By 2050, more than one-fifth of the U.S. population will be 65 years or older, compared to 15.6 percent today. A recent study by Statista cites that, despite the rapidly growing population of seniors, the U.S. only has 19,000 not-for-profit senior living units and 1.7 million licensed beds, as of 2016. The national average cost for assisted living is $4,000 a month; however, when it comes to a senior living facility with 24-hour care for those with Alzheimer’s disease or a disability, that number jumps to upward of $7,000 a month, depending on the state.
Self-Help for the Elderly is a nonprofit organization that began serving low-income seniors in 1966 as part of President Lyndon B. Johnson’s “War on Poverty” initiative. With humble beginnings in San Francisco’s Chinatown, the facility has since grown to serve more than 40,000 older adults annually across San Francisco, San Mateo, San Jose, Santa Clara and Alameda counties in Northern California.
“At that time, Chinatown was suffering from the highest poverty range,” says Anni Chung, president and CEO of Self-Help for the Elderly. “The neighborhood also had the highest senior suicide rate among immigrants because of poverty that was compounded by our country’s immigration reform, lack of formal education and lack of basic training for employment.”
For one Chinatown resident named Eugene, Self-Help for the Elderly wasn’t just a senior care facility. The place and the staff there were his lifeline. Eugene, who was in his 80s, didn’t have many family members and only spoke intermittently with his aunt who lived further away. Luckily, he lived close to Self-Help for the Elderly in Chinatown and went regularly not only to receive their services, but to also have meaningful human interaction. One day, Eugene stopped coming. The staff went to check on him and found that his foot was injured and badly infected. Eugene was unable to walk, and the staff at Self-Help for the Elderly took extra time to continue visiting Eugene with food, aid and care for seven months until he passed away.
“It was really sad to see him go, but he let us know just how grateful he was for the daily attention and care he received from our staff,” says Chung. To commemorate Eugene, his aunt and the staff throw a get-together every year on Valentine’s Day.
Self-Help for the Elderly has been working to promote the independence, well-being and dignity of elders through the organization’s many programs and services. “I think our uniqueness is our comprehensive range of services,” says Chung. “Usually, a lot of senior organizations offer just maybe one to three selective services, such as providing safe nutritious meals, or medical care, or senior housing and activities—but we're special.” By special, she means that Self-Help for the Elderly goes above and beyond in hopes that their seniors to achieve independence.
“I think our uniqueness is our comprehensive range of services. Usually, a lot of senior organizations offer just maybe one to three selective services…but we’re special.”
From adult day care and hospice care, to job-training programs and meal deliveries, Self-Help for the Elderly designed their services around helping seniors become more self-sufficient. Being multilingual and multicultural also means that they are able to help typically underserved minority groups as well.
“When the Chinese started to immigrate in large numbers to the San Francisco area, many of them were already 50 years or older. They couldn’t find a new job right away, they couldn’t speak English, and many didn’t have transferable skills,” says Chung. “We realized that the most meaningful way to help was to teach them work skills and help them secure jobs, so we actually provided licensed employment training for them to acquire skills to become things like home health aides.”
In addition to their unique employment training services, Self-Help for the Elderly provides senior living services for half the cost of the market rate. “We already anticipated the growth of San Francisco’s aging population, and sure enough, more than 25 percent is now over the age of 60, many of whom are also disabled,” says Chung. “So, with that information, we established a private public facility together with the Mayor’s Office of Housing and Community Development to renovate a Victorian-style house that’s now an affordable senior living facility that provides 24-hour care.”
The wait list for their senior living service is long, and while Chung would like to expand the facility and provide more room for boarding, she admits that the whole endeavor is costly. “Unlike other programs like nutrition or in-home support that allow reimbursement from Medicare for low-income seniors, there’s zero government subsidy for assisted living and residential care,” she says.
With the COVID-19 pandemic in full swing by March, Self-Help for the Elderly, which relies heavily on donations and volunteer services, quickly found itself strapped for cash and manpower.
