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+[1.9584037065505981, 6.42074728012085, "I do not think. Okay, great."]
+[-2.727407217025757, -3.243987560272217, "So the primary goal today is to identify what needs you think are most important to the older adult population who served. That is those who are 60 years and older. We want you to think as broadly as possible taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see list of common issues and concerns impacting older adults. So please take a few minutes to read through the list and let me know when you're ready to begin. I will share that now"]
+[3.433438777923584, 7.102547645568848, "Yes I am. Okay."]
+[3.9950509071350098, 5.256547927856445, "So feel free to take a few minutes to review and let me know when you're ready."]
+[3.5953993797302246, 5.017848491668701, "Okay, I've read through it."]
+[-3.4265244007110596, -3.009854793548584, "Okay, great. So starting off for our records, can you please tell us your role and how you interact or engage with older adults."]
+[-0.4955696165561676, -3.892756938934326, "As I'm a branch manager with Orange County Public Libraries, I work with adults, while the general population directly I'm currently working in Laguna Woods, which is a 55 and better population for the city so I do interact on a daily basis with older adults Prior to working at Laguna Woods I have also worked in Laguna Hills and Irvine while also working for the county of Orange"]
+[0.17850998044013977, -4.109377384185791, "thank you and thinking about Orange County and looking at the list of common issues and concerns impacting older adults is there anything missing from the list"]
+[-2.127997636795044, 1.1550332307815552, "it don't think so. I was just going to it might be on here I was just looking for mental health but that's probably included with emotional well being and health care so no, I was just looking for that specific term but it looks like it's included"]
+[-1.4681029319763184, 1.4375122785568237, "Okay, thank you and have the needs on the list including mental health Please rank the top three that you feel are most important"]
+[0.5295107960700989, 1.2048372030258179, "transportation and mobility"]
+[0.4578811824321747, 1.199442982673645, "oh now I see mental health is up there under behavioral mental mental health sorry about that um, so yes transportation and mobility"]
+[3.732736587524414, 6.551167011260986, "see"]
+[-2.4897727966308594, -0.7555360198020935, "probably disability is by your definition with vision hearing loss cognitive decline and"]
+[3.8173439502716064, 6.734951496124268, "see."]
+[4.097386360168457, 5.492228984832764, "Thank you for your patience while I look. No rush"]
+[-0.6198517680168152, -0.4196425676345825, "and I looking for I guess it would fall under respect. A big concern that I hear is dignity. Yes, I would say respect and a lot of that has to do with cultural differences. And for you know language barriers and cultural there, so let's say respect."]
+[3.129441738128662, 4.4988837242126465, "Okay, thank you. So for the next few questions, we will go, we will be going through each of these areas that you have identified."]
+[0.3813443183898926, -2.910554885864258, "Well, specific to Orange County and even more specific to South Orange County, I see where it's largely an area where people are used to commuting and driving themselves. And often as they become older, they are not able to have that same amount of freedom due to either physical ability, doing vision, hearing, just mobility issues, or cognitive decline, and often a combination of both. So I see with transportation as there's a loss of independence. And then there's looking for options where I see people that are learning how to find other options for transportation, and trying to learn other options can be confusing and complicated. Plus, there's also how that affects someone having that bit of independence and taken away from them and a lifestyle change where they're used to be able to drive themselves independently, most often. And I realize not everyone drives, but in southern california, car culture, I do see and hear from people saying, Oh, I can't get to you as easily. I don't know how specific you want information. I don't know. Or if you just want more broad terms."]
+[4.87468147277832, 4.1803436279296875, "Yeah, as much as you feel comfortable sharing, okay, would be great as well."]
+[0.3360970616340637, -2.884094476699829, "I work at city of Laguna Woods where the library is located. And one of the options they have for Laguna Woods residents is they can get what's called taxi vouchers, or discounted vouchers for Uber taxi type of transportation. And they do have that program through city of Laguna Woods, I'm sure there's other cities, similar programs, but I see on a daily basis, residents coming in and by residents, I mean of Laguna Woods, because you have to be a resident of Laguna Woods to be able to qualify for the discounted transportation passes. So I do see that there are folks that are looking for those options to get to grocery store run errands most often to doctor's appointments, where they used to be able to drive and they're no longer able to drive themselves. So I see that need for services being addressed in Laguna Woods. And I know that's not unique to the area. But that is something that I'm able to see on a daily basis, that concern with transportation and looking for options to get to places that they have to go such as doctor's appointments, or just grocery store, or just places for fun. So I see the change of having to navigate that as an older adult, how that affects and takes energy can be confusing and just generally having to learn something new sometimes. It's a process sometimes we'll see. There are folks that all of a sudden they have a physical injury that happens where they need to immediately completely change their transportation methods that they have been used to for decades and decades. And now all of a sudden, they have to learn something new while possibly also dealing with recovering from a physical ailment, a loss of a spouse or life partner. So for transportation, I do see that as being a negative a big concern. Also, personally, I know family members who are dealing with that. So I know it's just not unique to the residents of the area where I work, but transportation is a concern and there's a lot of concern for loss of freedom. And also, I don't know if it's fear, possibly more just strong concern with how will I be able to get to the places I need to go, if I can no longer often drive, which is a big issue that I see changing, I have family members alone, they just downsized from my in laws just downsize from two cars to one. So they're also dealing with that, we're still able to drive, but they are dealing with the psychological effects of loss of independence, to not have their own vehicle available 24 hours a day, seven days a week. So that, for transportation, I, that's what I see is something that is affecting the local population."]
+[-0.6837525367736816, 2.3265035152435303, "Thank you for sharing, and what barriers exist to seeing improvement in this area of transportation."]
+[0.4790458083152771, -2.5669894218444824, "A lot of it just has to do with the, you know, the car culture in Southern California, but there is not a great infrastructure for public transportation. So that is definitely a barrier even with even if the individuals have the money are able to get bus passes or vouchers of some sort, the infrastructures not great."]
+[10.5691499710083, 8.500029563903809, "Thank you."]
+[-0.37681716680526733, -1.2405232191085815, "I think so there is the economic difference. But I do also see, just cultural there are there's a large population that I work with that are English language learners, that are either recent or long term immigrants where they are they have been here for a long time. And while they are able to get by day to day learning something new and perhaps is more challenging when English is not the first language. And I my experience with that is just literally having people ask for help because of the confusion and filling out forms and paperwork."]
+[10.635031700134277, 8.471602439880371, "Thank you."]
+[0.18618646264076233, -2.5859322547912598, "Well, you know, long term would be better infrastructure for public transportation. But in the short term, really, I think, you know, more options for explaining or more venues for explaining what the options are and having staff that can assist. Because it can be confusing a lot of times this is an individual that is how also having some cognitive decline. Or if English isn't their first language. I, I've had people come to me looking at trying to look up things on the internet or fill out forms. And it's confusing to me, there's terms and options that it's not simple. So perhaps provide having, you know, places or ways to have more help and understanding. If I need to switch to other transportation."]
+[-2.6946539878845215, -1.5583765506744385, "Thank you. And now moving on to the next issue that you have identified of disability. So thinking of disability, how are Why are older adults struggling with this issue."]
+[-1.949009895324707, -0.8934898972511292, "Just being able to continue life as they were used to as far as getting to places they want to without it being as difficult oftentimes ending up not oftentimes, but sometimes ending up kind of in a caregiver shut in situation where they're just not able to get to things they have to depend on someone else to do it. And then that, in turn, has to do with you know, affecting mental health and even physical health and losing some of the social interaction some of the routine the security of having a change in life. With Disability I see On a daily basis, individuals that are using mobility aids, such as wheelchairs, more often canes and walkers. And just by it, I looking at things differently because I realized, wow, there are a lot of places that are really difficult to walk around and get to and access with a disability. That I can understand people feel insecure, it's physically difficult, they need somewhere to stop and take a break, before, you know continuing on trying to move from one spot to another concern with just I guess, I know all of these things tie in together and aren't completely independent. And if I cannot, can I use public transportation, I noticed from personal and then also professional, and just from being in the community that the option for curbside services is often very helpful for individuals who either temporarily or permanently disabled such as recovering from a surgery or injury, or having a permanent disability, I see the curb size, curbside services are definitely helpful, and letting individuals navigate access to everything, you know, food. I work in a library library, but just having the options of having someone come to you instead of trying to get out of a vehicle and navigate an area where they're afraid they may become injured if they even have the option of moving."]
+[-0.8172340989112854, 2.4105634689331055, "Thank you, and what barriers exist to seeing improvements in this area."]
+[-2.3091092109680176, -0.8895452618598938, "Honestly, this one might sound a bit strange, but this is something that I do see, I hear people express their concern over I don't know the correct terminology for it. But when there's accessibility at the end of a curb, such as at a corner, where there's those raised, often yellow bumps, I do hear individuals and I have heard individuals say they fall in because working with an assistive device such as a cane, or a walker, or just unsteady feet, and it's very easy to lose your balance and trip over those bumps. I've also heard from individuals that maybe aren't disabled but just or you know, have small children whose toes catch on those bumps, or someone pushing a stroller that I understand the purpose of those is to assist individuals who may have visual impairment with knowing when they're entering or leaving a curb. But I know I've had people expressed to me that fear of falling is tripping on those yellow bumps. I know that's very, very specific, but that is something that I do hear individuals say often is a concern. They understand that to help folks with vision loss, but i i even encountered that when I had a family member with a temporary disability and was on crutches and was really having difficulty getting over those yellow bumps without ending up falling."]
+[7.142965793609619, 4.69426155090332, "Thank you for sharing."]
+[-2.1866562366485596, -0.7896673083305359, "Um, I don't know that. As far as mobility other disability again, maybe perhaps cognitive or language but as far as just strictly physical. I don't know that there's necessarily anything different there unless it's paired with an additional thing as such as cognitive decline or language barrier. I haven't noticed anything specific to just purely physical disability."]
+[5.619372844696045, 6.800421237945557, "Thank you. Um,"]
+[1.8784619569778442, -1.121501088142395, "Well, I just think, can continue. Enforcement and evaluating access as far as physical access is, is a big thing. And I know that happens in an ongoing basis when different buildings are renovated or updated, making sure they follow code. So just continuing to enforce that would be helpful."]
+[10.639054298400879, 8.387322425842285, "Thank you."]
+[-1.448974370956421, -1.940256953239441, "Just their experience another, you know, chapter in their life change, just as you know, children become teens and adults. And just transitioning to another period in your life where you notice there's a lot of changes as far as you may need to move your physical, and cognitive health might be different, you may no longer to be able to drive, just respecting that this is another stage in life. And that's I think we're hearing about it more, because the population, the aging population is growing. So I think there's a need for more attention. And I think individuals are trying to demand that because the range for what's considered older adults, depending on the definition can be started at 50,55, 60, 65. But still, it's possible to be considered an older adult for 40 or 50 years of an individual's life. So seeing the access and equity to existing services is important. And I think people are right to want that either for themselves, or seeing that they have someone else they know, that is part of the aging population. Well, we're all part of the aging population, but part of the senior population to realize, Wow, how hard is this for my neighbor, my family member, it's just the stranger I see on the street that going, Wow, how, how are they able to do this, I wouldn't want to have to try to navigate certain things. And so the respect, just I think there's needs to be more attention to another stage in life that's going to be lasting for possibly decades and decades, as opposed to seniors, it's a short, short period of one's life where there's a good chance it could be the majority of one's lifetime is as a senior and having, you know, respect for that is important. Just, you know, general, I guess all of those things being considered is responsibility to take part of take care of this part of the population that's aging, just as like there's so many I feel like protections and considerations for children. Everything from car seats, you know, age restrictions, free lunch at school, all sorts of different things, just respecting seniors are also another part of the population. And I realize there are options for free lunches and transportation issues, but the respect is not like oh, you're a senior, you're an accept exception to the population, you're now the majority of the population. So that needs to be addressed and respected."]
+[3.628861904144287, 6.4430766105651855, "Um, let me see. Let me think about that. I painted such a broad picture now let me think about it."]
+[3.9864845275878906, 7.766962051391602, "Yeah, no, all right."]
+[-0.8516702055931091, -1.3671762943267822, "I guess perhaps. I'm gonna go back to cultural like respect as being seen as something different possibly depending on what culture came from originally. You know, that type of attitude that a Um, historically has been part of, I would say, culture in the United States where there hasn't been a senior's necessarily known as a segment of the population that's respected and seen as wise and has a lot important place in society. Instead, it's seen more as, oh, you've retired, you're no longer contributing to society, you're a burden, financially and everything else. As opposed to celebrating that, okay, your survivor, oftentimes, military experience, most often come through some kind of having lived through moving to a different country learning a new culture, major changes, veteran status, so forth all I think all of those things demand respect, and they do get some, but not enough considering the huge amount of population that are seniors. How to fix that. That's a little harder, because it's not something that just say, I will change this and make this more accessible. I don't know, I guess just I think part of what you're doing for a little bit, I understand is definitely listening to the voice of the aging population and seniors making sure that they have a say that any changes are I know you're serving some through your project. And I think that's very important. Because it's one thing for me to say, I'm looking at this, how I see someone else and what they're telling me they might be feeling or what I think they're feeling. I think letting them know that their opinion matters for issues that directly affect them. is important. Probably more important than my own."]
+[10.593276977539062, 8.487136840820312, "Thank you."]
+[-1.0647228956222534, -0.920386016368866, "There are I think, a large one has to do with what we see in Southern California, that economic barriers can prevent someone from having access to pretty much every thing that could be available to them, you know, in a different side, from any cognitive language, so forth. I've seen individuals while they're waiting to try to get a caregiver, because now they found they need one. And while they're waiting for approvals and things to go through, sometimes individuals are able to have themselves or have friends or family where they can pay for a temporary solution till they have a longer more affordable one. Where for individuals that don't have that economic security of having their own money or friends or family, that is more difficult, and that can lead to more problems while they're waiting for assistance. So economic access, because I do see individuals that let's say maybe can't drive anymore need to figure out options, but if they're able to financially, get someone else to drive them, that's a totally different situation than not being able to put money towards something to find at least a bridge till there's a more permanent solution for often caregiving transportation, so forth."]
+[2.994434356689453, 4.556585311889648, "Thank you. And I know you already touched on this a little bit, but there's anything you want to add."]
+[3.8572821617126465, 4.371148109436035, "Thank you. And there's a few more questions. But that's it for the list. So I will go ahead and stop screen sharing."]
+[0.9782747626304626, 2.5126125812530518, "Can you please describe how accessible and adequate, accessible and adequate"]
+[-2.226804733276367, -0.24033285677433014, "Often, it's transportation and time, that's the issue as far as how quickly someone could get an appointment, and then what their options are for getting there. But I think the care is adequate, just from what I've heard, personally."]
+[0.9844185709953308, 2.4441776275634766, "Thank you. How accessible or adequate would you say that it's,"]
+[-1.4253759384155273, -0.7145482897758484, "for long term care, the I would say, the bigger problem is just cost, it's very prohibitive not knowing cause long term could mean anything from six months to 30 years or more. So the problem is, it's less accessible and adequate, because realistically, someone's not going to come up with a long term care plan, and then not have to have changes to that plan, either because they require a different level of care, or because it's not affordable, or the provider has changed, it changed for long term. And then that's a whole other thing where someone has to get used to it, now I need to work with someone else in my home or move to another facility, and all of them can be quite expensive. And it's hard to gauge that not knowing is long term, six months, a year, two years, 20, 30, 40 years. I mean, I I've come in contact with individuals that are in their 90s and, you know, have very little need for long term care, some that have had long term care for decades. So I can't even imagine as far as organizing that for yourself or a family member, how you go about knowing well, what's long term."]
+[3.598292589187622, 7.227117538452148, "No. Okay."]
+[-2.0662782192230225, -1.1141564846038818, "i Well, I do think just you know, making sure that there are I see individuals that are on a lot of medications at the facility where I work in city hall that is currently at the end of June expired and no longer needed medication Drop Location, where I'm at, I know there's changes and it's gonna be switching to I believe local pharmacies, but right now in Laguna Woods, they they're a location where individuals come and they can drop off items. And I see it's amazing that when someone loses someone, then someone else brings in the medication that's no longer needed. The amount just the sheer quantity is a lot. To me, I'm I'm sometimes shocked just the amount of sharps and pills and medications that thing oh my gosh, this individual really had a lot and I I just wonder like, how often is it reassessed because instead of just adding more and more and I you know, I don't have a medical background, but just the sheer quantity of medications that I see are brought in for drop off when they're no longer needed is quite shocking to me personally. And I don't know if these are medications for like, physical health, mental health, because I don't have access to that, and I don't want it. But just looking at what are perhaps other ways of treating health other than medications. And I do realize, yes, there may be some that are necessary, but I feel like gosh, there's there really had there are other options that are explored that the health insurance would cover that possibly wouldn't require someone to take so many medications on a daily more than a daily basis multiple times a day often. So I would just like to see more looking at options that aren't just in prescription pill and liquid sharps form."]
+[10.64228630065918, 8.468114852905273, "Thank you."]
