Integrating LGBT Older Adults Into the Older Americans Act

To be lesbian, gay, bisexual and/or transgender, and to age into a system that offers marginal support for dealing with the consequences of discrimination, is a harsh reality for millions of LGBT older Americans.
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An older gay man in Texas is taken from his partner of 22 years by his own children, transferred to a nursing facility in St. Louis, and rendered anonymous so that his partner can never locate him. In North Carolina, a transgender older woman loses her retirement savings when her church (where she maintained her retirement account) discovers that she is transgender. And in rural Louisiana, a gay man drives for hours to offer caregiving support to an older gay man with HIV/AIDS whose family has long abandoned him.

The stories we hear through SAGE's national network of affiliates are heartbreaking and alarming -- but they are not uncommon. To be lesbian, gay, bisexual and/or transgender, and to age into a system that offers marginal support for dealing with the consequences of discrimination, is a harsh reality for millions of LGBT older Americans. And as more LGBT people enter retirement age over the next few decades, this hardship will amplify unless we reform our country's aging network.

Last week, we witnessed a major step forward for LGBT older people. Senator Michael Bennet (D-CO) introduced a bill that if enacted would extend long-overdue supports to LGBT older people through the Older Americans Act (OAA). Widely described as the largest vehicle in this country for funding and delivering services to older people, the OAA provides more than $2 billion annually in nutrition and social services to elders nationwide. Yet despite its stature, this landmark legislation bears no mention of lesbian, gay, bisexual and transgender people -- no acknowledgement of their unique needs or distinct barriers that would merit specific attention; no targeted support for programs, training and research geared at this population; and no mechanism to understand whether area agencies on aging around the country are effectively serving this growing demographic.

Sen. Bennet's new bill, the LGBT Elder Americans Act of 2012, aims to correct these exclusions. Of foremost importance, the bill's proposed amendments to the OAA would specify LGBT older adults as a population of "greatest social need," expanding on the breakthrough guidance recently offered by the Administration on Aging where it clarified that while "greatest social need" in the OAA refers to isolation caused by racial or ethnic status, it can also be defined by area providers to include sexual orientation and gender identity. However, this guidance is optional for local providers; in contrast, the proposed amendments would codify this definition into the OAA and ensure that all planning and service areas abide by the same interpretation. And there's a well-informed rationale for these amendments: LGBT elders are more likely to live alone and without traditional caregiving networks (plus, a thinner support network can mean increased isolation); LGBT elders face significant health disparities (including physical and mental distress, disability, victimization, and lack of access to supportive aging and health services); and many LGBT elders deal with neglect and discrimination across the lifespan from aging and health professionals, their communities and even their own families, as described in the stories above. Over time, these conditions turn into a storm for many LGBT older people -- with no reprieve in sight.

Additionally, the bill permanently establishes the National Resource Center on LGBT Aging, seeded with a three-year grant in February 2010 by the U.S. Department of Health and Human Services' Administration on Aging. The National Resource Center is the country's first and only technical assistance resource center in support of LGBT older adults, and by permanently establishing the resource center and guaranteeing continued funding, the bill would ensure that aging providers could continue to access critical training resources on LGBT cultural competence.

The proposed amendments would also prioritize research and development grants for organizations working to improve LGBT health, long-term care needs, and access to culturally responsive services; more funding would lead to more robust services for LGBT elders in all parts of the country, from Texas to North Carolina to Louisiana, and more. The bill also includes a proposal to require long-term care ombudsmen to collect and analyze data relating to discrimination against LGBT older adults in long-term care settings. Long-term care ombudsmen are a vital part of the nation's aging network, yet they are not empowered to collect data on any discrimination they might discover, including complaints of discrimination by LGBT older people. Finally, the bill would mandate data collection and reporting from area and state agencies on aging on their effectiveness in reaching LGBT older adults. Few agencies collect data on sexual orientation and gender identity, which prevents them from understanding whether LGBT older adults are being adequately served or if they remain isolated from the community services they need and deserve. The research that does exist shows that less than 8 percent of area and state units on aging offer services targeted to LGBT older adults and only 12 percent report outreach efforts to this population.

The various ideas expressed in this new bill already have the support of the national aging network. In April 2010, the Leadership Council of Aging Organizations (LCAO) -- a consortium of 65+ national aging organizations -- included eight historic recommendations in support of LGBT older adults in its "consensus document" for OAA reauthorization. This document guides LCAO's advocacy on these issues and indicates its priorities to Congress. As OAA reauthorization proceeds in 2013, the needs of marginalized elders -- including LGBT older people -- will be foremost among an aging network that has long prided itself on paying attention to our country's most vulnerable communities. LGBT elders should be no different.

Sen. Bennet should be commended for his vision and support of these issues. If enacted, this bill would help millions of LGBT older people age in better health, with greater financial security and with broader community support.

And since aging affects every one of us, we should all extend our support.

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