Testimony at City Council Hearing on "COVID and Seniors"
Below is the written testimony provided by Myung J. Lee, President & CEO, Volunteers of America-Greater New York to NYC Council Committee staff, Committee members, and other Council members.
Committee on Health Jointly with the Committee on Aging and Committee on Technology
Oversight – "COVID-19 & Seniors: Addressing Equity, Access to the Vaccine & Scheduling Vaccination Appointments Online in NYC"
Wednesday, February 17, 2021
Good morning, my name is Myung Lee and I am the President & CEO of Volunteers of America-Greater New York, the local affiliate of the national organization, Volunteers of America, Inc. (VOA). VOA-Greater New York is a human services organization that serves nine special needs populations through 80 programs in all five boroughs of NYC, Westchester County and Northern New Jersey, including homeless individuals and families, veterans, those recovering from domestic violence and the poor elderly. Annually, we provide housing—transitional, emergency and permanent, supportive programs—to 11,000 New Yorkers.
Next month VOA will celebrate its 125th anniversary, which is particularly meaningful for us here in New York as it was on March 8, 1896 on the steps of The Cooper Union that VOA co-founders Maud and Ballington Booth announced the birth of their new organization with a mission to reach and uplift the most vulnerable among us.
We have much to be proud of, having stayed true to our founders’ mission to identify the community’s most pressing social needs and, if it is determined that we have the right experience, relationships, and resources to address them, created programs to do so. When the AIDS epidemic struck, we were one of the first to offer a congregate living program for those living with HIV/AIDS. At the peak of veteran street homelessness we were involved in the effort to reduce veteran homelessness to functional zero and today are the largest provider of permanent supportive housing in NYC for this population. More recently, recognizing that people recovering from domestic violence need more than six months in emergency shelter in which to heal, and that their significant mental health issues must be addressed using a trauma-informed approach, we will soon be offering two Tier II domestic violence housing programs.
As for today’s topic, COVID-19 and Seniors: Addressing Equity, Access to the Vaccine, and Scheduling Vaccination Appointments Online in NYC, I would like to thank City Council and Committee Chairpersons Mark Levine, Margaret Chin and Robert Holden, for holding this hearing and allowing VOA-Greater New York, and others who work with older adults, to participate. It is an honor to be able to share our experience of the needs and fears of NYC’s poor seniors during the COVID crisis, and what we as an organization do every day—escalated, of course, in response to the needs that became manifest during the pandemic—to ensure the safety and dignity of this vulnerable population. In New York City, VOA-Greater New York has one permanent supportive housing residence for 92 formerly homeless older adults on East 12th Street in Manhattan. Another 2,000 older adults live in our other housing programs – mainly SROs – throughout the five boroughs, but these are not programs dedicated to older adults.
Let me first say that VOA-Greater New York is and has been concerned about the needs of the poor elderly as their numbers grow, as they age in place often without the access to the support they need, and as their vulnerability is magnified by the critical lack of supportive, affordable housing. On any given day there are approximately 1,200 older adults sleeping in a NYC homeless shelter, with an estimated 3,200 at risk of homelessness. Demand for adequate, subsidized, supportive housing for seniors, particularly in NYC, far surpasses supply. Compounding this imbalance, the city’s senior population is expected to increase to over 1.4 million by 2040.
In response to both realities—the aging population and lack of adequate housing—VOA-Greater New York is committed to developing affordable, purpose-built housing for seniors. East Clarke Place Senior Residence (East Clarke Place) in the Concourse Village section of the Bronx (in CD 4), designed entirely with the needs of older adults in mind, is set to welcome its first tenants in early March of this year. The 14-story building has 122 studio and one-bedroom units. Thirty-seven of those units are reserved for chronically homeless older adults who will move into fully-furnished, accessible studio apartments with all the services they need to stay permanently housed, safe and connected to a caring community. A full time live-in super has one unit, and the remaining 84 will be filled by lottery – applicants will need to meet age and low-income requirements. No one will pay more than 30% of his or her income toward housing.
To understand the magnitude of the need for housing for low-income older adults, for those 84 community units, we received 26,000 applications including 200 handwritten ones. Considering that many older adults do not have a computer or smart phone, are afraid or unable to leave their homes during the pandemic to access a public library computer or, in many cases, do not know how to use the technology required to find and complete a housing application, imagine how many more eligible individuals are out there who did not apply. We have a second development process, similar to East Clarke Place, to open in 2023 and another in concept stage.
Our city’s poor older adults live in inadequate housing. Many are climbing flights of stairs in buildings with no elevators to arrive in apartments with spotty hot water and heat. They often live alone without family or friends or any support system and must choose between purchasing food and paying for other essentials. They often are afraid to venture outside – or are unable to do so - and are at risk of social isolation—made worse by the current global crisis. If they are not officially, they are essentially, homebound, many by physical barriers and others by psychological ones.