+[-1.300270438194275, -1.5297447443008423, "Um, let's see, I don't entirely have as much contact with that. I think the bit that I do see is feeling that. And this could just be a matter of impatience, but just how long it takes to when you are, you know, someone who might need help to get social services can be difficult. Because I don't know, it's, if that's oftentimes you don't see it. I don't have the perspective to know what this person considers an emergency. I have seen, you know, individuals where there's concerns that are immediate than they call the non emergency police line as far as the if there's concern of elder abuse, neglect, a welfare check, and that police will respond, but I don't see what happens beyond that. So I don't know as much. I do know, like the immediate, like, non emergency police lines responsive, but I'm not sure what then happens with social services and human services to address concerns like that."]
+[10.66926383972168, 8.43041706085205, "Thank you."]
+[0.3013156056404114, 0.6185896992683411, "So economics, finances"]
+[10.544191360473633, 8.545143127441406, "Thank you."]
+[3.9613428115844727, 6.046962738037109, "It sorry, it faded out a little bit. Oh,"]
+[4.376397132873535, 6.495348930358887, "no, sorry."]
+[-1.180364966392517, -2.667400598526001, "I do think there's a wealth of information, knowledge that older adults have. So definitely make it sure they're part of the conversation. Just the government really needs to tap into that knowledge, I think is a good starting point."]
+[0.16246171295642853, -4.6932759284973145, "Thank you. And thinking about all the older adult residents in Orange County, who is getting the least amount of attention,"]
+[1.8967947959899902, 2.989962577819824, "getting the least amount of attention"]
+[2.5610945224761963, 6.83989953994751, "and I'm thinking about because I know."]
+[-0.5516183972358704, -1.2908971309661865, "Trying to think of the different resources, and I know some are addressed, I have seen just thinking out loud, I've seen a lot of help for folks that do have language barriers, get it from their cultural groups, their church groups, I see that is coming, there's still a much greater need, because if someone's not part of some kind of cultural or religious group, then they wouldn't have access. So language is a concern. And not just language, just like cultural difference. So I'm going to go with yes, those individuals who have immigrated to the area, you know, at some point in the lives, it could be very recent, my next door neighbor just came here from Ukraine a year ago, she has a language barrier, she is living with family members, so they are able to assist her. But I also you know, have other neighbors with similar situations from different countries where they've been more of a refugee situation. And so I will have to go with language and cultural because a lot of times individuals, there might be help and options, but they may not even know that because perhaps from their experiences and the culture they came from, that's not something that we offered so they wouldn't even know to look for certain types of services or assistance because that would not have been provided in their experience where they came from either due to you relied on multigenerational families to take care of yourself or it you just came from a place of political unrest where that just hasn't even been an option so lack of knowing so again the culture and language thing I would say that can cut across all different economics just as far as getting the word out there to know there is there are some services and options and places to get questions answered."]
+[0.18126782774925232, -3.972942352294922, "Yeah, thank you and thinking about all the issues facing older adults in Orange County what issue is being overlooked"]
+[2.234639883041382, 2.8366858959198, "tried to address a lot let me think of what being what's being overlooked."]
+[0.03657137230038643, -3.4130589962005615, "Good, I feel like counties doing a good job of trying to identify"]
+[1.129439353942871, 6.438740253448486, "I think"]
+[-1.8284358978271484, -0.7057008147239685, "I don't know maybe I maybe I just haven't heard about it. But I hear a lot of confusion with possibly how to Prepare for when you or someone you know who's older will need to transition to needing more caregiving, just where to start getting more information. And it may be there. And I'm just not aware of it, which I guess could possibly mean it's overlooked. Just understanding where to start. Perhaps for my age, I'm, you know, the sandwich generation of children in college, I have parents in their 80s. And just trying to figure out well, how does one prepare for when more help is needed, as far as often like caregiving are not able to live independently understanding the process to set up a good plan for individuals."]
+[-0.9227306246757507, 1.4382123947143555, "Thank you. And in addition to what we've already talked about, we can dive a little bit deeper into the topic of bridging the digital divide."]
+[-1.8624274730682373, -2.0890793800354004, "Okay, well, I do. I see all different levels of digital use and access, both on a personal and professional level. Where I work in the library's pretty much every year after Christmas, I'll have individuals that are given e readers, by family members, they'll come into the library and schedule a one on one tech help with setting up their Kindle or other e reader. The age ranges from in their, I would say 50s to 90s. And these are individuals that have gone from regular print book to large print, to now need to and sale the large print books too heavy, I need an e reader. So I see there's it's not one size fits all, as individuals that very much are super tech savvy, you know, whip out the smartphone, the e reader have an Amazon account. So not trying to think it's a one size fits all for seniors is important. Then I also think of my own father who never used a computer in his life and never intended to so would still go and do banking at the bank and doesn't have doesn't use an ATM card. So I think just recognizing that digital divide, it's I know it may not be cost effective, but keeping different options where there are individuals that don't want to or you know, have a computer that prefer to call and speak to someone one on one for anything. I get a lot of individuals that will call at the library. And even if they have a computer, perhaps, you know, it's something they were told to do you know, for a mental health call and interact socially with someone. So the digital divide is, I guess, providing options because while that may not be cost effective to have a live person who can answer or you know, a chat bot or you know, online help, and everything, just understanding and respecting that I see all different levels of, you know, ability with technology. And then that's and that's just talking about the ability of wanting to use technology, not if there's an economic barrier. That's a whole other thing in itself. I just mean the desire to use technology and respecting that. Perhaps still need to have all different levels of options. I do like the idea of there's an I hear individuals say they like being able to do stuff from their smartphone or computer because if they don't have transportation or mobility, but they have the cognitive ability, and the economic ability to have Wi Fi a computer or smartphone. That is great. Everything's more accessible through technology for them, but then there are individuals that either don't want to because they don't want to adopt technology or have even been told. Go out and interact socially with people and be aware of those, you know, scams and Brought, don't put your information into a computer, if you're not 100% Certain, so just respecting that the digital divide is it's varied, it's not just a divide, it's like all up and down and roller coaster of different levels. So that's, that that's problematic, but but I see it all the time."]
+[3.092346668243408, 0.14195139706134796, "Thank you, and what new or revised policies are needed"]
+[-0.4538269639015198, -1.4098938703536987, "language accessibility is a big one. I see a lot of individuals that are very sharp, you know, no cognitive decline to speak of retired professionals highly educated, but might not have the command of the English language. So having options in different languages, because it is very different for someone to be able to have conversation on day to day going grocery shopping type of interactions, as opposed to filling out tax firms and dealing with legal language is a whole different level of fluency. So language barrier."]
+[3.66899037361145, 11.00600528717041, "Um,"]
+[-0.555073082447052, -1.3830921649932861, "I don't know. Because that's, I honestly don't know. That's difficult. I mean, I almost feel like that's complicated. Because I want to say, you know, someone that ways to translate items without being unbiased, but how I don't even know how to third party check on translations, if once they're, you know, able to vet them that it's not biased in some way. Perhaps I'm just reaching there. That's very complicated."]
+[1.7000863552093506, 0.5860997438430786, "I do look at the local census. Numbers, demographics for the area I work at. And that's what I use for planning. I also direct observation, and then I will, you know, I'm a librarian, so I research stuff. Census data is helpful. But I realized not everyone does the census. But that is helpful. As far as seeing some some areas where it could perhaps go to focus, this is a bigger trend, where I work directly, so I need to focus more on one thing instead of another."]
+[-1.3416876792907715, -2.9637131690979004, "I, I do, I work with the seniors or I work in Laguna Woods senior community library. But we also have a Senior Services Committee, which I am a part of, but there are two co chairs that recently led the May 2023 Older Americans Month events for Orange County public libraries. So they would have a lot of direct, you know, information based on the direct experiences up to planning and success and interactions with individuals. I know, they said, we had some different things from craft to making some recipes to just telling about libraries, vendors from, you know, perhaps health care agencies and so far, so it was like a I say like a health fair or job fair, but it was for older Americans during the month of May. And I know the response was that it was very welcomed that individuals who attended are happy to see something and commented, there's usually nothing for us. You know, while it's great, there's stuff for kids preparing for kindergarten and different things. There's not as much the other end of the spectrum and They were happy to see that they're being given a place and respected and so but I yeah, I do have two individuals I don't know if you want me to tell you you know how their names or how to contact them or email, what would be the"]
+[4.288365840911865, 4.048461437225342, "Yeah, sure. I can definitely get their names and emails or if you'd be able to connect me with them that would be amazing to hear. Yeah,"]
+[-0.908046543598175, -3.462937355041504, "whatever your preference is because our email through the county is quite long. So, but they, but their names are Isabelle Stevens and Josh Hartel. And I will send you that information. Okay, but they were, you know, chair and co chair of Senior Services Committee and instrumental in preparing, planning and executing the different activities we had last month."]
+[4.36986780166626, 4.0033159255981445, "Okay, that'd be great. Thank you. Yeah. I would love to hear from them as well. Yeah, okay. And"]
+[-0.49913835525512695, -3.815670967102051, "they both work for OC public libraries, but they work in different cities than I do in Garden Grove and Seal Beach. So they're, while I'm in Laguna Woods, so their experiences, I'm sure there's going to be some a lot in common, but they also work in different cities. So I'm sure they'll have some different things to say."]
+[5.057790279388428, 3.499177932739258, "Sounds great. Yeah. Thank you. Yes. Yes. Great. Thank you. So that concludes our interview. I will stop recording now."]
+[-2.6308844089508057, -3.3233165740966797, "Okay, so the primary goal today is to identify what needs you think are the most important to the older adult population that you serve, which those are, who are 60 and older. Okay, so we want you to think as broadly as possible, taking into consideration to older adults, caregivers, families and their communities. So, right now I'm going to share my screen. So you can see a list of common issues and concerns impacted or the adults condition is simply now"]
+[3.7277886867523193, 15.256217002868652, "Yep."]
+[3.6876132488250732, 4.578620910644531, "Yes. So take a few moments and go over it and the following questions will go from this table, okay."]
+[3.1755530834198, 8.927691459655762, "Yeah,"]
+[-0.45812779664993286, -3.8880059719085693, "thank you. So, the thinking specifically about the older adult population in Orange County, for records, can you please tell us your roles and how you interact and engage with older adults."]
+[-0.6309088468551636, -3.5839083194732666, "Yeah, so I am I oversee many volunteer programs at One OC, who serves the entire Orange County community. And one of our programs is the RSVP programs. So that's a retired and Senior Volunteer Program where we specifically work with older active adults in and placing them in volunteer roles and positions. So we have a full program and we actually have that program for San Bernardino County as well. But I guess for the purpose of this we'll focus on the Orange County program"]
+[3.6900124549865723, 6.570955753326416, "Let's see."]
+[2.341486930847168, 5.197021484375, "I don't think so. Not from my experience and working with with that, I think they're very covered on here."]
+[1.0989717245101929, 6.460447311401367, "I think"]
+[-1.7196087837219238, 1.3698346614837646, "perhaps the I would see this as one in the same so I would kind of say and this is what maybe we specifically work towards so maybe I'm a bit biased and skewed here but we work really specifically with the emotional well being and the behavior and mental health because those are areas that volunteering and being connected to your community can really help support um, it also helps you know, identify other things on this list earlier if you aren't connected and everything so I would say those would be if I can do a tie for first or maybe that's just my first and second and then I think from what I see maybe"]
+[-2.069708824157715, 0.5901384353637695, "I would say personal care management or disability"]
+[-1.916256070137024, 0.7009856700897217, "so disability is"]
+[1.7855288982391357, 4.766831874847412, "number three Yeah."]
+[-1.9965215921401978, 0.5734702944755554, "Personal care. Okay, so number one. Number one."]
+[-1.8960330486297607, 1.457524299621582, "I guess I was kind of seeing them as I guess I was trying to do too is this number one because I kind of see them as interacting a lot that behavior on mental health and emotional well being."]
+[-1.8277357816696167, 1.4275153875350952, "So behavioral and mental health would be you One. Okay. Yeah. And then the other one is for number two will be your well being"]
+[-1.8206676244735718, 1.4305990934371948, "Oh, yes. For number one you say So for number one, I have behavioral and mental health. Yes. Is emotional well"]
+[-1.4494199752807617, 1.5111736059188843, "being emotional well being okay."]
+[4.728661060333252, 8.015613555908203, "Okay,"]
+[5.948550224304199, 6.735047340393066, "thank you"]
+[3.0372610092163086, 4.567511558532715, "so when you think about all the things that you mentioned, like top three that you mentioned. So now I'm going to go ahead and ask like, a few questions, for each of those things."]
+[1.100813627243042, 6.451780319213867, "I think"]
+[-2.251910924911499, -1.3083209991455078, "I think because of, I mean, many of these go into the other ones, but I think just in the world that we're in right now, many have been, you know, either isolated in some way or, or scared of going out during COVID. And I think the recovery after that, I think in many different fields, are seen sort of the effects of that. So I think it's maybe top of mind and probably encompasses some of these other issues and concerns. So if they're just beginning memory loss, or forgetfulness, if they're starting to worry about meeting a caregiver, and not possibly being able to afford one, if it's perhaps their first time struggling with mental health, again, induced perhaps by the pandemic, I just think it's top of mind for most of our population, but I think it hits the older population in a different way, because they may not be able to access all of the"]
+[1.5970981121063232, 5.772430419921875, "all of the"]
+[0.9930000305175781, 1.5322624444961548, "available programs that could support them, they just might have more barriers to access for support in this area."]
+[-1.0389728546142578, 2.069071054458618, "Thank you, and what barriers exists are seeing improvements and behavior on mental health."]
+[-0.6469478011131287, -0.00019188087026122957, "Um, for that, I think some of the things that are listed on here, I mean, the technology piece of it, if they're just even trying to identify where they could go for that. Then on top of that, depending on if they have transportation or anyone to help them access those things, and it could also be an economic piece if they're older and no longer have health insurance through their work, because they're retired or otherwise."]
+[4.19765043258667, 6.623574733734131, "Oh, yes, yes. Sorry."]
+[-0.3708057403564453, -1.270601511001587, "Yeah, I definitely think based on, obviously, your economic picture, but also different cultures have different, you know, if you don't speak English, it might be harder to access services. Depending on how culturally you live, if you're living with, you know, your kids or your grandchildren that might be able to support you that might give you more support than maybe if culturally, you're a part of a culture that where you are living more alone and isolated. So I definitely think there are different groups that just have very different experiences with it."]
+[-1.8483966588974, -1.7336686849594116, "The best way to address it, I think it's really taking into account you know, all of the barriers and designing programs and community support around that. I also think there's a piece of it that's preventative so understanding that. I guess understanding and for and empowering and giving people tools to address these things, even before they reach being an older adult is if you've access programs before, if you've gone to therapy, if you have identified, you know, resources, where if you're realizing that you're forgetting things or things like that, I think there's a preventative aspect to this where we could educate the general community before they're getting to that place."]
+[-2.849093198776245, -1.6925989389419556, "Thank you for sharing that. And so now I'm going to go ahead and ask the same questions for the second issue that you mentioned. So how and why are older adults are struggling with emotional wellbeing. Yeah,"]
+[-0.9450899362564087, -0.8071787357330322, "I think a lot of the same points there, but maybe really focusing on the fact that their life may look very different than it did maybe when they were working and had, you know, a lot of tasks and families family around a lot of obligations. And I think it's a really big change for people when perhaps they lose their partner, or perhaps their kids move away, and they're feeling more isolated, if they haven't ever had the time or experience to get involved with their community or make new connections. Again, this could go back to a cultural background of feeling comfortable doing that."]
+[1.1890217065811157, 6.429435729980469, "I think that"]
+[1.5040262937545776, 3.0525012016296387, "that we are definitely seeing, and I don't think this is a new one, I think that it might be exasperated by the pandemic, but I definitely think this has been a"]
+[0.9950979948043823, 5.127621173858643, "long running"]
+[-0.8863112330436707, 0.5233647227287292, "piece of of aging, unfortunately, that you do feel more isolated and more lonely."]
+[-1.1548537015914917, 1.9209964275360107, "Yeah, and What barriers exist to see an improvement, and on this issue emotional wellbeing."]
+[3.6539013385772705, 10.991464614868164, "Um,"]
+[0.03495774418115616, -3.5490562915802, "And so I think that's all all very, can be cultural dependent, which would split it up into groups within Orange County. Definitely."]
+[-1.124214768409729, -2.5603389739990234, "This I think, honestly, we see this addressed so much through the programs that we offer. Volunteering is a really fantastic way for people to feel like they have a purpose like they have, you know, something coming up, they have something on their schedule, there's something that they can or shouldn't be doing. Even if it's from their home, if they don't have the transportation piece. There are a lot of opportunities that even without technology, older adults can can volunteer from their homes now it could be making meals or birthday cakes for foster youth or like some really cool programs that that really just gave us a sense of purpose and have that connection to the community even if it's just for a brief few minutes of someone coming to pick up something that you made for someone else. So I think that's a really, really fantastic way to address this."]
+[3.4807393550872803, 5.309040069580078, "Thank you. And now we're gonna move"]
+[3.1199522018432617, 4.785984516143799, "on to the next issue, like you mentioned, I just want to clarify."]
+[-1.8409346342086792, 0.7306922674179077, "Let's go with disability."]
