For several decades there is a trend of downsizing the federal role in social services and social work, to return power to the states in the form of different grants, and to increase reliance on the market as a solution to problems. Today, local agencies play a key role in helping older adults cope with decreasing funding from federal programs. In 2006, 61 percent of social-welfare spending came from the federal government; state and local governments funded the rest (Gais, 2009). Many experts consider local organizations to be the most capable for assisting the growing number of low-income elderly people in the future. Local organisations already help older adults locate and enroll in various programs and services.
According to a 2009 study (Kunkel et al., 2009), local agencies have increasingly served as a single point of entry for older adults, providing access to information on the array of home and community-based services for which they may be eligible, regardless of which federal or state program funds the services. Traditionally local governments and local non-profits play the most important role in creating a network of support for low-income populations.
Local Governments
Local governments have a long history in the United States as political entities that deliver certain services to the public. The Census Bureau describes a local government as "an organized entity, which in addition to having governmental character, has sufficient discretion in the management of its own affairs to distinguish it as separate from the administrative structure of any other governmental unit" (Hogue, 2013). Pagano (2009) calls them "orga-nized entities that possess substantial autonomy over their administrative and fiscal affairs and that are accountable to the public".
The functions and responsibilities of local governments are not uniform across the fifty states. Legally, local governments are created and empowered by the states, and can exercise only those powers clearly given to them by the state legislature. About half of states, however, have adopted "home-rule" provisions for local governments. Under home rule, local governments can exercise all powers not prohibited to them. This has given many cities a significantly more flexibility in meeting present-day challenges. In addition, many smaller cities have hired professional city managers to run the day-to-day operations of government on a nonpartisan basis (Katz, 2003). There are several types of local governments in the United States (U.S. Census Bureau, 2013a):
• County Governments
• Town or Township Governments
• Municipal Governments
• School Districts
• Special District Governments
In collecting statistics on governments, the Census Bureau uses the term "municipal governments" to refer to "political subdivisions within which a municipal corporation has been established to provide general local government for a specific population concentration in a defined area" (U.S. Census Bureau, 2013a). Municipalities or municipal corporations are general-purpose governments with directly elected legislative bodies, usually called Councils. They have budgeting, revenue-raising, and ordinance-making powers. Although the functions of municipal governments vary by state, municipal corporations are granted police powers and are charged with protecting residents’ safety, health, and welfare, typically through the provision of public safety (e.g., fire protection, police, and emergency medical services), zoning and land-use powers, and local public works (including streets, bridges, and water and sewer systems). Usually, municipalities are governed either by an elected mayor and city council, in which the mayor is the executive officer, or by a manager system, in which the council hires a professional municipal manager as the executive (Pagano, 2009).
By the end of the 1990s, most state and local governments had at least the institutional capacity to respond to the challenges of the 21st century (Katz, 2003), including aging in poverty. Five national organizations joined forces to identify ways to prepare local govern-ments for the aging. Known as The Maturing of America – Getting Communities on Track for an Aging Population, the project is being led by the National Association of Area Agencies on Aging, in partnership with the International City/County Management Association, National Association of Counties, National League of Cities and Partners for Liveable Communities.
In 2005, 10,000 local governments were surveyed in order to (n4a, 2006):
• determine their "aging readiness" to provide programs, policies and services that address the needs of older adults and their caregivers;
• to ensure that their communities are "livable" for persons of all ages; and
• to harness the talent, wisdom and experience of older adults to contribute to the community at large.
The survey 2005 found that only 46 percent of American communities have begun to address the needs of the rapidly increasing aging population. The survey results show that although many communities have some programs to address the needs of older adults, few have undertaken a comprehensive assessment to make their communities "elder friendly" or livable communities for all ages. Survey results indicate that while local governments across the United States offer older adults basic services such as health and nutrition programs, they are less likely to provide or tailor programs that affect quality of life and the ability of older adults to live independently and contribute to their communities such as housing, transportation, and workforce development.
The 2011 report shows notable areas of advancement by communities since the 2005 survey: an increase in the availability of specialized training for public safety and emergency staff in dealing with older adults, significant growth in the provision of in-home support services for older adults, an increase in programs that support older adults’ participation in local educational opportunities (e.g. discounts, transportation), and an increase in volunteer opportunities for older adults (e.g. arts, culture, human services) (n4a, 2011b).
Neither report focuses on poverty among the elderly population. However, local govern-ments did identify the top three challenges that their communities face in meeting the needs of or planning for older adults in both the 2005 and 2010 surveys. While responses varied, the challenges most often cited in 2005 were in the following order, housing, financial issues, and various health issues. This line-up contrasts with the top three identified challenges in 2010, which were, financial/funding shortages, transportation, and housing. This shift in re-sponse reflects other indications that local governments face funding shortfalls in addressing the needs of the elderly.