VOA-Greater New York’s Care of Seniors During COVID
At VOA-Greater New York, as our longtime residents age, their needs become more complex and we do our best to meet them, keeping them in the community as long as we possibly can. During COVID, staff continued to show up and to meet the demand for even closer attention to the needs of our clients, particularly our older adults. In general our older adults have fared well during the pandemic. They looked to staff for guidance and expressed gratitude for the care we took to keep them safe, pleased to see staff sanitizing all public and high-touch areas like doorknobs and railings, several times throughout the day.
When Community Centers and other usual sources for meals abruptly closed, we lined up alternate food resources as quickly as possible and, in the meantime, filled the programs’ on-site food pantries with non-perishable food items for clients who needed immediate help. We also turned to community partners with whom we had strong relationships—or they came to us—as in the case of Bronx Community Board 9. CB9 has a wonderful relationship with Commonwealth Veterans Residence and became a great source of support during the pandemic providing toiletries and non-perishables on a consistent basis, supplying groceries to veterans independent enough to cook for themselves, and connecting Commonwealth to RAP4BX, a non-profit that recruits local restaurants to provide meals, resulting in delivery of 300 meals three times a week.
Many of our older adults were fearful of going out and indeed, we preferred that they stay in, so staff ran errands, helped them call grocery stores for home deliveries, and made sure we knew which of our older adults might need help but were too proud to ask. Our External Relations Department secured thousands of books, puzzles and other activities that staff brought to tenants, in an effort to keep them occupied, socially distanced but not isolated.
Concerned about missed medical appointments with, for instance, podiatrists since foot care is so important for older adults, one of our larger SROs had a medical service come on-site to address foot issues and fitting of special shoes. We reached out to a number of licensed home health care agencies and brought in home health aides and various other services to assist our older adults. We helped convert in-person medical appointments to tele-health ones when possible—though a lack of technology, specifically tablets with which to visit clients in their units, made (and still makes) that very challenging. Corporate partners like PCSWireless responded to our request for tablets and quickly sent a dozen specifically for our older adults to use in the form of a “lending library,” but we need hundreds more.
Large donations of PPE were gratefully accepted, and we distributed them to clients as well as staff, but we still had (and have) huge amounts of cleaning supplies and PPE to purchase. We made sure that tenants were regularly updated on new CDC and other government health guidelines and had copious amounts of signage posted. We established a rule that allowed no visitors on-site. While this posed a risk for social isolation and there was some resistance to this policy, others were grateful that we implemented and maintained this safety protocol.
We maintain a Wellness List at every program, comprised of clients who agree to allow us to check on them daily. During COVID we expanded that to two daily check-ins for those on the list, and a check-in every two days for those not on the list. Even residents staying offsite with family members or friends and only return to the program to pay their rent check receive a check-in call from staff every two days just to maintain contact and to check on their health. When a tenant did become ill and was ordered by their physician to self-quarantine, we made it possible for them to do so, relieving them of as much worry as we could. If they were sharing a bathroom, we provided them with one of their own, delivered meals to their door, and ran any errands they needed us to run. We were the family they did not have or could not see during COVID-19. Clients expressed appreciation for the honesty and confidence staff conveyed that we would make it through this as long as everyone—clients and staff—as a community, complied with our written and verbal instructions for social distancing, using PPE properly, quarantining if infection was suspected, and most recently, taking the vaccine when available. The latter – taking the vaccine - is where we have fallen short through no fault of our own.
Getting the COVID-19 Vaccine
Now that the vaccine is becoming more available, we have launched a comprehensive marketing campaign at each of our program sites to encourage all eligible staff and clients to take it: colorful posters dispel the myths; “Ask Me” posters feature a staff member who has received the vaccine and is willing to talk about his/her experience; “I got the vaccine.” buttons are given to those who have taken the vaccine. But we are finding the problem is as much about concrete practicalities as it is about fear or resistance. Most of our older adults do not have smart phones or other technology that would allow them to go online to book a vaccine appointment.
The majority of our seniors, most of whom are formerly homeless, have co-morbidities and many have mobility issues. During winter in particular, with the danger posed by icy sidewalks, gusty winds and cold temperatures, our older adults simply cannot go outdoors unattended. The vast majority of our programs do not have vehicles with which to provide transportation and during COVID it would not be safe to bundle several of our seniors into a van even if we had the vehicles. To counter these constraints, if we are to vaccinate the majority of our seniors against COVID-19 we must bring the vaccine to our program sites. It is simply impractical, as well as dangerous, to expect our seniors to venture out to get the vaccine.