+[-2.379038095474243, -0.8726994395256042, "I think disability, one, figuring out how to adjust your life for a disability. But I think the examples of vision or hearing loss are things that we know happen to older adults, no matter what no matter what cultural background you are, or anything like that, it kind of unequivocally happens across the board biologically. And those things we know can be incredibly isolating. And can really affect your whole way of life, you can feel like you're not participating in life anymore, which can lead to the cognitive decline and, and can really have some horrible, horrible consequences for the way that you spend the, you know, the end of your of your life. So I think disability and really understanding and being equipped to, to adjust to a disability is a big thing."]
+[-1.8929164409637451, -0.25856995582580566, "Yeah, I think a lot of this goes to like, the insurance piece being able to get into doctors getting the equipment like hearing aids and, and things like that can be very expensive, it can be very hard if they need to be fitted multiple times, if you lose one, I think really accessing the medical care around these things can be one of the biggest barriers, I would say. In our"]
+[-4.0307416915893555, -1.9829397201538086, "lives difference, different experience for different groups of older adults, and for different from different backgrounds. Regarding this issue."]
+[-2.4521334171295166, -0.8095868825912476, "Some may feel more or less comfortable asking for help in these areas. There may be from a cultural perspective, more or less shame, depending on your background and asking for these things. But I think, as I mentioned, biologically, we know that a cognitive decline or hearing and vision loss, but it's just it happens across all groups."]
+[1.2896854877471924, 6.265257358551025, "Um, I think a"]
+[1.7469215393066406, 5.5327982902526855, "lot, as I said, with the first one, I think, a lot of education."]
+[1.7748719453811646, 5.627340793609619, "A lot of"]
+[-0.49179619550704956, 0.843757688999176, "preventive education, I guess, but also, again,"]
+[-0.5384142398834229, -2.175467014312744, "equipping people"]
+[-2.047302722930908, -0.39570584893226624, "with the knowledge of what is included in Medicare of what is, you know, where can they go for doctors that specialize in working with older populations, and ones that have, you know, a proven track record of really caring for their patients. So I think it goes to both available health care available medical care, as well as the knowledge around what that medical"]
+[-1.650974154472351, 0.16052010655403137, "care is."]
+[-3.1493079662323, -0.01890123263001442, "Thank you so much for answering that. Those questions and the following question won't go based on this table, so I'm going to start sharing my screen. Okay. The first one is geriatric care."]
+[3.6745500564575195, 11.012195587158203, "Um,"]
+[-1.2749762535095215, -4.159748554229736, "I guess I don't have personal experience with enlisting geriatric care. I do feel like even as someone who's not a caregiver of someone who's in need of Geriatric Care at this moment, I do know of places that I would go in Orange County for that. So I would say that it is least at least prevalence. I don't know how the economics work into that. I don't know how accessible it is from an economic standpoint, but I do know that there are a lot I have resources in Orange County for that."]
+[0.9778608679771423, 2.410845994949341, "Thank you so much. How accessible and adequate"]
+[1.2724183797836304, 5.547298908233643, "I work with"]
+[-0.9987896084785461, -4.165496349334717, "the Council on Aging on some projects. So I definitely know there are a large number of long term care facilities in Orange County. Again, the ability to get into those depending on your background or your economic status I'm not aware of but once again, I know there are many of them. I also, though, know that we have an ever growing older population. So I am not sure if that is on par with the need in the county. I'm just aware that there are a great number of long term"]
+[-1.2168974876403809, 0.12074390798807144, "care facilities."]
+[-1.034434199333191, -3.9986538887023926, "Say I kind of have the same answer for that I once again, I'm aware of a number of resources for those things in Orange County, through the numerous hospital systems that we do have here. And through nonprofits in Orange County as well that work to get those services out. I don't know how it meets the full need of what is in Orange County right now. So they're there, it feels like there's knowledge about them, but I'm not sure if it's fully meeting the need."]
+[3.699639320373535, 15.117232322692871, "Yes."]
+[3.1303598880767822, 4.267115116119385, "Can you mention some of them. Yeah."]
+[-2.9593522548675537, -0.622312605381012, "So working with different organizations, there's Mariposa, there's Nowruz. There's a good number of clinics that really focus on specific populations. And those are more towards, for instance, Nowruz focuses on Persian populations of all ages, but they're very focused on that. I know. Mariposa specifically focuses on women at any age, and they have programs specifically for older women as well. And then I know you've been working with Kaiser, they have resources for that as well. I know through Laguna Woods, their care coordinators at some of the levels of living are very good at arranging those services as"]
+[5.3975725173950195, 6.304354667663574, "well. Awesome, thank you so much."]
+[-0.3965563178062439, 0.5407411456108093, "What about humans, social services, have adequate accessibility in those services are."]
+[-0.46546053886413574, -4.094018459320068, "know, again, not having access to them for my personal family in Orange County. I'm not sure what the process is for going through those."]
+[0.5594202876091003, 3.2826271057128906, "So much. Now we're going to move to the next question. And the next 10 years"]
+[0.5105405449867249, 3.206871747970581, "the next 10 years did you say it's I would guess,"]
+[0.5901438593864441, -3.350550651550293, "housing, maybe one of that affordable housing, as people as we know that housing prices continue to escalate here. And we know that people are living longer, but also perhaps having more needs that they're addressing as well, both medically and mentally. So I think I think housing need might be one that is a big piece of it. In Orange County specifically, I guess."]
+[3.560393810272217, 8.901976585388184, "Yes. Yeah."]
+[-2.280675172805786, -1.4855586290359497, "I continue. Like I said, I think that behavioral mental health will continue to be that just because also we'll have older adults, people who are over 60, who both need care themselves, but are becoming caregivers as well. And I think that will continue to"]
+[-1.3350274562835693, -0.2551783621311188, "be a huge need for both them needing care"]
+[-1.5900020599365234, 0.14182215929031372, "and then trying to give care as"]
+[3.4986157417297363, 8.334763526916504, "well. Yeah."]
+[-1.007059097290039, -2.8378913402557373, "So in your opinion, what do you think the government's role should be in meeting the needs of older adults"]
+[-1.1912225484848022, -3.762875556945801, "in Orange County. I think making mental health"]
+[-0.9425400495529175, 0.4630090594291687, "and healthcare services as accessible as possible and as affordable as possible, would be government's role in that"]
+[3.1105406284332275, 6.784599304199219, "Can you give an"]
+[2.39137601852417, 5.6792497634887695, "example or elaborate a little bit more"]
+[4.957895755767822, 7.427924633026123, "Interesting."]
+[1.515348196029663, 6.257655143737793, "I would assume those getting the least"]
+[1.928566575050354, 3.1629929542541504, "attention and support. I think perhaps, I think of and this is just,"]
+[0.0418485589325428, -0.9486094117164612, "I think of newer refugee groups that are coming over the Afghan refugees that had come over recently. Yeah, I think a lot of those groups and also, I guess, I would throw into here, undocumented people that are here, I'm, obviously are not getting access to those services, the caregivers of those who are undocumented. That would probably be the least represented group"]
+[5.4198713302612305, 6.10906982421875, "that I would think of. Thank you so much."]
+[3.6472861766815186, 11.003663063049316, "Um,"]
+[-2.8807244300842285, -1.174525499343872, "I really do think that connection piece is a huge one. I think there are many groups that advocate for different for different physical illnesses for dementia and Alzheimer's. And absolutely, those things need to be taken seriously and really need to be planned for because of the level of care that they require. But I do think that perhaps being overlooked is just the emotional well being and the"]
+[1.8381072282791138, 5.824251651763916, "I guess enjoying life part of it."]
+[-2.8009252548217773, -2.0571908950805664, "It seems to be very once you get to a certain age seems to be very physically focused."]
+[1.7486865520477295, 2.184941053390503, "The resources, I guess, that are available. Thank you so much."]
+[2.8256819248199463, 4.80626106262207, "Now we're going to move to different questions like focus more on your on your topic of expertise."]
+[-1.177575707435608, -2.4014506340026855, "There are a lot people who are still living very, very active lives. So what's working is giving them still, you know, things to do. They're very, they're experts in a lot of areas, they've done amazing things, they have a lot of experience. They can be fantastic mentors, they can be fantastic trainers, they're, you know, helping nonprofits, they're helping their communities, they're able to outreach to others and be caregivers. So I think what's working is not treating every older adult as if they need help, like part of what can help them and give them purpose is actually understanding that they can give help, still they can. They're still very adequate. And they might have now some different barriers physically or even mentally, like we talked about. But I think that there are volunteer roles that fit for any different kind of person. If they don't speak this language, there's a ton of things that they can do to help their own community and being you know, speaking in their own language, but still making awareness of resources and and doing that. So I think what is working is having a huge variety of ways that people can volunteer and be connected and feel that sense of purpose and meaning."]
+[2.0288631916046143, 6.42160177230835, "I think what is isn't"]
+[-1.0675666332244873, -2.5708909034729004, "working, is thinking that volunteering just looks kind of like going into like a food bank and packing a box, or kind of the maybe a traditional or typical or older way of thinking about volunteering, connecting with your community and supporting and everything doesn't have to be a physical act, it doesn't have to happen outside of your home, it doesn't have to happen, it can be whatever you want it to be. So I think it could do some updates as far as like, what people think is available in that way."]
+[5.623372554779053, 5.966463565826416, "Thank you so much,"]
+[3.010317802429199, 0.0663238987326622, "when new or revised policies are needed."]
+[2.8584187030792236, 8.19741153717041, "Um, gosh,"]
+[-1.0640321969985962, -2.632821798324585, "around volunteering specifically, I"]
+[1.7593954801559448, 3.870915174484253, "don't know if there needs"]
+[-0.42890551686286926, -2.288872718811035, "to necessarily be a policy change or anything around it. Perhaps there's some sort of initiative or some sort of incentive for organizations to offer volunteer opportunities, or varied volunteer opportunities. That would be the only thing that I think could possibly cross over into policy, but I don't know, perhaps some incentive piece for organizations that can come can have volunteers and come up with roles for people to be involved and connected and"]
+[1.2089502811431885, 5.778210639953613, "so much for your answers."]
+[0.20784002542495728, -2.0884897708892822, "Like, I think local government like city governments and things like that. And maybe hospital systems. So some private companies, I guess, as well, but I think I don't think it's necessarily like someone needs again, I don't think policy needs to be created. But I think the help in spreading the word of the benefits of that and spreading that there are these different opportunities. I think that local governments and even again, hospital systems and things like that could do better at that being a solution sometimes that sharing that and that making that connection for people or sharing those resources."]
+[3.65092396736145, 11.003260612487793, "Um,"]
+[-2.2646358013153076, -2.339177370071411, "there's different I know, we work with Americorps is who's who's one of the funders for our RSVP program. And so they have data on how having older active adults, you know, involved in their communities, and everything does help their well being does help their quality of life. And so that's the data that we go off of, and I would venture to guess that there's quite a bit more data about how staying just socially connected, really helps cognitive function and other things that older adults also are concerned with as well."]
+[2.7237493991851807, 4.873201370239258, "I can't off the top of my head, I can send you some of those."]
+[1.72472083568573, 7.9363226890563965, "So much."]
+[-0.6890723705291748, -4.093170166015625, "The Council on Aging, I think is a fantastic resource in the Orange County community as well. They're very passionate about it. We work with them to get long term care ombudsman, volunteers. The Council on Aging, aging. Yeah, they're fantastic. They are super passionate about the work that they do. And I think they would have even more talk about data being driven and the programs that they do and trying to really address you know, the physical, mental and just quality of life aspects. There are really fantastic organization."]
+[4.66133451461792, 3.6289432048797607, "Thank you so much. Yeah. May may follow up with you if necessary. Yeah, of course. There's so much yeah. So this was the end of the questions or the interview. So thank you so much for your time. It was very helpful for research. And please LIKE if you feel that you want to share something else, I mean, dismissed They're like saying that right now just like just to confirm that to me my email or like send it to the website I wouldn't accept sharing right now"]
+[4.115894794464111, 7.681403160095215, "All right and"]
+[-2.5483739376068115, -2.953749418258667, "once again we saw the primary goal today is to identify what needs you think are most important to the older adult population you serve the population user who are 60 years and older we want you to think as broadly as possible taking into consideration the older adults, caregivers families in their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults"]
+[4.7354416847229, 8.05219554901123, "okay"]
+[3.8778040409088135, 4.584679126739502, "share your screen"]
+[4.670323371887207, 5.416126728057861, "so please take a few minutes to read through this list and let me know when you are ready to begin and take as much time as you need and let me know what this is a one page document I'm trying to fit it out into one screen but let me know if I need to enlarge it or you know move around so just feel free to let me know what you need"]
+[4.569243907928467, 5.480954170227051, "Yeah, sure if you can enlarge it I would appreciate that"]
+[2.2116453647613525, 7.290072441101074, "no this is"]
+[4.391226291656494, 6.1688103675842285, "Yes Yeah. There we go. Thank you so much course."]
+[4.222519874572754, 5.379012584686279, "Let me know when you need me to scroll down okay"]
+[4.313609600067139, 5.403748512268066, "okay, can you please scroll down"]
+[5.920016288757324, 6.7240495681762695, "Thank you"]
+[4.442452907562256, 5.466441631317139, "Okay, all right. I will just leave this page up on the screen and we can move up and down however you like."]
+[-0.7707117199897766, -3.118896961212158, "Yes, so my my role with with the elderly adults would be more on the housing side. And what type of emotional well being, you know, are they are they incurring, you know, on a daily basis because of, of, of anything having to do with with homelessness or you know, disability and like diet, mental health, emotional health as well as you know, addictions alcoholism and just basically, you know, being you know, their emotional health and their and their welfare"]
+[0.10987159609794617, -4.135091304779053, "state You're thinking about Orange County, and looking at the list of common issues right that I have on the screen and concerns impacting older adults."]
+[-0.6703006029129028, -0.8646061420440674, "It looks like there there's culture. I don't I don't think I seen anything in regards to let's see access to culturally and linguistically appropriate care. Oh, there we go. That's under health care access and delivery. I'm sorry, I didn't see that one. But yeah, it's it does say access to culturally, culturally and linguistically appropriate care so that's in their ultimate abuse neglect"]
+[3.7059667110443115, 6.561372756958008, "See"]
+[-0.8803378939628601, -0.12037896364927292, "support work family."]
+[4.2341766357421875, 5.363767147064209, "I'm just gonna scroll really slowly."]
+[3.3967552185058594, 6.101198673248291, "Okay. Um, I don't see anything. Maybe in regards to"]
+[0.7568807005882263, 0.9450901746749878, "jobs."]
+[-1.4806935787200928, -1.882318377494812, "Like, I know, even you know, I know that our elderly sometimes do want to be have some sort of, you know, they want to feel like they, they, they still are a part of the society and that they're not just forgotten. And some of them do love, you know, do like to volunteer or they do like to, you know, kind of have like a be a part of if they don't have their own family be a part of like a, an adopt an adoptive family, like an adopted elder sort of deal. Where were families or even just in general, maybe, you know, businesses or schools or, you know, people like, like nursing, like you know, I get nursing homes where you know, people go out to visit them or play cards with them or take them you know, a pet to go see them, you know, just to kind of like brighten their day. I don't think I've seen anything in regards to that"]
+[-0.02578977309167385, -0.04907045513391495, "I mean, it says, you know, loneliness, including quality of life, life satisfaction, community support from work, family, or Church Age Friendly neighborhoods, but I don't see anything in regards to having you know, those type of resources for somebody or"]
+[2.4484736919403076, 7.80884313583374, "I mean,"]
+[-2.1263015270233154, 0.2594587504863739, "health care and everything like that, that's, that's good, but like as far as you know, people going to see them too whereas they need like PPE or you know, things like that. I don't think I've seen that. I mean, it might fall underneath the health care, access and delivery"]
+[3.7193198204040527, 4.882785797119141, "that's fine. So but it doesn't really say anything in regards to you know, get getting out you know, things like that to them."]
+[2.423862934112549, 3.921137571334839, "Please rank the top three that you feel are the most important."]
+[-1.7105672359466553, 1.3982027769088745, "The top three, definitely. One would be behavioral and mental health."]
+[-1.7452861070632935, 0.770583987236023, "Think that the second would be the disability"]
+[1.4422147274017334, 8.87179183959961, "And"]
+[2.112244129180908, 4.5114545822143555, "the third would be"]
+[4.257898330688477, 5.419893741607666, "let me scroll down the second half, two."]
+[-1.5628530979156494, 0.6800343990325928, "And then the third would be the the health care access and delivery."]
+[3.1049795150756836, 4.5170063972473145, "Now I'm going to ask you some specific questions about each one of the three."]