“They were really afraid of running out of funding for their community programs and knew the SBA [Paycheck Protection Program] was what they needed immediately for funding,” says Sanford Lau, senior vice president and team manager of commercial real estate banking at East West Bank. “After working through their documentation for a few days, we were able to gain approval and fund their PPP loan by the following Monday. We wanted them to maintain all of their programs and staff because we understood how much the organization meant to the community.”
Without income or funding, on March 17 Chung made the decision to shut down all their programs except for homecare hospice and the 24-hour senior living facility. Despite pausing the programs, Chung was also determined to keep workers on payroll and keep them employed.
“We’ve grown over the years, and today, we have about 271 employees—that amounts to about $1.5 million on our payroll,” says Chung. Because many of Self-Help for the Elderly’s programs involve group activities or visiting senior homes to help with things such as cooking and cleaning, the pandemic effectively wiped out 80 percent of the work that their employees had been doing.
“If we hadn’t gotten the PPP loan, I think I would have had to lay off about 100 workers,” says Chung. Most of her workers are also older and would likely not be able to find new jobs during the pandemic.
“If we hadn’t gotten the PPP loan, I think I would have had to lay off about 100 workers. We also serve 5,000 low-income seniors every day by sending home-delivered meals."
“We also serve 5,000 low-income seniors every day by sending home-delivered meals,” says Chung. “With this pandemic and how it affects seniors, we knew that our home-delivery meals were a lifeline to many of these seniors, and I really didn’t want to pause this service.”
Cooking and delivering meals to 5,000 seniors is a costly and labor-intensive task. In addition, with the threat of COVID-19, Chung was also required to provide all employees and volunteers with the appropriate PPE attire. “This really ate up so much money,” says Chung. “Everything from the gloves, masks, caps and aprons cost us thousands of dollars on a weekly basis, and we kept going through them so quickly.” To try and continue the service, Chung organized many fundraisers, asked for donations and asked the California Department of Aging for funding.
In a last-ditch effort, Chung called Travis Kiyota, senior vice president and head of global policy and public affairs at East West Bank. “I was desperate and scared of running out of cash. The team at East West Bank moved quickly, and the next day, we worked on and submitted the PPP loan application with the help of Sanford and his team. We were approved just in the nick of time, and it was such a breath of fresh air,” recalls Chung. With the PPP loan, Chung has been able to continue paying all her employees and deliver meals to seniors.
“I am just so grateful for East West Bank, and also very grateful for the many volunteers who continued to show up,” says Chung. Even in the midst of the pandemic, she says about 350 volunteers came on-site to help cook and prepare the meals. She had also contacted many Lyft and Uber drivers who also willingly volunteered to deliver those meals.
With many senior care facilities being discussed on the news as epicenters for breakouts of COVID-19, Chung and her team used extra precautions to ensure that no one was infected or contagious. “We’ve been watching all three of our senior facilities like hawks,” says Chung, “and as soon as the shelter-in-place was enforced, we stopped allowing outside visitors to come in.”
All staff at Self-Help for the Elderly were tested for COVID-19 before going to work and were also given strict training on new rules, cleaning practices and health checks for their patients. All facilities have also incorporated temperature tracking to ensure that no one has a fever when entering the premise. “They’re the gatekeepers, so we have to make sure that, first and foremost, our own employees are healthy and able to assist our seniors responsibly,” Chung says.
In addition to the testing and training, all staff and volunteers are provided fresh PPE daily. “We’ve been very lucky in being able to provide all the necessary protective equipment consistently,” says Chung, “and we’ve been even luckier that no one on or around our facilities has tested positive for COVID-19.”
Chung also believes that because most of the seniors and employees at Self-Help for the Elderly are Asian American, many are already comfortable wearing masks. “We actually mandated that all of our staff wear face masks before it was even lawfully required,” says Chung.
While the threat of COVID-19 is still very real today, Chung is optimistic that things will get better, especially with the development of a vaccine. “Knock on wood that everyone will continue to test negative, and we’ll keep doing what we do best,” she says. “Our immediate next step is to partner with a hospital and effectively test all of the senior residents in our facilities for COVID-19.”
When asked how tired she is with the intensified workload, fundraising, training, cleaning and testing required, Chung laughs it off. “Whenever I hand-deliver a meal to one of these seniors, and I see them smile,” she says, “it makes it all worth it.”
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