The 2010 report (n4a, 2011b) provides recent information about available local programs for the elderly, such as:
• 69 percent of local governments report the availability of health care services that meet a range of needs;
• 85 percent indicate that congregate and home-delivered meals programs are available, and more than half of local governments report that the meal provider/deliverer is a nonprofit or faith-based organization;
• over 70 percent of communities report the availability of exercise classes;
• nearly 90 percent report the availability of local parks and other venues that have safe, easy-to-reach walking/biking trails;
• 80 percent of respondents reported programs that provide transportation to and from health care services, as well to other destinations (such as grocery stores and cultural events);
• 80 percent of respondents reported volunteer opportunities for older adults;
• 90 percent of respondents indicate that older adults are represented on advisory boards, commissions or committees that deal with planning issues that affect them;
and
• 77 percent of respondents indicate availability of in-home support services for older adults.
On the other hand, only 17 percent of communities reported having comprehensive assessments and strategic plans in place. Moreover, the most important indicators for support of low-income elderly persons demonstrate negative trends:
• Reported property tax relief for older adults on limited incomes shows a steep drop in availability, to 54 percent in 2010 from 72 percent in 2005;
• Availability of programs to educate and inform older adults about financial fraud and predatory lending has declined somewhat (to 65% in 2010 from 69% in 2005);
• 48 percent of respondents report the availability of workforce skills development ser-vices targeting older adults, while 39 percent report employer engagement/education programs;
• Subsidized housing availability slipped to 63 percent from 70 percent in 2005; and
• Many communities report a decline in availability of programs to detect and prevent elder abuse and neglect.
At the same time, many local governments also report challenges related to funding.
Communities are looking for new opportunities to expand programs, leverage additional resources, incorporate business and strategic planning practices, and work collaboratively with community partners in order to broaden and strengthen the nation’s system of home and community-based services so that American older adults can age in place with independence and dignity.
Voluntary or Nonprofit Sector
In the second half of 20th century privatization of public services has appeared as a new trend. Savas (2000) explains that privatization is "the act of of reducing the role of government or increasing the role of the private institutions of society in satisfying people’s needs; it means relying more on the private sector and less on government." Barker (2003) defines private institutions as "nonprofit agencies that provide personal social services, mostly to members of targeted groups (such as residents of certain neighborhoods or those of certain religious affiliations, ethnic groups, age categories, or interest groups)". Private services can be "nonprofit," "for-profit" or "proprietary" social agencies. The most common privatization strategy is delegation, which calls for a positive act by government. Delegation requires a continuing, active role for government in retaining responsibility for the function, while delegating the actual production activity to the private sector. The governments can use different "tools" such as contracts, public-private competition, franchises, public-private partnerships, subsidies – by grants or vouchers –and mandates (Savas, 2000).
The most powerful support for the growing aging populating is coming from the non-profit sector as the private for-profit agencies are often criticized as discriminatory and selective.
They charge a fee for the services they provide, and as a result, they are only accessible to fairly wealthy or insured clients and not relevant for low-income older adults. There are a number of expressions that are used to describe nonprofit sector, that are more or less synonymous, such us civic sector, non-governmental sector, voluntary sector, third sector, and so on. All of these terms refer to "institutionalized expression of the life of civil society"
(Pot ˚uˇcek, 1999). The sector is made up of nonprofit organizations, voluntary associations of citizens who share common values and are willing to work together. They form an essential institutional framework that enables citizens to associate and influence public affairs as partners of government and market institutions.
In the United States, the term ’nonprofit organization’ is used the most, emphasizing that organizations are not dedicated to generate profits for their owners. In general they may accumulate profit, but it must reinvested into the basic mission of the agency rather than distributed to the organization’s founders, which exempts the organization from paying federal income taxes. In addition to their institutionalized structure, nonprofit organizations are equipped to control their own activities involving a meaningful level of voluntary participation, either in conducting the agency’s activities or in managing its affairs. Moreover, nonprofit organizations are institutionally separate from the government; they are neither part of the government structure nor managed by boards that are dominated by government officials.
On the other hand, this does not mean that they cannot receive significant government support, largely in the form of grants. However, in their basic structure nonprofit organizations are fundamentally private institutions (Pot ˚uˇcek, 1999). Some nonprofits operate in a space between the public and private sectors by filling service gaps not popular enough for government to provide or profitable enough for business to offer.
Nonprofit organizations address increasingly demanding, complex, and intractable social problems in America’s urban and rural communities, with increasingly dwindling financial resources (Renz, 2002). Nonprofits can be economic engines: when a community is in economic distress it is often a nonprofit – sometimes funded or acting as an agent of the federal or state government – that steps in first to stimulate the community and establish a base for rebuilding a neighborhood through job-skill training, reclaiming brown fields, reducing violence, and investing in the social and economic infrastructure of the community (Garvey, 2009).