+[1.69398033618927, 5.042996406555176, "Probably will, I think, number one, because of"]
+[-2.372589111328125, -1.1021565198898315, "not, you know, it's hard enough as adults or as children to, to receive help for for those types of, you know, of issues. But for elderly, for elderly, you actually have to have somebody who is willing to, to take you to a doctor who's willing to take that time, you know, to schedule all those appointments for you and to differentiate if it is either from you know, Alzheimer's, or if it is actual mental health, and behavioral issues. Because sometimes, a lot of you know, a lot of times, people don't, they aren't able to differentiate, you know, from from that, like, I know, especially like if, if, if there is an elderly person, like say, in a, you know, like a, a nursing a nursing home, or a nursing care, or if they were like if they were to fall and like breaking her hip, and then they need to go get surgery, and then they stayed in aftercare for a while. If they started to become depressed, or, you know, they didn't have enough people to come visit them, or their family members were, you know, like they, they can sometimes get into like a battle, you know, between legalities or who's going to do this, or who's going to do that for them. It can cause them a lot of serious issues. You know, and they, a lot of people don't tend to know, like, well, maybe they're just getting old and they're suffering from Alzheimer's or sundowners or what have you. But it can also be the mental health. So yeah, so it's a really, it's a big issue in regards to that. Because not only that, you know, the family, they tend to, to kind of like, not want to believe that there's any type of mental health issues or behavioral health issues with their, like grandma or their mom, or their dad or whoever it is. So there's that. That disconnect right there. And especially with between the families, but not only that, like, you know, say that the, that they're that they had, like, addictions problems for a long time or alcoholism. And that can can, that also can affect their mental health and their ability to, you know, live a good healthy, you know, long life, or, you know, any type of just really, like, yeah, just just have a good quality of life. Not only that, like some of them feel like their burdens on people, and then also that would that can affect their, their mental health, you know, and, like, all of this stuff, I mean, like it, the pandemic, being lonely being, you know, cultural, you know, different different types of cultures, and then like, maybe they're having, like caregivers go in, and they have a lack of communication, because they, you know, they're, they don't speak like if they're not English speakers, and they can't really get like a caregiver provider who can speak to them, then there's that that misquote, you know, that that lack of communication, and that could cause you know, different things where you can't understand if they're, if they're suffering from any type of mental health. Yeah, so"]
+[-1.87490975856781, 1.4660940170288086, "Again, we're talking about the first of the three that you mentioned, the first three or the first of the three, the behavior, mental health or so we're still on this topic."]
+[-1.272063970565796, -1.350996494293213, "Well, let's see. One of the biggest barriers I think would be culturally because a lot and you know, a lot of people Um, like, as far as the Native American culture, I know, that it's really hard for people to ask for help. And it's really like, it's kind of like a stigma, you know, like, they're, they tend to not want to even go to a doctor for help. You know, there's systemic racism in healthcare. And they're, like I said, there could be a communication barrier because of non speaking English patients, and not enough interpreters. Or just people basically dropping the ball and not really caring, you know, about our elderly people. And just thinking that, Oh, well, you know, what, they're old. Why, why even bother, at this point, trying to try and to get them any type of help. I've seen, you know, I've seen all kinds of different things or, like, you know, if they're homeless, and they, they're suffering from mental health, or nobody was going to want to, you know, nobody wants to go near them. Nobody wants to touch them, they just based on fear of, of not, uh, being, you know, kind of, like, ignorant to the fact that these people are somebody's, you know, they were somebody's grandmother, they are somebody's grandma, they, you know, or, yeah, there's lots of barriers. Again, you know, travel, getting them to and from their doctors, having that person who, who can drive them to and from, you know, the necessary financial, you know, obligations to people. And, you know, some people don't have that money to go to go get help for to go see a doctor, or even have family members who, who can afford it, or have that time to, you know, so the, that's the biggest barriers is, is to actually have that support, you know, from, from either the community from your doctor from, you know, from your caregiver, and, and your family or your or your friends or your church."]
+[10.634332656860352, 8.473068237304688, "Thank you."]
+[-1.8287400007247925, -1.4317526817321777, "Oh, yeah, definitely. I mean, there can be people who, you know, live on, on reservations, and they don't have that mental health. You know, they don't have that mental health or behavioral health clinic, you know, near them, and then they would have to, like, you know, traveling to the cities. And then the referrals, like in order for mental health and behavioral health referral, you know, sometimes those takes long those those take long, you have to go through like psychiatrists, you have to go suicide, like our, you know, psychiatrists, psychologists, you have to go through different phases of medication to see if the medication is going to be working. You know, in regards to medication, you know, do a lot of people don't don't trust people to other people to come into their homes, and especially, you know, after the pandemic, or during the pandemic. They didn't want people to come into their homes because they were in fear that they would be sick. You know, if they live more in an inner city, you know, area where they only basically have like walking clinics, and there's long waits to see therapists you know, yeah, or if they don't have any type of transportation or they don't know how to navigate, you know, the internet, and let's say if, if the only way to see a mental health therapist or doctor is over, you know, a zoom call or something like that, and, and the elderly and especially if they have mental health, behavioral health issues, and they're, they're not able to, you know, navigate a computer or their phone cell phone. So, you know, that would definitely be one as well."]
+[7.191196441650391, 6.119119167327881, "Now, what do you suggest is the best way to address this need or issue"]
+[-1.0348573923110962, -2.138481378555298, "Of all those people, so you basically find out I mean, that's the only thing that I can think of, like, you know, door to door to door, but that's just like not even, that wouldn't even be that would be way too hard way to take way too long. I guess it would, I guess the best way that you could probably do something like that would be through community, you know, you would host community meetings and figure out what the biggest need was in, in, in, in the elderly community, and or hospitals and or nursing homes, you know, have somebody go out to those places and, and document and figure it out."]
+[1.037261724472046, -2.231860399246216, "Gosh, okay. Like, I know, because I come from a smaller community, you know, I come I come from like, a, like a, like, smaller cities, smaller towns, versus versus these, you know, bigger, bigger areas. And"]
+[2.4940505027770996, 7.021112442016602, "if you could"]
+[4.465229034423828, 5.5869035720825195, "I guess you could actually do it that way, it would take some time. And but it can be done. Because you can, you would have to just treat it like it was a smaller area."]
+[1.4856643676757812, 8.823074340820312, "But"]
+[-2.3387224674224854, -1.0220427513122559, "try it, yeah, like try to condense it in some way, shape, or form and then go in and, and and figure it out. There's always there's, there's always information, and it's readily available on the internet, it's readily available. You know, to everybody, like birth certificates, and whatnot. I mean, you know, people who have passed, you know, people who are still alive, you know, births, you know, all of that stuff. So then why would it be hard to figure out, you know,"]
+[2.9373271465301514, 8.099437713623047, "that"]
+[-0.8319815993309021, -2.2282462120056152, "type of that group with, you know, like that age group, you would be able to figure it out, but it would have to take some time, and it have to take money, and then it has to be, like some sort of initiative, you know, for for, like a city or town to start. And yeah, yeah, I think that I think it can be done. And I think it can be done in that way. You know, you could actually go to doctors offices, or you can go to hospitals, and you can kind of like do surveys and see who wants to be a part of those surveys, because you always have to take HIPAA into account. Right. There is HIPAA, because, because of it mean, you got to be very careful in regards to, you know, the type of information that you're giving out. And you don't want to incur lawsuits and stuff like that. So you have to fight figure out and find a way to kind of get around that. And again, it's it goes straight to, you know, like, like, like government, because the government would have to be definitely be involved in something like that, to that to that extent."]
+[3.187613010406494, 4.682694911956787, "Oh, I'm going to ask you the same set of sub questions. With this issue"]
+[-1.7583072185516357, -0.7856680750846863, "with disability there's death, there's like tons of there's, there's tons of reasons for disability. And in and then it's just the number one, of course is natural, you know, natural occurrences, you know, number two would definitely be, you know, not not taking care of themselves, you know, or not enough not enough self care or not enough. doctor's visits, like there's not a whole lot of people, like I said, you know, who have that transportation to be able to go to, you know, their doctor's offices every, like twice or three times a week or whatever is needed. And that would probably, you know, have to do a lot with maybe support community and family as well. And money, you know, that's, that's a big barrier, as well for for people with disabilities, because when you're on disability, you know, you're only making a certain amount of money. And not a whole lot of people can afford to, you know, get caregivers to take them, you know, every few days to go see your doctor and have upkeep and physical therapy and, and the medication be able to afford the medication."]
+[1.4537532329559326, 8.863046646118164, "And"]
+[4.1268510818481445, 6.463550567626953, "oh, sorry, no, no, go ahead."]
+[-0.14087991416454315, 2.397472858428955, "I guess the barriers that would exist, I would think is"]
+[-1.7094900608062744, -0.8823251128196716, "again, financial, you know, financial stability, the other barriers that exists for you know, disabilities is called when you when you're like, when when you see it, but you don't take action, or you kind of like, pretend Yeah, it doesn't, it's not there. So then you don't, then there's not that help for them."]
+[1.2814340591430664, 3.4954798221588135, "And then again, a lot of people you know, they tend not to want to,"]
+[-1.4242100715637207, -1.0940394401550293, "they tend not want to not want to ask for help. And also they don't want to be a burden on others. And some don't know how to communicate, you know, like they they won't be able to communicate that there's a form of, of disability or they're called, they like kind of, you know, keep to themselves, or they don't have that outlet or people to support them and help them with what they need."]
+[0.8062702417373657, -2.7298262119293213, "Oh, yeah, definitely. Again, I'm gonna have to, you know, go back to, you know, being in you know, in smaller, smaller cities, smaller towns, you know, if you're not in an urban setting, where the we're all, you know, like, where you have access to everything, you know, if you're in a place where it's more away from, you know, bigger cities and bigger areas, like say in Orange County, if you're like out more like say, San Juan Capistrano, or you're out more like near Not, not closer to like Santa Ana or Tustin or like, you know, orange or city of orange or anything like that, then yeah, you're gonna have you're gonna have more barriers because there's not as much access to to to bigger facilities that you may You need"]
+[-0.9555150270462036, -2.2958571910858154, "So you would have to have like tele, you know, tele tele med like telehealth, you know, probably better to have like maybe go into, like having the community senators and everything like that, where they would offer, you know, some sort of some type of classes for, for elderly people and people with disabilities, and make sure that they had, you know, transportation, make sure that they have, you know, people going in and checking on them and being able to help them get to and from, and to have that education for their families and for the for the community. So you have to have that you have to have that education out there for the community."]
+[3.34721040725708, 5.818498611450195, "Now and again, moving on, again, same set of question."]
+[-1.2346441745758057, -0.7911900877952576, "So for, let's say health insurance, right, when you retire. You know, you have to literally go on, you have to pay for your own health insurance. So if a lot of you know a lot of Merrick, or a lot of elderly people there, they live on a fixed income. And if they qualify for a certain health insurance, you know, possibly some of that won't cover what they need, like, say, you know, they need a wheelchair, and they've already had a wheelchair, they've been disabled for however many years, and that will turn no longer works. You're only allowed to get certain DME products right every three years, or every four years, or every five years or over 10 years. If like, something breaks down on them, or you know, like, say, a scooter or their walker or something like that, and they're not able to afford to get another one, then that's definitely you know, a barrier right there. And where are they going to get the resources to, to be able to, you know, get any type of extra help. So they're gonna need, you know, that's a barrier, because sometimes, you know, those aren't readily available to them. And that goes hand in hand with education. The availability of providers, you know, sometimes like, like I said, you know, they're in short to short supply of mental health therapists and psychiatrists, and psychologists. Whatever, they whatever illness or sickness that they have, it gets, it gets worse because it doesn't, it's not addressed properly and right away. Let's see, some of them don't have access to you know, their, their cultural culture or linguistically appropriate care. You know, there's, again, for Native Americans, there's not a whole lot of people who know how to speak can know their languages. And how, how are they going to get help when somebody, they can't even speak one dialect. And then how are they going to be able to communicate with them, you know, and again, with caregiving. II seen a decline in in caregiving services, especially like, during the pandemic, where you weren't able to go, you know, the caregivers weren't even able to go into the homes, they were only able to drop stuff off at the doors, and they still have safety precautions, when it comes to caregivers, not only that, the cost, the transportation is a barrier, because they, you know, as a caregiver, you don't get paid a whole lot of money. So how are you gonna get to and from if you can't afford to even pay for your gas, or you're gonna, you know, the transportation costs have gone up in buses, or in cabs, and Ubers. Not only that, people don't feel safe using public transportation anymore. So it's like, okay, well, either I'm gonna, you know, go to work and get assaulted on a bus or a train, or I'm gonna stay home, and not. So a lot of people. Not only that, a lot of people are moving out of the state. And so we don't have as much, you know, have as much people that are even working in those types of types of jobs."]
+[3.9492406845092773, 6.413503170013428, "So the answer Oh, sorry. No, no, go ahead."]
+[-0.7568023204803467, 2.2915968894958496, "The barriers, you know, for improvements. Ah, you know, what, I think that there will will definitely brought up a lot of those barriers. But I think there can be improvements, but I think the improvements have to start at a level of level inside the home, you know, not a whole lot of families are you know, like, like, so oriented to where"]
+[1.9764455556869507, 6.872870445251465, "they,"]
+[-1.7715959548950195, -1.3436199426651, "they help each other out, like before, you know, when, when people used to, like, you know, they, they have big families, you know, they they're close and, you know, everybody kind of like takes turns helping one another out. I see more and more people. Especially in Orange County, where they're there. They keep more to themselves, you know, and they look out for Yeah, and then once it's just, it's so it's so random. Like, just for example, I was leaving work one day, and there was this elderly lady and she was in the shade and she had I noticed a big like a tarp over something and it was over her cart. And I just pulled over and I gave her my card. I'm like, you know, if you need any help, looking for a home or looking for a place, you know, give me a call. And she said that she was and that she started to show me like her, her neck and everything like that where she had bites all over, you know, and she was suffering from you know, all this all these ailments and everything like that. And she worked she said, I still work. But I either need another job or you know, some form of help and it was like wow, like you're working you have a job. But you know, you're still homeless because there's no can't afford, you know, she can't afford to, you know, get a proper place. to live off of what she's making. So there's, there's so many different types of barriers you know, for for the elderly, and that don't have that support or family or that care. And the community is just in general, there are some people that care about people. And there's, there's just other people that, like, the guy behind me just honked and wanted me to get out of the way, so he can go on with his life instead of, you know, instead of caring and helping your fellow man."]
+[-1.6192494630813599, -2.4967548847198486, "Yeah, of course, you know, of course there is. You know, you see it every day you see, there's, you know, there's racism, you know, there's ignorance. There's fear. And that could easily cause people not to want to help other elderly people and also responsibility"]
+[3.63067626953125, 6.699280261993408, "Gosh, let's see."]
+[-1.4778658151626587, -2.0633344650268555, "I think like, one of the biggest things to address something like that would be to again, you know, go to our youth, you know, go into schools go into edgy, you know, educate them educate, like them on how"]
+[1.214600920677185, -2.4199025630950928, "you know, it would be it would be good for, for our youth to get more involved in planning, you know, a future where they would want where, where they would like to live where they would feel comfortable, when they're older, like, what are some of the things that you can do, to combat you know, homelessness to combat not having the best health care. And to make sure that, you know, there's cultural activities for, for people in, you know, in society, in your area in your community in general, you know, to instill those values back into, you know, back into our youth into and to have like pride and to be able to, you know, have that knowledge because, in reality, elderly people carry all that knowledge, you know, they are knowledge keepers. And so to try, you know, just make sure that we have that, that future planning, instead of not, and then all of a sudden, just like, boom, having to deal with it as it comes. So, you kind of have to Yeah, you definitely have to, you know, like, educate and plan."]
+[-1.1646993160247803, -4.052030086517334, "Thank you. We're gonna move on to the next question. Can you please describe how accessible and adequate the following care or services are in Orange County, a geriatric care. I'll come back to each one of them the first one here battery care, B, long term care C, mental slash behavior health slash substance use treatment, D human slash, social services. So the first one is here, we actually care and the question is how, if you can describe how accessible and adequate the following here or services are in Orange County."]
+[-2.913447856903076, -0.28522464632987976, "So for geriatric care, how how accessible are the services is that"]
+[-2.9703609943389893, -0.0986461192369461, "by how, how you know if you know if you have any opinion on any of these so how accessible and adequate the following care or services are hearing on counted in the first one was via TRICARE."]
+[-3.165580987930298, -0.4274073839187622, "So for geriatric care, you know, there are quite a few hospitals and there are quite a few clinics that that do help and assist with geriatric care. I think, though, that for that, it just, it's all about being able to afford it and the affordability of it and the amount of people who can, again, help and support with them receiving that care."]
+[-3.0159902572631836, 0.08695091307163239, "Long term care. No geriatric care. Oh, sorry. Yeah. I mean, so the next one's long term care. Oh, the"]
+[-2.7563858032226562, 0.2636982500553131, "next one, long term care, long term care. And, you know, I'm not, I'm not 100% too familiar with with the long term care, but again, you know, the,"]
+[-2.725804090499878, 0.2935490906238556, "let me read this to you. Because I know, we find that sometimes people aren't, you know, they do ask us what that means. So, a word define long term care as a variety of services, which help me both the medical and non medical needs of people with a chronic illness, or disability who cannot care for themselves for long periods."]
+[1.2186886072158813, -2.55268931388855, "So from from what I know, and what I've seen so far, I mean, in Orange County, it's all about, it's all about being able to afford that type of care. You know. And because it's such a high cost of living in that area, it's only, you know, it's only afforded to people who can really navigate the system. And, and, or can't afford it. So, I would kind of, like, do a 5050, it's like, really 5050. You know, you see a lot of elderly people, it's becoming more and more apparent, that, you know, they're there, there's a lot of them that that are being taken advantage of, and that there's a lot more becoming homeless, you know, it's even in the numbers, right. I mean, as far as I know, as Native American, elderly people, they're at the top of the list right now, their percentage of them becoming homeless is higher than have an adult or have an IQ of a child or a teenager."]
