Hawaii’s population is aging faster than the national average and has the longest life expectancy in the nation. By 2025, 20% of Hawaii’s projected 1.4 million population will be 65 years of age and over, and at the same time, its oldest-old population (aged 85 and over) will exceed 36,000 (an increase from 25,000 in 2008) (U.S. Census Bureau, 2005). Of the state total, approximately 995,000 will reside on Oahu, with about 199,000 age 65 and older. The “aging tsunami” has profound implications for public policy and for every institution in our society.
KIRK CALDWELL’S 7 POINT SENIOR INITIATIVE
DESIGNATE general funds to direct services for senior citizens. Honolulu is the only county in the state that does not allocate funds for direct services to residents over the age of 60.
The Honolulu Elderly Affairs Division, which falls under the City Department of Community Service, was budgeted just under $8.24M for expenses in FY13. Of this amount, only $473,094 comes from the City’s General Fund; the rest is funded Federally or by the State. The City’s contribution to EAD’s budget covers less than half of the division’s salaries alone ($1,057,092).1 In addition to overseeing the Federal and State contracts providing direct services to seniors, EAD is primarily tasked with providing information regarding elder care and services to the general public as well referrals.
Despite encompassing more than double the number of seniors in Maui, Hawaii, and Kauai Counties combined, Honolulu allocates no money from its General Fund to provide direct services to seniors. In comparison, Maui spends $130 per senior per year on direct services; Hawaii, $60; Kauai, $21.
Direct services typically include home-and community-based services including bathing assistance, home-delivered meals, companion services, and prescription drug delivery. Honolulu does provide other direct services paid for by state and federal money, including transportation and recreation.
SECURE additional funds to better serve senior citizens for instance the federally-administered Community Development Block Grant Program.
CDBG funds can be used for public services for income-eligible participants, such as senior meals, renovating senior and youth centers, rehabilitating existing housing units, and funding fair housing and homeownership initiatives.
CONVENE a “Senior Summit” –an opportunity for non-profits, service providers, county agencies, Federal and State officials, and relevant experts to discuss how the City can better serve the needs of its senior citizens.
This frank and inclusive dialogue would aim to produce a detailed 120-day action plan including specific funding requests, structural changes, and full implementation of the Aging and Disability Resource Center. Invitees would include the AARP of Hawaii, the Police Advisory Board of Elder Affairs, the Hawaii Family Caregiver Coalition, the Kokua Council, the Honolulu Committee on Aging, and the Hawaii Alliance of Retired Americans.
Senior summits have been organized elsewhere in the country on both the county level and by members of the public. Ventura County, California, has held an annual summit for the past three years that is structured into separate components for the general public and geriatric healthcare professionals. Baltimore is home to a Senior Life Leadership Summit that is organized by an alliance of non-profits and paid for with sponsorships; according to its website, the summit is targeted at “developers and managers of affordable housing, providers of aging services, funders, advocates, and policy leaders… as well as regionally-based representatives of public and private organizations that support seniors needs and interests, such as public transportation, libraries, community colleges, health care systems, and senior advocacy organizations.”
FAST-TRACK an effective response to the pedestrian fatality crisis. Pedestrian safety is a critical issue for Honolulu’s seniors. Hawaii consistently leads the rest of the nation in fatalities among senior-aged pedestrians.
Numerous figures from multiple federal agencies illustrate that Hawaii is and has consistently been one of the worst states in the nation at pedestrian safety. In 2010, Hawaii ranked sixth in the nation in pedestrian fatalities per capita; Honolulu accounted for nineteen of those twenty-six deaths.7 The numbers become even grimmer when limited to seniors: between 2001 to 2005, the number of pedestrian fatalities per capita among residents over the age of 65 was nearly three times that of the rest of the nation (40.2 deaths/100,000 senior-aged residents vs. 14.1).
While there has been a positive nationwide trend in reducing traffic fatalities, Hawaii remains an outlier. Thirty-one states, as well as the District of Columbia and Puerto Rico, were successful in reducing traffic fatalities in 2010 from the previous year. Hawaii, however, experienced a 3.7% increase in traffic fatalities during the same period, suggesting that current traffic safety measures are failing to produce positive results.
Traffic safety reform must be systematic; token or one-off efforts have and will continue to fail to result in long-term improvements. Enforcement of traffic laws, maintenance and improvement of infrastructure, and better public education are all necessary, as well as effective oversight. Of particular interest is Montgomery County, Maryland, which has reduced its pedestrian collision rate from 46.7/100,000 residents to 40.1 between the years of 2005 and 2011. The decrease is believed to be due in large part to the 2007 introduction of an aggressive pedestrian safety initiative spearheaded by the County Executive, focusing on the improvement of the “three E’s” of education, enforcement, and engineering. Montgomery County saw marked improvements in both pedestrian and driver safety in its targeted High Incidence Areas, in locations with modern infrastructure improvements, and particularly around schools.
While better safety education and enforcement of traffic laws would certainly reduce Honolulu’s pedestrian fatalities, the most substantial innovations have been those in the area of engineering. So-called “smart street” or “traffic calming” enhancements have been shown to dramatically increase pedestrian safety by reducing both speed and vehicle delays; these measures include traffic synchronization, deployment of roundabouts, pedestrian refuge islands and medians, extended turn bays, consolidating driveways, separation of traffic lanes at intersections, bump-outs and curb extensions, designated turn lanes and turn prohibitions, chokers, enhanced signage and lighting, reversible traffic lanes, and speed bumps.
A big part of the answer lies in implementing the “COMPLETE STREETS PROGRAM”
Pedestrian safety and building safer crosswalks are part of a new movement across the country called “COMPLETE STREETS”. It is about making streets safe, accessible and attractive for all users (vehicle drivers, pedestrians, bicyclists and persons of all ages.) It includes maintenance, new construction, and reconstruction of our streets. The goal is to create livable cities that provide opportunities to drive, walk and bike in an attractive, green environment.
HELP seniors “age in place”.
As retirement planning and elder care become issues for a growing number of Honolulu residents, the City will find itself increasingly motivated to facilitate aging in place. City agencies should make accommodations for such instances, such as fast-tracking home improvements that allow accessibility for seniors and the disabled.
REENERGIZE and refocus the Elder Affairs Division.
The next Mayor must make it a priority to re-energize and refocus the Elder Affairs Division, first by providing administrative support to the EAD from the City’s fiscal and personnel offices and, second, by requiring the EAD to prepare a Strategic Plan. The Plan the EAD uses to secure federal funding is not sufficient, primarily because its focus is on service provision. A Strategic Plan would have a broader mandate and, when executed properly, would serve as a guide as to EAD’s role in the community, its relationship with service providers, its functionality within the City government and its relationship with the State’s Executive Office on Aging.
EMBED Aging Issues across all City Departments.
Sooner or later, the Mayor must embed aging issues across all City Departments and this includes designating EAD as the Lead Agency for this issue set. As Mayor, Kirk would place a priority on such issues as aging homeless, housing/HUD issues facing residents with dementia, solutions for EMS when dealing with “frequent flyers” and programs for the Fire Department relating to emergency preparedness.