At VOA-Greater New York, we ask ourselves all the time, what would our clients – those with complex underlying issues, are homebound, the elderly, those without the wherewithal to ask for help let alone keep themselves safe during these COVID times – have done if they lived alone, if they didn’t have someone like us?
Ms. Albert (age 64), Webster House SRO
Ms. Albert is a survivor of childhood sexual abuse. She has a significant mental health diagnosis, history of substance use and a 10-year history of homelessness starting when she left an abusive husband. Ms. Albert worked for eight years as a NYPD attendant. She has been at Webster House for seven years. She has maintained sobriety for fifteen years and is described by staff as a shy but humorous person who will run errands for her less mobile neighbors. During COVID her apartment flooded and ruined her small television. After three months of attempting to manage without a TV, occupying herself on her own while staying indoors and social distancing due to COVID, Ms. Albert finally asked staff for help. With limited funds she was struggling to find ways to fill her time and was concerned for her sobriety. Staff understood this and, when another resident was moving out of the program and had indicated that she’d purchased a new television, staff asked if she would donate the old one to Ms. Albert. In mid-January of 2021 Ms. Albert received her new (gently used) television and was thrilled.
Mr. H (age 74), Webster House SRO
Early on in the pandemic, Mr. H, a veteran, contracted COVID-19. His symptoms were severe and he was sent to the Comfort Navy ship stationed at Pier 90. He has since made a full recovery, but upon his return to Webster House was weak. Staff were concerned about his ability to prepare meals for himself, so they arranged for Meals on Wheels and another meal service to deliver. While Mr. H did reluctantly accept this help, staff wanted to initiate home care services as well, but this veteran, who is ferociously independent, adamantly refused. He has been doing very well since being back at Webster and appears to have no lingering effects from COVID-19, but staff continue to watch him closely—from afar!
John (age 70s), East 12th Street Senior Residence SRO
John struggles with keeping his unit clean, and for years resisted help from staff. Adult Protective Services (APD) had been brought in which resulted in only semi-yearly thorough cleanings, shortly after which John’s unit would again fail the monthly SRO room inspection. His Case Manager spent many hours encouraging this proud man to accept a home health aide, but to no avail, insisting he could manage and making it clear his ethnicity and culture dictated that he did not accept help, that he could care for himself. Finally, with the Case Manager’s non-judgmental urging and the Program Director’s more direct approach, they convinced John that he had earned the right at his advanced age to receive services and that there was no shame in this. Quickly, staff got John recertified for Medicaid so he could qualify for long term home health care assistance. John eventually embraced the idea of the attendant helping with his housekeeping challenges as well as daily errands. In fact, John appears to have a good rapport with Nicole, his home health aide, who is there three days a week for four hours a day. John’s room now passes inspection every time. Nicole meets with John’s case manager bi-monthly to keep staff apprised of any issues or his changing needs.
Mr. E (age 60), Rose House SRO
In the early days of COVID-19 when all was new and scary, Rose House had a tenant, Mr. E, who became very ill and repeatedly went by ambulance to the emergency room. Each time he was discharged back to Rose House to recover. Mr. E was extremely frightened, fearing he had COVID, and, as staff learned more about the virus’s presenting symptoms, suspected that this gentleman, although not formally diagnosed, likely did have it. Staff erred on the side of caution and asked Mr. E to isolate in his room and use a separate bathroom reserved only for him. Staff checked on him daily and supplied him with PPE and lined up a food delivery service through the NYC food program. Before the food service began, the tenant made a special request for homemade chicken soup from his favorite takeout place and staff picked it up for him. They also made runs to the pharmacy and ran any other errands needed to make him more comfortable, both physically and emotionally. He overcame his illness and has been doing well. Since that experience he is much more engaged with staff and expressed—for the first time since he’s lived at Rose—how appreciative he is to be here and how grateful he is to have been supported during one of his most vulnerable and difficult times.
What we need from the City:
- On-Site COVID-19 Vaccines and Testing: Mobile units are needed to bring the vaccine on-site since many of our clients are unable to travel (to Yankee Stadium, the Javits Center, or other boroughs) and are, essentially or actually, homebound. It is simply impractical, as well as dangerous, not to bring the vaccine to them.
- COVID-19 Vaccine Education: A significant number of our older adults are reluctant to get the vaccine. We need healthcare professionals to come on-site ahead of time to tell individuals of its safety.
- Technology: We need smart phones and/or tablets to bring to clients for tele-health and other medical appointments, and to keep those at risk of depression and social isolation, connected to family.
- Affordable Housing: We need many more affordable, supportive housing units, appropriate for seniors, as our SROs become, for all intents and purposes, NORCs.