+[1.7327452898025513, 8.090388298034668, "So"]
+[-0.5398715138435364, -0.009743081405758858, "there's like, yeah, I would say definitely, like, 5050, you're either you either can afford it and have the support or you don't."]
+[-2.214329481124878, 1.355108380317688, "And the third one is mental behavioral health, substance use treatment. For older adults, of course."]
+[-2.0333805084228516, -1.757007360458374, "You know, again, across the board, I don't think that there is a whole lot of a whole lot of adequate services for the elderly, when it comes to mental health and behavioral health. Because again, it takes a lot to differentiate from"]
+[2.4907479286193848, 7.330853462219238, "from, you know,"]
+[-2.9408249855041504, -1.195864200592041, "dementia, from Alzheimer's from and, you know, to differentiate that from like, if it's either mental health or behavioral health, or if it's just basically them, you know, like getting older and losing, you know, losing that memory and being able to, you know, be in control of your, you know, have your own mind. So, again, a lot of people tend not to want to believe that, you know, their, their grandma or their mom or their aunt or anyone is is suffering from mental health. And"]
+[2.383317232131958, 7.809759140014648, "just kind of"]
+[-2.9824113845825195, -1.1866968870162964, "chop it up to you know, to to getting dementia and then sometimes Yeah, they take too long, you know, they kind of let it linger. Because they're, you know, in denial and and then it gets to the point where it gets worse,"]
+[-1.2870830297470093, -3.741506814956665, "you know of any services or programs in Orange County that provide, you know, mental behavior behavior here to older adults."]
+[-2.0323307514190674, 0.2684231400489807, "So, the, I mean, there's just like a psycho psychiatric facilities or, like gym like the I want to say the long like, not the long term facilities, but like for the shorter term facilities, like those type of facilities, they do have mental health and behavioral health you know, access but other than that, just like, like I said, regular psychiatrists offices or, you know, Kaiser or, you know, like, hospitals, facilities that offer those types of services."]
+[-1.0414574146270752, -2.180698871612549, "So I think that yeah, they definitely have those services available. I think that they're just like, too overcrowded, like, they're just the population is, is so there's just so much people that it's just so hard for, like social services and for them to can keep up with it. And people just get lost in the shuffle and or there's so much burnout from social workers, that they tend to just like, their, their their, their caseload are so high that it's it's easy for an elderly person to get lost in that in that shuffle and not receive any of the services that they need I don't think that APS is like their turnaround time is just so so long that people don't get the help that they that they need nor or deserve. And a lot more people are just too scared to, you know, to take that route into. And just to you know, to help, so, it's few and far between."]
+[3.8500759601593018, 5.434139728546143, "And Lisa, I have a few more questions. Do you I'm doing a time check. We're almost coming up to an hour. Do you have some plans to continue or is not we can schedule another time to finish out the rest. I'm going to defer to you one second, I'm sorry."]
+[-0.786142885684967, 0.10383230447769165, "Support Hold on one second."]
+[4.061570644378662, 4.64789342880249, "I actually have another meeting that I have to attend right now."]
+[5.357853889465332, 3.6191346645355225, "Okay. All right. Let me stop the recording right now."]
+[3.683286428451538, 5.707899570465088, "Okay. We can definitely pick this up another day. And then we can definitely"]
+[-2.666382074356079, -3.1909077167510986, "The primary goal today is to identify what needs you think are the most important to the older adult population you serve those who are 60 and older. We want you to think as broadly as possible taken into consideration the older adults, caregiver, families and their community. I'm going to share my screen so you can see a list of common issues and concern impacting older adults. Please take a few minutes to read through this list and let me know when you are ready to begin"]
+[2.8333451747894287, 5.23372745513916, "No, we have a little bit. Now more to go."]
+[3.9279301166534424, 5.358649253845215, "Okay. So if you go back up, I'll read down. Okay."]
+[4.260475158691406, 5.364782333374023, "Yeah, when you want me to scroll out and let me know. You scroll down."]
+[-0.33942657709121704, -3.7557966709136963, "Okay, I think we have one more is last issue. Yeah. Okay. I read them. Okay. thinking specifically about older adults in Orange County. For our record, can you please tell us your role and how you interact engage with older adults."]
+[-0.6439582109451294, -4.023815155029297, "I am the president and CEO of Alzheimer's Orange County. So in that role, I direct the programs and services of a roughly $10 million organization serving particularly frail seniors throughout the county. I also co chair the Orange County aging services collaborative, and supervisory data report for the county the collaborative is 42, Senior facing organizations. And the collaborative itself helps coordinate co joint activities of those organizations."]
+[-1.3871244192123413, 1.081703543663025, "There could be more specificity to the list. I think the list is reasonably comprehensive. But the breakdowns could perhaps be if you're trying to get to very specific issues, then you could probably break it down a bit more. For example, fitness and diet are not the same thing. Yes, diabetes and obesity are absolutely not the same thing. And they're both significant issues, heart disease and stroke. If you're talking about heart health, and heart disease and stroke would come under them. But other than a lack of specificity. I think you've you've captured everything"]
+[2.157543420791626, 3.7586188316345215, "up the needs on the list, or any of those that you think might be oh, excuse"]
+[-1.2485735416412354, -0.0843328982591629, "So respite could mean everything from adult day centers, to residential care facilities to in home support to ITSF."]
+[4.433002471923828, 7.292686939239502, "Okay. Okay, so I'm making a note of your comments here."]
+[2.057075262069702, 4.5613484382629395, "Four, I don't understand."]
+[2.1752209663391113, 5.957910060882568, "I do. And I mentioned what those are respite and the forms of respite."]
+[3.6121573448181152, 7.211474418640137, "Yes. Okay."]
+[0.49162161350250244, -2.2295010089874268, "That's impossible. There it depends on the individual senior if I'm looking across the county, then transportation is certainly high. I think Alzheimer's or dementia are high partly because of what I do for a living that is that's my forward facing issue. Yes, Alzheimer's. Transportation for sure. Not behavioral mental health, I already get some ton of like, go ahead and scroll down, please. Economic Security. And again, I just want to I'm going to continue to note, economic security is not food security is not housing security, it's different. So my answers might be different."]
+[0.3242240846157074, -2.3922879695892334, "Yeah, that's understandable. So for when you think of transportation how or why older adults struggling with this issue."]
+[0.14795905351638794, -2.6536076068878174, "The accessibility of transportation is modest at best, it doesn't help that we're in an octa strike for access today. But the access program only goes where bus routes go or in the equivalent areas, and for seniors in the county, that's not a reasonable quantifier. Because I can get, I can walk myself a mile to a bus stop a senior and wheelchair, a demented senior cannot. So the lack of facilitated Transportation provided by the county is a significant barrier to medical care to socialization to all of it."]
+[0.4948076009750366, -3.08463454246521, "County, the county construct the belief by the Orange County Transit Authority and therefore the county itself to the supervisors. That transportation should exist beyond bus routes. And that access. If you look at the quality of access and its ratings, it's horrible, and it's just not addressed. The strike this week is a perfect example of that daycare center participants medical appointments are being missed throughout the county yesterday, today and tomorrow and probably all next week just because they couldn't work out a deal with their union. So I think the funding focus of the county and Octa is inappropriately focused on able bodied and what's easy."]
+[7.174581050872803, 4.647333145141602, "Thank you for sharing."]
+[0.25126633048057556, -2.5142710208892822, "Absolutely. If an older adult has a physical impairment, transportation is even harder to access. If they have a mental impairment, be it mental issues of mental health, drug addiction or Alzheimer's memory loss, etc. All of those issues make accessing public transportation particularly difficult. We talk language barriers in there as well. Oh, yeah."]
+[-0.22701071202754974, -2.4706971645355225, "Invest. Expand the existing one, expand the existing programs for seniors and people with disabilities to more of the county two, actually fund it well enough to correct the issues of competence that are that are easily identified and have been identified with those programs."]
+[-0.7962931990623474, -2.553110122680664, "Well, it's an incredibly impairing condition. When we figure that people 65 and older are the only growing part of the population. And by our estimates, over 169,000 of them have either mild cognitive impairment on into some form 169,000 It's a huge percentage of the population. It's over a third. So if over a third of the County seniors are facing some form of cognitive impairment, we as a county are not adequately addressing it. county funding is almost non existent. Beyond some for Adult Day and some Meals on Wheels, there's not enough focus, there's not enough discussion in the county."]
+[0.05309690162539482, -2.248443603515625, "awareness on the part of our elected officials at all levels state local, county wide and federal and funding. The infrastructure exists to provide supports and services through community benefit organizations of all types, everything from hospitals to organizations like ours. But there's the money to actually provide the needed services does not exist currently."]
+[-4.1710004806518555, -1.9354612827301025, "Are there different experiences for different group of older adults from different backgrounds."]
+[-0.5147188901901245, -1.4653668403625488, "Absolutely. People from different ethnic backgrounds who have a different countries of origin, who have different languages who have different faiths systems have different belief systems, you have different cultural systems, all of them have far more trouble accessing what supports do exist than those who are from the more traditionally, Anglo, Protestant etc. So if you take any of those groups in the community, in Orange County, if you look at the concentration of seniors, they are massive percentages of the population. It's not a White County, but we operate our programs and services as if it was, and I'm not saying the folks who are, who are Anglo don't deserve support, I'm just saying everybody else deserves the same supports."]
+[-0.5461854934692383, -1.8876821994781494, "There needs to be a great deal of community conversation facilitated at the county level on where the gaps in service exist in those communities that needs to be done in the language. folks live their lives in from the cultural perspective they live their lives and and that needs to be integrated into a countywide plan on how we're going to address the issues. And again, that can be done easily through the existing network of community benefit organizations that exist and have those relationships in those different communities."]
+[0.1075267493724823, -0.6804372668266296, "Thank you for sharing, when you think of economic security, how or why older adults struggling with this issue,"]
+[0.5782663822174072, -3.3242733478546143, "Orange County has an incredibly expensive place to live. Even for those considered to be of affluent their primary asset may often be their home. If they're not interested, willing or able to sell their home, then they're often reliant on modest savings and or Social Security. When you go to the other end of the spectrum where we're not talking about homeownership. For those who have social security, it is often the only thing they have to rely on, it is not enough to live on in Orange County. And then when you go to that percentage of the population that never qualified for Social Security, everything from undocumented to those who are documented, but with no reliable work history, they have nothing to rely on except family, friends, and are at risk of homelessness. So wherever people fall on the income spectrum, there is great risk for seniors, they are not generating income, therefore, whatever they have is what they have."]
+[-0.778562605381012, 2.2486624717712402, "What barriers exist to see improvement in this area."]
+[-2.018784999847412, -2.011246919631958, "The general lack of awareness of the of the problem. There's also a general public lack of awareness, legislative lack of awareness. And I think there's also a an unwillingness on the part of many seniors to discuss their financial situations in a public space or with those who might be able to offer assistance. There's a stigma."]
+[-4.093399524688721, -1.9256213903427124, "Yeah. They're different experiences for different group of older adults from different backgrounds."]
+[0.2593989968299866, -0.822120726108551, "Yes, and I would go back to my answer to the previous question, where you have everything from folks who are undocumented to entry level documentation to net Social Security to no social security, to affluent but only owning their home, it is markedly different for most individuals situations based on their ethnicity, their financial backgrounds, all of those."]
+[7.180045127868652, 6.152876377105713, "What do you suggest is the best way to address this issue,"]
+[-0.09880378097295761, -1.2236090898513794, "we need to start investing more in financial literacy for middle aged and older in and not only providing it but also creating forums that are accessible to provide financial literacy so that folks can come and get a grip on their finances. Going back to the Alzheimer's and dementia space, if if a third of our population has significant cognitive impairments, we need to provide facilitated financial planning for that population. All of those need to be everything needs to be accessible in the same way as I've talked about before, ethnicity, gender specific sexual orientation, culture, ideation, all of those things."]
+[-3.0583128929138184, -0.20101191103458405, "Thank you for your feedback. Can you please describe how accessible and adequate following care and services so first is the geriatric care."]
+[4.6419291496276855, 8.140422821044922, "Again, I want to make sure I understand."]
+[-1.239081859588623, -4.208405494689941, "Can you please describe how accessible and adequate geriatric care in Orange County"]
+[3.1525352001190186, 7.808013916015625, "sure, in general,"]
+[4.54960823059082, 7.939330101013184, "Okay, so"]
+[-1.2630400657653809, -3.7272939682006836, "geriatric care in Orange County is remarkably inaccessible. By inaccessible it doesn't exist in many spaces. We are incredibly short on geriatricians in this county. Physicians specific to senior care are very short. We just don't have enough of them. If you're trying to get into a neurologist, it can be a three to six months wait despite the level of crises you're experiencing. So one, there's a lack of clinical providers in geriatric space, two, There's not enough funding for the geriatric social work experience, which is a big chunk of what geriatric support is. So there's not enough money for people to provide geriatric support for homelessness issues, you need a social worker who understands what seniors face, if you're on the street, and you're homeless, you're geriatric at 50. Biologically, so it's a different world. Each one of the spaces that we deal with food insecurity, dementia, all of those need more resources to address the barriers in their own specific space. Again, it boils down to an issue of money."]
+[-1.0349202156066895, -4.161715030670166, "Can you please describe how accessible and adequate long term care and services in Orange County,"]
+[-1.3122552633285522, -0.619322657585144, "Long Term Care is more accessible when you get to nursing homes, which is where no one wants to be ever with respect to nursing homes, but because it is federally funded, it is the place people often end up because they have no other options or alternatives. We don't fund residential care facilities. So after a person is no longer able to live at home safely, there is often no place for them to go until they are qualified for nursing home. So that gap means that the caregiver is going to get ill the caregiver is going to hurt themselves, the person experiencing issues of aging, requiring additional assistance is going to harm themselves or wonder. So until we address that gap with some form of in home support or residential care, that is not a nursing home, and a step down level and non medical intervention. And we're going to face those problems and it's going to increase because the aging populations increase."]
+[-1.2350373268127441, -3.7902638912200928, "Can you please describe how accessible and adequate mental health behavioral health or substance use treatment treatment services in Orange County,"]
+[-2.0259270668029785, -1.7034715414047241, "it's one of the few areas that has been growing to bewell initiative has actually put some significant resources from the state, local and federal government to play. So out of everything in a strategic plan for aging that I hope is addressed, that's one that I hope they check off and go, there's more to be done. But we're doing the right thing. Now, let's focus our energy and resources. And let's put some of the same level of energy into Alzheimer's disease that we're putting into mental health or into homelessness that we're putting in a mental health. Because that I believe, while not adequately addressed, I do believe that the right moves are being made"]
+[-1.2717052698135376, -3.728950023651123, "to you know, any services or program in Orange County that provide mental health or behavioral care for older adults,"]
+[-2.0655570030212402, 0.39949047565460205, "the entire bewell initiative and everything that falls underneath them. So bewell as the umbrella has many, many component parts, working with many different organizations, all of which provide some level of mental health support. So it's dozens of organizations. But the umbrella most commonly recognized is the bewell organization."]
+[2.8911142349243164, 5.625824451446533, "So that in and of itself is a question that's, I don't know how to answer actually."]
+[3.781972646713257, 15.478878021240234, "Yeah."]
+[-0.12102968990802765, -3.0946667194366455, "100% transportation is one of them. I think Alzheimer's and dementia specific Orange County is going to be one of them. Alzheimer's, dementia, mild cognitive impairment, forms of memory loss. I think those two and I do think that gap we that I mentioned earlier, that respite in home care and facility based care that's non medical prior to the need for nursing home hospital or hospice, that's not paid for that we're gonna have to figure that out. We've got 10s of 1000s of people living alone, for example, who experienced some form of dementia. At some point, they're not gonna be able to live alone, but they're not gonna need a nursing home. What are we going to do."]
+[-0.053241483867168427, -2.4884390830993652, "If by government, we mean the county, because there's city state, all kinds of difference with let's focus on the county. I think the county has a coordination role. If you look at the county has a role I believe in identifying the gaps in needs and services. Helping formulate a plan to fill those using the existing network. I think the county fails when it tries to do in itself. When the county tries to provide the service. I think that's a weak formula. But when the county figures out where the needs are, and figures out how to access state, federal local funding to cover those needs and then uses the existing network of community support. Again, everything from hospitals, community clinics, CBOs. I think that's the most successful means of actually filling the needed gaps."]
+[-0.02730565518140793, -4.780911922454834, "Thinking about all the older adults, and resident in Orange County, who is getting the least amount of attention,"]
+[0.3498878479003906, -0.5780059695243835, "undocumented,"]
+[0.10735228657722473, -3.911452293395996, "thinking about all the issues facing older adults in Orange County, what issues is being overlooked,"]
+[-0.01783810555934906, -0.7602161765098572, "undocumented, and those people who do not qualify on their face as low income because they have physical assets like a home or car. So believe it or not, I think it's the folks who are at the lowest end of the financial spectrum often and those who are sometimes at the upper end, not the highest of the high, obviously, but you have no cash assets, but their physical assets, keep them from accessing services, and the perception of them is that they don't have need. And on the lower end, they have trouble accessing services often, partly because of language and culture and partly because of fear on their part."]