According to the research of Philanthropedia (2011), a division of a central source of information on U.S. nonprofits, GuideStar, very few foundations fund aging programs and services and few individual philanthropic dollars go to this field. Only 2 to 4 percent of all philanthropy benefits seniors of any kind, and of that only 30 percent benefits low income seniors. Experts who were interviewed by Philanthropedia expressed concern that this country will not be able to meet the demands of the fast-growing aging population if more money and resources are not devoted to this sector.
The same research identified major types of nonprofit organizations working in the field of aging. As a result of those conversations, the following types of nonprofits are included in this research.
• Health Care, Care-Giving, and Long-Term Support Services. Health is one of the major topics concerning older adults. More than 50 percent of older adults have two or more chronic diseases and 90 percent have one chronic disease. Some of the commonly known diseases affecting the older population are arthritis, Parkinson, Alzheimer, and other types of dementia. Types of nonprofits we are considering in our research include ones that provide health care, offer financial assistance, work with caregivers and support services for family members, and training professionals working in this sector.
• Housing. Most seniors must face the options of either aging in place or living in institutionalized care. Aging in place refers to older adults choosing to live indepen-dently or live with a family member. Institutionalized care includes respite care, group homes, retirement homes, or long-term care in nursing homes. Aging in place is a strong preference for some seniors, but is often only feasible with the assistance of organizations that provide home-care services.
• Economic Security. Nonprofits that work on advocacy to protect substantial cuts in Medicare and Medicaid, offer financial assistance and guidance, prevent discrimination against older adults in the workplace, and help older adults make career changes play a crucial role in helping older adults gain economic security.
• Other Services. Other types of issues pertaining to older adults that do not fall in the above three categories include transportation, civic engagement, socialization, and prevention of elderly abuse. Transportation is important because it helps older adults maintain their mobility. Civic engagement helps older adults, who now live longer and healthier lives, express their concerns and issues in public forums. Socialization includes providing continuing education (computer literacy classes, therapeutic arts programs, etc.), meeting points for socialization (senior centers and adult day ser-vices/adult day care), and opportunities for volunteering. Volunteering keeps older adults engaged in society and provides an opportunity for younger people to interact with older adults.
A major critique of nonprofit organizations is their reliance on voluntary contributions and fundraising as its fundamental source of income. While it is true that many organizations are well funded, many social workers are hesitant to work in these organizations because of the smaller salaries in comparison to government social workers. With a reliance on voluntary contributions, the financial resources can be really limited and organizations are faced with firing staff members, cutting back benefits to the clients, or turning to government aid that leads to the loss of autonomy to government demands.
2.4 Summary
This chapter shows that the United States is projected to have one of the largest aging populations in the coming decades. The most significant factor for tremendous growth in the next decades will be the aging of the "baby boom" generation. At the same time, there is a growing concern in academic and civil society about financial insecurity among current and future seniors. Evidence suggests that this group has not saved enough money for retirement, and that the recent economic recession exacerbated the situation.
While the nation’s elderly population has experienced the most significant absolute and relative declines in its poverty rate over the past 80 years – from 1959 to 1999, the poverty rate of the elderly went from the highest to the lowest among age groups–there is an on-going discussion in the United States as to whether traditional methods of poverty measurement reflect the true number of people in need. A major shortcoming of the official measurement of poverty is the so-called "notch group" – individuals whose incomes put them above current eligibility guidelines for home and community-based services, but who are unable to afford services at full cost.
As presented in this chapter, alternative measures confirm that an alternative term is needed in order to take this "notch group" of the elderly into consideration. This is especially significant because in the US the term "poverty" is strongly tied to the government’s official poverty measure. As a result, this research refers to "financial insecurity" of older adults: a condition of having not stable or limited income or other resources to support a standard of living now and in the foreseeable future.
Even as the number of seniors in need increases, the network of support available for the elderly in the United States has experienced recent budget cuts. There is a growing gap in available services and programs for the nation’s low-income aging population.
In order to formulate possible solutions to serving low-income seniors at the local level, this research refers to the concept of resilience, which has not previously been widely applied to social and economic phenomena such as aging in poverty or financial insecurity. The next chapter describes in detail how the concept of resilience can be applied to the stresses that existing local support networks for aging adults are experiencing in order to identify areas of weakness and provide recommendations.
The previous chapter described the broad demographic shift that is taking place as the US population ages, and the financial situation that many low-income aging Americans face.
This chapter will provide an overview of existing theoretical approaches to both aging and financial insecurity, and introduces resilience as a conceptual framework for the research.
Urban and regional research shows a growing interest in exploring the concept of resilience as applied to today’s unprecedented rate of rapid urban growth, and the uncertainties and complex challenges that cities are face as a result. The concept of resilience offers a useful starting point for understanding the mechanisms that hinder or enable cities to cope with structural change, disruptive events, and situations of crisis, as well as to recognize slow, continuous change and find ways to manage it. Despite the increasing size and disciplinary diversity of the literature on resilience, there is still no widely agreed understanding nor difinition of this concept. This chapter develops a theoretical framework particular to this research that links the issues of aging low-income adults with current demographic and economic dynamics in urban areas of the United States.