+[-1.0709952116012573, -4.063167572021484, "I'd like to dig a little deeper into the respite care that you mentioned, what are some ways that respite care is working or not working for older adults in orange county."]
+[-0.8630059957504272, -0.9920752048492432, "I think the concept of IHHS is solid. I think now that has a little more funding, it's better. But it's hopelessly underfunded. When you offer someone eight hours a week, for example of personal care, and they're a paraplegic or quadriplegic, senior, it's woefully inadequate. The fact that they have to find their own care is not necessarily bad, it can often be a family member, but there's not enough. The infrastructure CalOptima, for example, is not enough to really fully support them in finding those people supervising them vetting them and that sort of thing. No shame on CalOptima there's just not enough money for people. Bottom line, there's not enough money there. So in that form of respite, it needs more resources and some more infrastructure in the middle part of respite, which is residential care facilities, Medicare funded beds funded a level most facilities will never take. So even if we increase the number of Medicare funded Beds in the County, it's not going to fix the problem. I think there has to be a concentrated effort to create living spaces for seniors who have nowhere else to go and can't live at home safely, but who don't require nursing homes, it needs to be managed with the federal funding systems for nursing homes, with the argument that it's way cheaper than a nursing home, and we're gonna have this person in the nursing home tomorrow if we don't figure it out. So I think there needs to be some very creative legislative action happening to access federal funds for those interim living arrangements."]
+[2.9861252307891846, 0.06265442073345184, "So on that note, what new or revised policies are needed."]
+[0.6911181807518005, -2.2856547832489014, "We need at the county level, we the city level, they need to keep doing with their ADAs, their mother in law units, allowing more spaces like that, at the city level, like Laguna Woods village, they need to allow roommates in group living situations so that people can afford a space to live at the county level. There needs to be more effort resources in coordinated planning at a very systematic level, instead of just these 123 smaller initiatives needs to be much more global with much more money we're talking many millions, if not billions of dollars need to be invested if we're going to really climb that mountain. So legislatively, it's accessing funds, allocating funds, and creating a system for monitoring them safely and quantifying their return."]
+[0.19308248162269592, -2.8976492881774902, "So there's a great dearth of data in any area of senior service delivery, and also in Alzheimer's and dementia. So we've just released some figures on county wide prevalence, my organization has just ended last week. There's no other data in the county that's county specific except what we release. And we're looking at it extrapolating that information. So on a general data note, it is the weakest part of planning for seniors that we as a county face, we've Collaborative has released multiple data reports we're about to release another one. No one's collecting comprehensive county wide data on working with the different datasets to aggregate them better to create cross correlations to create ways that we can work better together with those who are collecting data until that's fixed, and that needs a whole that's not just the county, that's a county commission, with hospitals, Cal Optima, everybody's sitting at a table, investing time, effort, money and creating a county wide data collection systems. That has to happen before we're ever going to move the needle on any of this stuff. We don't know for sure how many people really are at risk transportation wise. CTA doesn't know it they only deal with One segment of population. So until we figure out how to get better annual data collection and analysis, we're guessing"]
+[-0.6854640245437622, -2.989104747772217, "I think you can talk to any member of the aging services collaborative. And that would be effective. Holly Hagler Meals on Wheels, Orange County, Lisa Wright Jenkins Council on Aging, I could go through the jack at Figure Resource Center, Mario Ortega, abersoch. All of their CEOs have a very specific lens. If you're talking to Mario, he has a very good eye into the Latino community in Orange County. If you talk to Hnun Nguyen at some length society, she has a really good eye into the Korean community, Elena and also so I think, one making sure that you're reaching those disparate populations, the LGBT Center, for example, they all have a very specific perspective. Our organization kind of reaches across many of those groups. We don't do it perfectly, but we at least attempt it. So the fact that I'm an Anglo gay man, that's only my personal perspective, when I speak in this interview, I'm trying to represent the organization and all of our constituencies. So when you get to these other organizations that are very specific to a culture or community I think you enhance your insights into that very specific community and that's really needed in Orange County. It's a diverse place"]
+[4.980780601501465, 3.4735665321350098, "well, this concludes our interview thank you so much for your time you've been incredible Oh my god. Well, I just I need to conclude by saying that if you have anything else to share, please feel free to reach out or you can leave anonymous comment on our telephone our website. I'm gonna stop recording now. Let me know"]
+[-2.6385586261749268, -3.1611335277557373, "All right, the primary goal today is to identify what needs you think are most important to the older adult population you serve those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through that list. And let me know when you are ready to begin and I will be asking some questions based on that list"]
+[4.66690731048584, 5.428974628448486, "I know it's small try to pack into one page. Okay, I can you know, let me know if I need to move up or down or enlarge any part of that let me know when you're ready."]
+[1.0617852210998535, 5.557067394256592, "So for"]
+[-0.9096667170524597, -3.156263828277588, "Here, so my I'm the Assistant Deputy Director for adults and older adult mental health services. And so in my role, I oversee our older adult system of care. So along with the other adult programs that we have at the at the county of Orange in health care agency, we also have our older adult programs, that includes our recovery services, which is more of a clinic based setting, but we provide most of the services in the field or the or the home. Our shop and start programs, which some are related vote start is related to substance use for older adults, shop is like wellness checks are seeing how folks are doing in the community and making sure that they are connected and engaged in services if they need them. And then that also we have our FSP level of service for older adults, which is our which is our Oasis program. Additionally, which is a little bit it's not specifically over the older adults, but I do oversee in this room, the Housing Services program, and we have in in our housing, our mental health and substance use housing services, we have older adults specific housing system as well."]
+[0.17897745966911316, -4.137730121612549, "Yeah, thinking about Orange County and looking at this list of common issues and concerns impacting older adults."]
+[-1.5788298845291138, 1.2620229721069336, "Well, I mean, so behavioral and mental health. In your examples, there's tons of things just because it's our it's our specific, but I don't I think it all of the categories that I'm I would probably want to touch on or talk about today. I'm seeing there let me see if there's anything missing, but like I said it's more in the details of that behavioral and mental health area that I think that I think I would have, I would have stuff on because all the all the other areas housing, homelessness, access to food, being isolated, those are all things that affect us in behavioral health and substance use system and you already have those on there. So each of the other areas kind of affects substance use. I don't think there's anything missing from that just how it affects mental health and substance use is is the details that are probably okay,"]
+[2.5669121742248535, 3.8748257160186768, "well often needs on this list. You know, including anything that you suggested even though I know you think that what you said that everything's pretty much on here in terms of the category please ranked a top three that you feel are the most important."]
+[-1.4871138334274292, 1.2560615539550781, "For so for, for me, obviously behavioral and mental health, health care access and delivery and then housing, homelessness kind of tied together, but those would be the ones would be the ones Okay,"]
+[3.1002776622772217, 4.493858337402344, "and I will ask you some question. And with respect to each one of the topics that you just identify are the top three."]
+[-2.1066458225250244, -1.6215463876724243, "I think there's a few things. There's, there's still a lot of stigma attached to, you know, behavioral health, substance use, especially right now we're seeing a lot of folks who started their  substance use in their 20s, or 30s, and now are in their 60s, but are being referred into our services. So we have this co-occurring mental health and substance use issues with folks in there, you know, who are are older. And so that's, that's become a, that's become kind of a big, a big issue that's newer, that we really haven't had to deal with in the past. We don't have detox programs specific to older adult populations. And oftentimes, folks who are having that kind of struggle don't really like that substance use treatment is so group focused in, in, in, in kind of that community focus about working on your substance use issue, and it doesn't work for older adults to be with really young kids in there, it just doesn't, that's just not how, like the issues surrounding that are so different. And so having specific focused services that they are substance use that are provided to older adults is something that we're lacking. Same for housing programs, right, we have a few of them, but but how to make sure that our housing programs that we have out there that provide our behavioral health housing, I'm talking about at this point, kind of provide the specific mental health treatment to folks who are who are experienced, experiencing homeless, but our older, older and age, again, that kind of sense of community and where you live. Oftentimes, that's that's a struggle when you're when you're living when it's, there's a bunch of younger people around you, and you're not, you're not really kind of fitting in with our community. I think an additional piece for mental health is really is really how we get services to our, our older adults. Transportation, around getting folks to their appointments is a struggle, getting like being able to provide services directly to like in the home for folks. Because there's oftentimes there's isolation, issues that surround that, like making sure that we get out to treatment. Because right now we have a kind of a crisis in hiring staff to provide service. But the numbers needed to kind of get out and make sure that we're meeting clients where they're at, is a struggle for us. We don't, we don't always have that it's new graduates who have never worked. Sometimes it's good sometimes that that is what people are looking for, but it's not always and so they're having folks who are who come into the system who have some experience and, and I've worked that that's helpful to our older adult population and feel more comfortable with the more experienced clinician. And so that's another kind of crisis that we're in right now. We have like food scarcity is an issue in in making sure and how we kind of wrap services, additional services around our mental health programs. We have referrals, but there's just not the numbers that we're seeing right now mental health some good like good conversation around it, and then Health Awareness Month and everything right, we have a good conversation around things right now. There's more. There's more information out so people try to access more. But we then we see that we have more people in our programs who have additional issues when we go out and visit with them that additional issues and in food and food scarcity is really a kind of a big piece for that is just in general referrals for health care and, and for other other needs, that those referrals that system of referrals for that, for that kind of stuff is not built up well for our older adult population. So those are those are some of the some of the areas where we're just kind of struggling a little bit or when we see, there's really a greater need is how we can wrap services around folks, not just, you know, they're coming to us for mental health. But we we see, our system is holistic system. And we know that older adults, when they come to us for their mental health issues have a multitude of others that we need to, it's very important, especially with health issues and medication management, super important for us to coordinate care around all of those things. While you may have just answered the rest of them, I told you, no, no, no. Stop talking. That's too much. No apologies."]
+[3.450044631958008, 5.649496078491211, "I want you to I want you to continue. I mean, at some point I well, but no, no, no, really. I I just don't want. We don't want to we don't want you to think that yeah, I already answered your question. But let me find Well, kind of follow with the I know, some of the things that you may have already mentioned."]
+[-1.5910836458206177, -1.525238275527954, "Yeah, so barriers, I did mention a few is being able to get to where our older adults are usually in their home. I mean, our goal is to get folks out in into the community, but a lot of but a lot of times, that's not always possible. And so making sure that we can get into the areas where we need to see older adults, making sure they understand how to access our system, it's it's a confusing system or for all of us, it's confusing with, if you have a mental health issue, it's it doesn't make it easier to try to access. And a lot of times because of stigma, especially with our older and older adult population, reaching out and asking for help on these things is not it's not something that's huge. So making sure that we eliminate stigma, making sure that we get the message out to people making sure that we advertise in the right place. For folks that they know how to access our system, making sure people understand that they, they're not going to have to go into a location or sit in a group with a bunch of kids who don't really have the same kind of issues as them. And really in built a good system. Some people may just think of oh, I need to go get mental health treatment, I needed to get my son to use treatment, but don't understand that there's services that are really focused for our older adult population. So getting that information and that message out to people is a big, it's a big barrier. We want to make sure that people know about us and know how to access and know the breadth of services they have to access."]
+[-4.028798580169678, -1.8862849473953247, "Now are different experiences for different groups of older adults from different backgrounds, for example, where they live, disability status, income, education level, etc."]
+[-1.8226275444030762, -2.211348533630371, "Definitely, definitely. Like those specific areas of focus. We have to take a look at in part of our larger system, right and so developing. Because not every older adults as a population themselves get their information in one way. But also lower income families get their information from another source and not everybody has access to internet and for older adults. Oftentimes they don't use internet, right. And so how we get that information, how we provide it and how we get it out. It definitely changes based on not just their status as an older adult, but also all those other factors that you just mentioned."]
+[1.1748815774917603, 6.26657772064209, "The I think, sorry, that which issue"]
+[3.7271554470062256, 15.551125526428223, "Yeah."]
+[-1.28373122215271, -2.109788417816162, "And we have to, we have to go to all the different communities, we have to have community events, we need to go and talk at senior centers, older adult, older, older adult, like places older adults frequent. And make sure that, excuse me, it makes sure that we that we really, that we really are finding out what's been difficult for people in the past, right. And so we know that sometimes people have difficulty accessing, and we can kind of make up in our minds. This is the reason why they've had different difficulty accessing some of those things I probably have done today, where I just may have made some assumptions. But realistically, unless I go and have a conversation, or ask folks about how we would have made their experience better, it's it or what what areas or barriers they're running into. And so we always want to make sure that we're getting out to people. Well, this would have made my experience better. But those are folks who actually were able to access, but we're looking forward to the people who weren't. And so how to get that information out with the million other priorities that we're working on. Those are all those are all big pieces, but I think community groups and the other groups that we attend, are helpful in that we put into, but that's always an ongoing process."]
+[-1.7321499586105347, 0.6019701957702637, "Okay. Okay. So now seems to have a question for the second topics that you pick, which is health care, access and delivery, right."]
+[-2.1569132804870605, 0.5630444288253784, "I think I don't think it's that different from how they're accessing mental health services. I think that there's"]
+[-1.898003101348877, -1.1618547439575195, "I get a message I get multitasking by accident. I apologize. I think that, especially right now are one of the things as it relates to us, as far as healthcare access and delivery, is that we have a lot of neurocognitive disorders that are kind of making it difficult sometimes not only make it difficult for older adults to access health care, but also to differentiate between a mental health condition and neurocognitive condition like dementia or Alzheimer's, right. So those that not only does it make it difficult to access the care you need, but it also, sometimes you show up in in a place that's not the right place for you. That sounded bad. What I guess I'm trying to say is we need to make the place you show up the right place for you to be able to get help. And so. So that's the access piece I'm talking about is. So folks, oftentimes show up at a health clinic or show up at a mental health clinic or show up at a substance use program. And that's not necessarily based on whatever condition they have the place that can treat what's going on with them. Not, hey, you showed up here, this is the wrong place, go there. But hey, welcome in. Thank you for coming to our clinic today. Here's some things that I can give you in here. And here's another program where you're going to need to go and I'm going to work with you on these other things. While and make sure you link there. So I think that that that access issue or that healthcare issue is that we're not we're not well coordinated as a whole health care system. Well, we're each of our individual groups is is really good at doing what we do. But we know with older adults, you don't always show up at the place where the right place right for you. And so that so we have to coordinate that system better. So that so that wherever you show up, it's the right place."]
+[-0.7397063970565796, 2.299572467803955, "So again, and what barriers exist to see improvements in this area."]
+[-1.5418791770935059, -1.3356587886810303, "That I think the biggest I think the biggest barrier. I mean, one of the biggest barriers is that those systems don't talk well to each other. If you're if you show up at a substance use program. It's it's almost impossible for for that program to share information with other programs, right. And there may be a huge issue with that, that needs to be handled. But unless you can get somebody to sign a release of information to share information across, it's very difficult. You also another barrier, and so that that ability to share information is, is difficult. We don't have health, like large health record systems that that work together, right. And so if somebody wants access to some information about a client that I'm working on, they need to sign a release, they need to request the records they need, it goes through this process. And at that point, we may have already been doing something with a client that we don't even know about. Person who came in would have to tell us that they're getting treatment at these other locations, and how in order for us to know that and so just that coordination of health, for the whole person, it's so important for older adults, it's important for all of us, but it's really, it's so important for older adults, because everything's kind of intermingled. And we just don't have we don't have that that's the kind of the biggest barriers, the ability to communicate across health systems."]
+[2.9589970111846924, 5.000726222991943, "Yes, I mean, I think that that's, that's always the, that's my, that's gonna be my answer to all of those. And similar to the first one, it just, it's just really"]
+[1.8282204866409302, 7.204343795776367, "how we"]
+[-1.7087898254394531, -1.513009786605835, "there's so many, there's so many little things, two, stigmas one, but just so many little things that little, so many pieces of a person, that, that make them different, and want to access things in a different way. It's for some, it going to the mental health clinic is an okay way of doing things. And for others, the only way that you would want to access any treatment is by going to your primary care doctor, right. And for others, it's it's a, you know, a religious leader or other just depends on your on your situation. So there's so many things and it's in, I think, across, across our healthcare system across and I know across the county, right, this point, right now, we're looking at all of those things for everyone and how to, and how to get that message out in a multitude of ways. So that people, whatever category they fit into, there's something that makes sense for them in a way to access."]
+[2.4828970432281494, 7.8249192237854, "I mean,"]
+[-1.0691187381744385, -1.7975431680679321, "again, talking to talking, I mean, talking to the experts talking to the professionals in the field, I didn't mention that the first time, but also talking to the people who need the services, right, or family members of people who need services, going to advocacy groups, right, like talking to the folks who are who are advocating for our older adults and for but but it's, I think, too often, it's not because we're not thinking about it, but probably just because we're so busy. But I think too often we try to make up the reason or the view, the way to help people, instead of asking people will help you. And so I think they'll be like we have expertise, and we can figure out how to, we can explain to folks the regulations we have and the funding we have, and we can explain all that. And so that's the those are the questions that we just need to find out and more aware of and really be like, oftentimes, I know all the pros, I know what my programs, do I have several programs, I know what they do. Like those are the kinds of things that also make a difference. Like all of those things are are pieces of what helps people kind of feel good about coming into services and feel comfortable with us. And that's really what it's about is we don't want somebody to come once hate their experience and go away because we know they need help. So knowing that these two is"]
+[1.5780901908874512, -0.7896901369094849, "important Moving on to the third topic, which is housing."]
+[0.16015592217445374, -1.8338623046875, "I just think there's not enough. I mean, honestly, I think that's the probably the biggest piece of it is, and I don't want to repeat myself too much. But it's, it's a different older adults need different things in their housing and housing is. There's, there's, there's issues related to hoarding or there's issues related to having a lot of things and having to move into another, another home. Right. Not that those are the only things but there's, there's additional issues for older adults that we don't often see with some of the younger folks who need housing. But there's also medical care, and also all sorts of stuff. And so So yeah, it's it's, I think those are having homes specifically dedicated to our older adult population, with services specifically dedicated to our older adult population, which is just basically not enough to help to help support that. And so how we kind of focus on those ideas and areas so that we make sure that we're they're not forgotten when we're when we're developing new housing and new housing situations. In that, where's that we remember to wrap services around those housing, it's not just about building up a place for people to live. It's about having the right services there so that our older adults want to live in that location. Similarly, like what I was talking about the clinics and things like that, it's it's at wanting to be a part of a home because it has the things you need at it, instead of just having a home with nothing else like that, that it's a struggle if you're homeless to move into housing. Specifically older adults do that we don't have enough of them."]
+[-0.6525179743766785, 2.167034387588501, "I mean, the major barriers are funding. There's another another barrier is is nimbyism, not not that folks are like, Oh, we don't want older adults in our but we don't want housing projects in our in our area, right, like, and so are we don't want mental health housing or we don't want bridge housing or so that continuum. We could we could, you know, buy up a bunch of properties. But if if the neighborhood or the neighbors are not helpful in that, and we have had folks in government saying no, these programs shouldn't exist in this area. That's that's a problem. And so nimbyism is a barrier, it really is whether or not people understand that, that they're just true neighbors anyway. It doesn't, it still still holds us back from kind of developing things forever. We at any moment, wherever we want to sell another piece."]
+[-1.71137535572052, -2.531622886657715, "Yes, definitely. And so some older adults tend to like to live in communities with other older adults and others don't write like so it doesn't, it doesn't necessarily, it doesn't necessarily mean that we have we have to have a community of older adults. But we have to think about even in even in the housing communities that we have that are not dedicated to older adults, we should we need to be thinking about what services do we wrap around this that would be helpful to an older adult who may want to live with with some young with younger folks, or just a wider variety of those not just an older adult site, right. And so still having those services available for for somebody with issues related to aging, but not necessarily only like you have to live in this spot because you're an older adult, like then those kinds of things are different. So yes, there. There's definitely differences, but I think for the older adult population, that's what's probably I mean, as it relates to housing, that's probably one of the ones that it's big."]
+[0.20230130851268768, -1.9901078939437866, "Again, I think we need to take a look at and this one, this one I won't say the same thing I said the other times because I have people already telling me about like some of the housing situations that are in in my new role with the housing but but I do think that addressing In addressing needs for all, like ages and stages of life in our in our housing and our homeless, and our mental health and substance use housing, addressing those issues is really kind of the biggest thing is we can't say we can't leave out a population because it's not this is just a general program, it being a general program means that you may have older adults there. If just because I'm, you know, 65, 70 years old doesn't necessarily mean I want to go to the older adults recovery program, I might want to go to just the  clinic. And, and are we thinking about how we how we can make that easier for folks in all of our programs, not just ones dedicated to older adults. So I think, in housing especially we that's something that we've, like, Oh, we're working on older adult housing right now. So we're going to focus all the energy in on that. But we don't we forget that maybe there'll be an older adults who want to buy their houses, and we don't, we don't take that over there and focus that same kind of energy on what those services"]
+[-3.1204538345336914, -0.014039208181202412, "need. That questions are the next set of questions. First one is geriatric care."]
+[-1.849177360534668, -1.477018117904663, "I would say it's, I would say it's adequate. But again, accessible, is the is the hard part, right is making sure that people know how to get to services, how to have there's not enough transportation, like most things are advertised on the internet. And that's not always the way that people get information. And and so the care I think, I think the care for older adults at the Locate the especially in the economics, really speak for mental health and substance use. I think that that care is really good and well rounded. And we have really good services for folks. It's, it's, it's making sure that people can access it. That's not That's the difficult, it's a difficult thing."]
+[1.216447353363037, 3.0056395530700684, "Well, I would say there's probably not enough. There's not enough so maybe not quite as adequate. Especially specifically dedicated with, with the,"]
+[1.1144144535064697, 5.3599934577941895, "with the"]
+[-1.7802335023880005, -1.581109881401062, "there's definitely not enough beds, and definitely not with all of the services that need to be provided for, for older adults. What we do have is good. It's not a it's not, there's not enough. There's just not enough. And so as there's so the the numbers needing to get into services far outweigh the numbers, we have services that the artist provides, I would say, being able to access it is definitely difficult because there's there's just not enough. And then what's provided when you when you're there is good, but could be probably couldn't be better."]
+[1.8653831481933594, 6.916455268859863, "Gotta be"]
+[-1.7264069318771362, -1.177864909172058, "we have a very full continuum, we have a lot of services, provided we have a ton of those things. Right. How do we make sure that not only does the does the person who might want to seek treatment know about it, but a family member or somebody who's looking to pay for services, or somebody who's who, just as who's working in the field, but in a different area knows about all the things that we have, though, that's where we're, that's where we're struggling. What we have and what we can provide is very good in the quality of the clinician, the quality of the work is great. It's it's just making sure that people can get into services and have those especially with Seems like the transportation, like I said, making it to getting somebody to an appointment, making sure that we go out to those programs and get out to people like that's those are the things that we really need to focus on."]
+[2.1857998371124268, 6.209083557128906, "I do. Everyone"]
+[-1.5086266994476318, -1.815595030784607, "mentioned them at the beginning, but I I'm very interested in how many other people do and so that's that's the, that's where I think this is going to be beneficial is, is I'm my worry is that a lot of people don't, right, like, I'm not gonna go off on all the things I know. There's, there's several, and I know, and I know, pretty much all of them. But But in addition, the ones outside of that the county provides but but I'm, I'm not sure that a lot of people know, specific for older adults. And I don't know that they know that we have, even though it's in our name, I don't know that they know we have a specific program designed with housing, in our housing area, and in our in our mental health and substance areas designed for older adults. I don't know that many people know that."]
+[4.035097122192383, 6.399392604827881, "Last, how about, sorry,"]
+[0.21901628375053406, 0.22494979202747345, "I was gonna say if they don't, I want to know about that. And I want to know, like what we can do to advertise."]
+[-1.3960583209991455, -1.5358269214630127, "Yeah. I mean, so I think, again, I think that they're, I think that they're adequate, are adult protective services. Again, it's hard, and it's also so accessible, it's again, hard to know that from the outside, right. Social Services can't like they can't, if you make a report and EPS report, you can't all of a sudden, know everything about how that report got followed up on. Right, they don't share that information back to you. And so how how I would know, as somebody outside that, that those services are actually benefiting clients or that they're that they're that what they're accessing, is actually helpful to folks. It's hard. It's hard to say, I know that services exist. But I don't know if they're adequate or not, because I because we can't really get that information about about health, or I can't get that information about how how beneficial it's been for folks to go there. You only kind of see it, as you continue treatment with somebody, you might see that somebody's doing doing better, or that they're not having the same issues anymore, but you may not necessarily know. So it's hard to say I would say I guess I would say it because of the shortage and staff across systems, it's probably just not enough people to do the work to the quality or the level that would be important."]
+[-2.1736066341400146, -1.5548113584518433, "Like there was a lot of substance use, like new substance use, you know, in different types of substances being used, you know, 20, 30 years ago, right, and now folks who were dealing with that are aging into the older adult population. So I do think that substance use is going to be there was a big kind of a spike around that. I'm praying. And so I do think that folks who the the older adult system is going to we're going to see more and more substance use issues or substance use related issues with people, and then all the medications that people were on a few years back. Because of that, and people becoming addicted to it, we see a lot of opioid issues with our older adult population. So all so those things are kind of new. And I think over the next few years, we're going to not that it's new, but it's in our in our older adult population. We're going to see that increase as we kind of flow through time here and we're, we're we're over the next few years, we kind of see how that those issues in our society affect our our aging population. I think"]
+[1.093769907951355, 2.576016426086426, "I think access I think"]
+[1.3728259801864624, -2.316636323928833, "I think housing like housing, housing in general. our homeless population is is also aging, right. And so they're aging on the streets, unfortunately. And so how and so that's going to be another issue as far as providing service. And then I would say those are probably on Just trying to oh, I mean, I don't know that it's new. But our food scarcity issue issues or being able to get, get a hold of resources that that are needed."]
+[-0.14759837090969086, -1.5011472702026367, "Inflation, it everything that's going on those those resources. While they're out there just aren't, I would say in the next few years, they're not going to be unless we do something kind of important about ensuring that resources are out there for folks, I think, I think over the over time, as well, well, it's difficult for all of us to kind of pay for the food that we need and health and have healthy options for nutrition. But I think that that's going to become over time. Also difficult for folks for older adult population. So I would say that's another issue over the next few years. So I say, like, access to food resources, healthy food, housing, and an SUV."]
+[1.4868680238723755, 0.13350608944892883, "I think that, in general, the government needs to set up task forces, which I know they have, but really"]
+[1.8432297706604004, 3.1160027980804443, "take a focused"]
+[-2.0570175647735596, -2.3492391109466553, "or make a focused effort, kind of like what you guys are doing now. Really, really focused on on older adult issues, right. And there's going to be a huge, like, it's going to be a high a high percentage of our population is going to be older adults, here in here in a few years. Right. And so"]
+[0.5780478119850159, 3.027019739151001, "silver tsunami, yeah, exactly. And so"]
+[-0.25871410965919495, -1.9581456184387207, "how if we're not, if we're not really taking a focus, look at what's what services are working, what things are not, in, and what we need more of. That's the goal. Like, here, you're taking a big picture, look at like, here's what's going on for all of the folks in our community, whatever, however big or large that community is, depending on what part of government you're in, if you're not focused on that, in, in the years to come, we're going to be behind, and we're going to be playing catch up. And so that's, that's what government's job is, is to really say, like, look at our community as a whole and find areas where we're missing out on"]
+[0.023163288831710815, -4.905029296875, "thinking about all the older adult residents in Orange County, who is getting the least amount of attention"]
+[1.2004685401916504, -2.455216407775879, "it's a hard one. It depends on what you mean by it. So at least amount of services, I would say our homeless population, but they get a lot of attention, because they're, there's people always talking about it or or saying that it needs to be done. But the amount of services that are actually available to them. In the ease of access for folks were who are homeless is very difficult. If they're not in your face. That doesn't mean they need less help. They're just not there. Services, I don't necessarily think that's the case. And so I would say, you know, isolation, which we have a lot in posted neurocognitive disorders who can't necessarily kind of speak up for themselves, right. It's all family members or folks, those are those, most of the people I would say, get the least attention because they're not the squeaky wheel right. Now, it shouldn't be it's not the way it should be. I just think that's the way"]
+[0.0677720233798027, -4.055339336395264, "thinking about all the issues facing older adults in Orange County."]
+[-2.1822152137756348, 0.10885161906480789, "I would say it's that issue about coordinating holistic care."]
+[-1.6422525644302368, -1.7485849857330322, "I would say that that's the that's the area where we're not I mean, I think people who are deep into this know about that right and and understand that but, but really not real realizing that I can show up five places and be told I'm in the wrong place. Even though, even though I'm just a person who needs help, right, and so that's the And for an older adult, I mean, not a blanket statement, but for an older adult, to get around to a bunch of different places to try to figure it out on their own. That's tough. That's difficult. It's difficult for anybody, but especially someone who maybe doesn't can't travel or doesn't have a family member to take them around or pick those or who can't access things online. Right. Those are those that's, that's what I would say is nobody's really thinking about a system where any place you walk in, you can you can, you're in the right place, right. And that's really for older adults, I think that's almost the most one of the most important things."]
+[-2.8795878887176514, -1.3297773599624634, "Right now moving on to our last set of questions. So in addition to what we have already talked about, let's dig a little deeper into your area of expertise. So thinking about your topic, which is dementia in focus, healthcare reimagined. So these are habits based on the California master plan. You're with mental health and recovery services."]
+[2.1678497791290283, 5.4291253089904785, "Think that I think there's not really. I think so."]
+[-1.5635074377059937, -1.8446567058563232, "I don't know, I don't know that it's much different than what I just said, I'm trying to think of I think, slowly, I'll start with where it's working. Because what my what I just said is where it's not working that then integrative collaborative thing. So I won't say that again. But where it is where it is working, I think is, first of all, having the conversation started. Secondly, the understanding that there is a specific population, a specific group that we need to be focused on, understand, and, and talk to right and figure out what people need in, we're starting that process. And then I think that noticing the, that our population is aging and providing in establishing more and more services. And not going away. So in the past, we might have gone away from saying adult and older adult mental health for my area, right, it might have just been adult mental, everybody's an adult, right. But really focusing that there's more to it than then than just we provide mental health services. And everybody can come in here that really that there's a there's a difference, I think is something that over the last, especially through COVID, really COVID really shined a light on the fact that if you don't have something special setup for our older adult clients, you're going to miss them, they're going to fade away. And that's not and that's not okay, that's, that's not part of what we want our community or our culture to be about. And I think that that's being recognized more and more. So it's that COVID thing is always a double edged sword, right, it shone a really poignant light on all of the things that we weren't doing very well. And so in and I think that that's opened our eyes and so what's good now is see where we're missing. With our, with our older adult population, especially those as it relates to dementia like"]
+[2.3660778999328613, 2.7443079948425293, "and other other issues."]
+[2.994853973388672, 0.06826936453580856, "Know what new or revised policies are needed."]
+[2.9177024364471436, 0.010142654180526733, "For I mean, at a very high level, we need some, we need some opening up on our ability to communicate across systems, right, we really need to be able to have are like less. Regulation is a bad word. I don't know. I mean, let's just less stringent on how we share or how we communicate across systems and more. So policy changes, I mean, it's it's my, the biggest ones are at a really, really high level about allowing for or requiring, sharing across us"]
+[2.7147164344787598, 1.7421140670776367, "know who or what entity is best suited to address this issue."]
+[-0.3825041651725769, -1.9204041957855225, "I mean, I think, for some of it, the federal government, but that's not very focused, that doesn't focus very well. But there's some like really high level regulate, or pretty 1000 foot regulations that need to be changed to be able to do some of the work that we're talking about. But the little bit of that it's a cop out, because that means that oh, well, now I have to wait for them before I can do anything. So I would say the I would say in general, to two groups, community, grassroots organizations that can kind of talk about can kind of put into focus where we're, where we're missing things, and then the leadership of our healthcare system that can make some of those changes, or can work around like those regulations in order to better serve folks, right. So those, it's, you need that combination, though, you need to know from that organization, or client level, what's wrong, and then you need the people who have the ability to affect change in our system, to be able to make those changes. So because otherwise, if they're not working in concert, that, like, I can make all sorts of changes in my programs, I don't know if it's actually helping anybody. And there's a bunch of people tell saying, like, this is what we need, but they're not talking to the folks who can actually do those chain, then we're not doing the stuff that we want to do. So we shouldn't be working together."]
+[1.8600624799728394, 0.9403456449508667, "Okay, now, what sources of data do you find relevant to your work in, in this area, you know, the mental health area that you're"]
+[1.5788819789886475, 0.5121034383773804, "So my data is the the one of the big things is our we call it a penetration rate. What it really means is the number of so our mandate is to serve medical clients. But that's not even really what we just, I would say, the number the percentage of older adults in Orange County, and and then we take a look at what the expected numbers are for folks, for folks who expect to need to access services. And so that's, that's one big number that we that we take a look at. And if we're lower than the state average, or we're just low, like it just seems like a lower number than what you would expect to see and and have folks access services, then there's something that we need to do. Right. And so that's a big data point for us is whether or not we're actually serving the numbers that we would expect, when he's should or might need to seek treatment. And if we're not, that means we're missing somewhere. And so we have to figure that out. That's probably the that's probably the biggest one. Another one is co-occurring substance use or co-occurring medical conditions with mental health. And what what that looks like and what we what services we provided so that we can meet the needs, again, meet the holistic that."]
+[2.532927989959717, 7.500442981719971, "You know, certainly. I mean,"]
+[-1.939389705657959, -1.2821662425994873, "so you're more than welcome to talk to my to my to my Associate Medical Director who's over our adult programs, like I think I think those are folks to talk to you, the doctors and clinicians who provide the service on a day to day basis are a really good folks to talk to. I'm sure you have a wide swath, but I think that the people I mean, I think older adults, older adults are folks that would you should talk to, yeah, in the in the people who are providing service day to day who talk to talk to folks every day in their homes and in their clinics and in the community who can tell you like this is where this is where I struggle. This is I want to provide this, but I can't because of this reason. Those are all the folks I think are important."]
+[4.735660552978516, 3.258039712905884, "Yeah, of course. Awesome. So this concludes our interview. Thank you So much for your time, you have been incredibly helpful to our research. If you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website www.advanceoc.com And you can leave an anonymous voicemail on your telephone line at any time. And of course you can also reach out to me now you have my contact information."]
+[4.515394687652588, 6.926565170288086, "Sounds great."]
+[4.085363388061523, 4.3651580810546875, "I'm gonna I'm gonna stop sharing here we go."]
+[4.565766334533691, 7.2336201667785645, "Good afternoon."]
+[4.5775041580200195, 7.242304801940918, "Good afternoon."]
+[-2.7029974460601807, -4.810145854949951, "So you know, my name is Tirana and I'm a part of the research team with advanced OSI. And we're a local nonprofit conducting the county of wonders older adults needs assessment. Thank you for your willingness to take part in this interview. The purpose of this interview is to identify the needs of older adults and to gather insights from your expertise and experience. The information you provide will be used for the development of the Orange County's master plan for aging. This interview will last approximately an hour and with your permission, our discussion will be recorded for transcripts and note taking purposes, the recording will be shared with any will not be shared with anyone. And after transcription is complete, the recording will be deleted. If you do not feel comfortable being recorded, turn off your camera and change your name your face everybody."]
+[1.4636061191558838, 8.803245544433594, "And good I consent"]
+[-2.4620983600616455, -3.450653076171875, "your responses are confidential, meaning that we will remove identifying information in our report. Please note that your participation is voluntary. And you may choose to answer any question in part full or not at all. You may also withdraw from the interview at any time. If you are unfamiliar with any of the terms that we use, please let us know and we will provide the definition or an example of where will we meet. Yes. No. Okay, the primary goal of today is that I identify the needs that you think are most important to older adults and older adult population, those 60 years and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen now. And I'm going to share with you a list of common issues and concerns impacting older adults. I'd like you to review that list. Take a few minutes to review that list. And let me know when you're ready to move forward"]
+[4.559993743896484, 5.429515361785889, "now it's my Zoom screen covering anything because I know some time to does I see the whole paper Okay, cool."]
+[4.394885063171387, 5.773540019989014, "Okay. Um one just jumps out at me as something that needs to be added. But"]
+[-0.515220046043396, -3.867001533508301, "okay, so I was going to ask you that, specifically about older adults in Orange County, for the record. Please some of your name, your role and how you interact or engage with older adults."]
+[-1.2254558801651, -3.5786855220794678, "So my name is Tammy McConnell. I am the Emergency Medical Services Director for the county of Orange. i My EMS resides within the health care agency of the county. By background, I am a registered nurse by education training. So I have experience in acute care, hospital public health nursing, and then of course, emergency medical services. Part of you know one of the main Well, a lot we EMS in general has a huge interaction with the adult population. I oversee the EMS system in the county, which means that it is this office that sets the policies protocols and treatment guidelines for ambulance companies paramedics, first responders in response to a 911 call for medical emergency and also for non emergency transport of patients. So you know, a large you know, section of the EMS system responds to the age group of over 60."]
+[3.3921897411346436, 4.048163890838623, "From the list."]
+[-2.308978796005249, -1.3710538148880005, "I think we really need to add, besides car accidents and falls, bathtub drowning or you mean drowning in general, but it's it is specific to bathtubs. And I only bring it up because I would, I don't know is is before COVID. We did a we were looking at all of the drownings in which there was a 911 response, expecting to be looking at a lot of and when I say drowning, I mean it's they're not, you know, they're, it's almost like a near swim, you know, it's there. They've the call comes out as somebody's in the pool, they're drowning, but they're not drowned so they could be already deceased or just needing to be rescued and then revived. So when we queried our system, really anticipating to see more drownings for the in in children. And then look trying to look at, you know how to look at prevention efforts. more from a barrier standpoint, we were very surprised to see the numbers of drownings associated with the higher the older adult occurring in the bathtub we actually saw in our data, more drownings of older adults than children, which was kind of mean, we knew it was there, but I guess we didn't realize it to the scale. Everybody assumes that drownings are mostly children. And that is not that was not the case that we found in our EMS data. So I think it's really important to at least pointed out now our EMS data is only going to be data from paramedics that have gone out to the scene. It does not it's not going to include data where the person is already deceased, EMS wasn't out there and it was just a corner call. So it's not all inclusive of of the entire number of you know, drownings that were they were deceased or they were revived but anyway, that's why I think it's important to include"]
+[2.518580913543701, 3.78552508354187, "thank you now of the needs on this list, including the drowning in the bathtub drowning Please rank the top three that you feel are the most important"]
+[0.1310017704963684, 2.7153797149658203, "Hmm Oh you mean just in the injuries"]
+[0.6476492285728455, 0.29750028252601624, "What do you owe the whole the whole You mean"]
+[2.532133102416992, 3.533555269241333, "for the issues and concerns rank"]
+[0.01601012423634529, -4.25460147857666, "top three including your your ad of the bathtub drowning and this this is specifically for older adults here in OC."]
+[-1.480508804321289, 0.9039567112922668, "health care access and deliveries got to be on my top in my top few emotional well being um"]
+[-1.567344307899475, 1.2559356689453125, "probably economic security if I had just picked the three with my unintentional injuries a lot when I look at these I feel like a lot of them can be combined like I see I see behavioral and mental health combined with emotional well being diabetes and obesity I mean that's a specific you know diagnosis but that's like a subset of diet fitness nutrition"]
+[-1.213454008102417, 1.0058023929595947, "So Sam, what do you have for you got it narrowed down to three. You have healthcare access and delivery as one. You have emotional well being economic security and then you also We'll set your"]
+[2.2023162841796875, 4.050497531890869, "well just just just go with those three, by only up to plus three. Because I know this isn't all about me. So it's about the population in general, I just have a narrow focus because it's EMS."]
+[2.7506589889526367, 4.781457424163818, "And your, your expertise is important so, and your lens from your purview."]
+[-2.758236885070801, -0.6924880146980286, "Well, it is my personal experience, that even as a nurse, I have difficulty getting an appointment in a timely manner. I have difficulty accessing my records. And I think and then also having family members who are older had constantly, you know, trying to coach them about No, this is what you need to do when you go in to make sure you get what you need."]
+[-1.825610876083374, -2.074368715286255, "I think that the you know, technology is good. But when a patient especially an older patient walks into a doctor's office, and is only greeted by an iPad to check in and, and put their name in. It's, that's not it's just I don't know what the word is. It's not as familiar to them as it is with the younger generation, and they're not comfortable with it. So to me, it, it's a barrier and and a lot of these places that have things like that, there's no person there to help navigate that. And so I don't know how many times I've gone into a store or an office. And there's an older person stuck trying to do something and I've stepped in to try to help them navigate it. I I don't remember what your question was, but"]
+[-2.477938175201416, -1.4579720497131348, "just what do you why why do you feel older adults are struggling with this issue. And in the health care access and delivery,"]
+[-1.5085242986679077, -1.2926509380340576, "I think that the technology gets in the way. And I think that um I think the ratio of caregivers to patients or clients is disproportionate. I think it takes a lot, you know, a lot more time to educate and, and provide services to older adults than it is to a younger population. Yet, I just don't feel that there's enough I guess time and patience and staff availability to do that. And so I think that's suggest that that's a that's a problem with, they may be able to access it, but then the delivery is is is problematic. And let me give you an example. I mean, we run into this all the time with hospice services, and generally you're talking most you know, 95% of hospice patients are going to be over 80. And we run into this patients on hospice, they're on hospice, because they're dying. Yet there's something that happens that prompts the family or the caregiver to call 911. Well, when 911 is called, it's an emergency, we're trying to save a life, there's a disconnect, because the paramedics will come in and what you know, they're there to try and they're trained to take care of an emergency, save a life, transport the patient to the hospital. But the hospice organization doesn't want that patient transferred. They want to be able to keep that patient in in their home and be able to treat them there. Keep them comfortable there. But they lack the resources that would have you know that the family member or the caregiver could have access prior to calling 911. Like, that's what 911 does. And so that tells me there's a gap In the availability of enough numbers of hospice nurses or health, home health aides that can respond, in whatever circumstance it is circumstance it is to address what's going on with that patient to keep them out of the hospital, the whole point is that they're at home, there to receive palliative care to make sure that they're not, they're comfortable. So why is it that the family is if they don't, they must not have access to something they need to take care of whatever the problem is. I'll just end it at that."]
+[-0.28210723400115967, -0.6194579601287842, "Um, I think it comes down to cost, I think it comes down to money. I think that those with those with money, have the ability to hire somebody to be there 24/7 And to take care of those needs. But the families in the in the people that don't have that wealth, have to rely on themselves. And"]
+[-1.5353142023086548, -1.247069001197815, "so I think it comes it comes down to money. And money, the money would if if if money were the barrier, and there were gobs of money to be had, then there would be the money would pay for more caregiver resources. And it doesn't necessarily have to be a person. It could be maybe access to telehealth or having, you know, an iPad or something in the home to say, Hey, I'm having this problem. If the caregiver or the patient themselves can't adequately describe what's going on, you know, a picture's worth 1000 words, maybe they can, you know, have a video there. And they can show them this is my problem, or, you know, this is this is what's going on. And the person on the other end, the caregiver, the doctor, the nurse, whatever it is, they can say, oh, it looks like this, this and that. Why don't you try this, this and that. And so barriers to seeing improvements would be the lack of money to pay for those types of resources. That make sense."]
+[-0.836715579032898, -0.554850161075592, "Well, I think there's many cultural issues related to certain cultures. Trying to think of some, you know, don't don't allow you know, women cannot be seen or treated or handled by a male care caregiver. There's cultural."]
+[-0.5336588025093079, -0.4683734178543091, "There's cultural nuance, there's there's cultural nuances that have to be acknowledged and understood. I'm struggling to even tell you some of them. Why"]
+[-4.143909931182861, -1.8630671501159668, "you given you know, info about there are differences, because the question is, are there different experiences for different"]
+[4.062884330749512, 6.966151714324951, "Improve How do you improve I'm sorry, the address."]
+[-3.2374372482299805, -0.6187149286270142, "There needs to be more Um, geriatric, for lack of a better word, you know, older adult geriatric specific programs versus having a doctor's office that does it all. I think that geriatric programs are better at focusing and honing in on all those differences that affect that older population, versus a one size fits all in a regular clinic. So I think having more geriatric nurse practitioners, geriatric DEOs, and those types of offices, I guess, medical groups that provide that specialty care to me, to me, it's it's almost like we have, we don't, I mean, some of us do, but most children, you know, from pretty much birth to maybe, I don't know, 12 or 13, you take them to a pediatrician. But older adults just go to a generalist and internal Med, and I think it's only been in the last probably, I don't know, what 15 20 years where we've seen geriatric specific medical groups and plans and programs. And I think that is definitely the way to go. Basically, it should be mirrored like how we treat children, they go to that's a specialist. Oh, being older, it's in a geriatric a doctor who specializes in geriatrics and nurse practitioner, they're going to hone in on the geriatric issues more so than a general internal med family medicine doctor, that's my opinion."]
+[-1.4521564245224, -1.2481647729873657, "I think they're isolated in their own homes. And, you know, also I think we're dealing with a generation that grew up having to take care of themselves, they don't want to rely on anybody else. So they don't want to, they want to handle it, they don't, they don't want to call and call for help, necessarily. And so I think that that kind of mentality feeds into why they're isolated and lonely."]
+[-1.3854782581329346, 1.6716409921646118, "What barriers exist to seeing improvements with emotional well being."]
+[-1.8807640075683594, -2.0471432209014893, "I, it's a double edged sword. I think technology is a bit of a barrier, but it's also not a barrier. You know, I think that if, if the person can embrace and understand and use the technology, it can be a great benefit to emotional well being, but to use technology in lieu of that human connection, and that human touch that face to face. That's the barrier, because not all not all older adults are comfortable with technology. And and if you say, well, we're going to put an iPad with everybody and, you know, that'll help them connect to people. Not all of them are okay with connecting and so if that's the, if that's the focus, without there being another option of face to face interaction. I think that's a barrier. And there's, you know, the technology piece too is I mean, and I'm not even of this age, that I you know, they can't their eyesight, they don't get it there has to be very large print, it has to be, you know, modified for them to even be able to see it and understand it."]
+[-0.4692572355270386, -0.5521706342697144, "Oh, absolutely. I think that different cultures and groups where they, you know, embrace and they actually, you know, live with their, they have, you know, three generations living. I think that's very I'm positive, but in families where there isn't that"]
+[2.8803749084472656, 6.914334297180176, "Again, I just lost my train of thought,"]
+[-4.016853332519531, -1.779237151145935, "are there different experiences for different groups of older adults from different backgrounds with regard to their emotional well being and where they live disability status, income education"]
+[-1.6110116243362427, -1.6104111671447754, "this goes back to my comment about that generation. And, you know, I can only speak to my experience, but obviously, I'm a white, female. And, and in looking back at the older adults, in my own family, they're very self, self servant. They don't want to rely on others. There's, they're not in a family where you've got three, three, or even four generations living and taking care of each other. They see. Asking for help is a weakness, they don't want to be a burden to, you know, their family members. And so I think that mentality you know, feeds into and causes the, the loneliness on site, it's kind of like, they didn't they don't want to be a burden. So they don't ask, and so nobody comes by and that now they're lonely. So I do think that you know, I think all those things you said, the economic status, your cultural status, how you were raised, how you watched your, how you watched your grandparents age. And as you age yourself, it there's there's so many variables that affect that the emotional well being"]
+[-1.7519500255584717, -1.4960899353027344, "I don't know they have a good answer. But I could tell you that was it a couple of days ago, when the surgeon general whoever announced that this country has an epidemic of loneliness, I was just kind of taken aback because, you know, normally, when the surgeon general says, we've got an epidemic of something, it's usually you know, something bad, you know, it's some disease, and you don't think of loneliness or anxiety or depression is like a, as a medical condition in which we need to, you know, that we can do surgery on and or throw a pill at. And so I think just the awareness that this population, or any population has emotional well being issues. will help. I don't know what the answer is to you know, what types of interventions you could do. But let me I'm gonna tell you a little story. When my mom was put into hospice, she was 62. So she was less she wasn't, you know, of Medicare age, my dad's the same age. My dad is a, you know, a, just a engineer type. Take care of his family is not, you know, just very cut and dry. Not a touchy feely, psychosocial person. And so when the hospice people sat down with them and said, Okay, as part of your benefit here, yes, we're going to provide the equipment and the meds and we can provide some social services, and, you know, to you and your family. And so, later on, my dad pulled me and my two siblings and said, Hey, I just wanna let you know, I sat down with the caseworker and they offered some social services and I told him, I didn't need any but if you guys need it, you can go ahead and tap into it. And I and I remember thinking to myself, you're the person who needs it the most. And and it was difficult trying to address that like you You're the one that needs to talk to somebody about how you're feeling about the fact that your wife of 40 years is basically dying, and you're taking care of her. And he's and but I realized that he wasn't going to do that he didn't want to open up to a stranger. It opened up to me a little bit, but he was not going to open up to a stranger. I don't know how you fix that. And it was interesting, because I thought, Man, the first person who needs the most counseling and kind of somebody to talk to is you Dad, you're like, No, thanks. But if my kids want to do it, I'm like, Yeah, so just kind of."]
+[-2.1123580932617188, 0.6882346272468567, "Yeah, yep. And I mean, you know, as a mental health professional, I have a lot of thoughts around that. And, but it's, it's a common, you know,"]
+[-2.7734644412994385, -1.2873783111572266, "I don't know, if it's like a, if it's an age thing, you know, like, nope, take care. Like, I'm gonna power through this, and I'm not gonna I'm not going to acknowledge those feelings and know I'm okay. You know, if I as long as I don't address them, I'm, I don't know what it is. But."]
+[3.866532325744629, 5.42663049697876, "Okay. We have about 15 minutes left, have a few more questions. I'll move on."]
+[0.7739723324775696, 0.3496065139770508, "Oh, gosh, just because just everything is just so expensive. Um, I don't know that. Speaking from just kind of my own experience, I'm that type of"]
+[-1.899730920791626, -0.832330048084259, "I guess, programs that offer support to offset the cost of your meds, provide meals, and other other things like taking, I guess it goes into a different category, helping you with getting your groceries and having toothpaste and having shoes. Unless your family members aware, and you're as an older adult, you're self sufficient. I suppose. I don't know yet that when they go to the doctor, they might get that information."]
+[1.5977568626403809, 5.020904541015625, "IStrongerthanever123"]
+[-0.3410506546497345, -1.942318081855774, " think the barrier of prioritizing other things over what older adults need, you know, there's only so much general fund, there's only so much, you know, there's only so much money to cover a variety of social services where you know, our public welfare services. So I see that as a barrier. It's a it's a pie. And so I don't see their piece of the pie getting any larger, unless more advocacy on their behalf is happened is happening. Unfortunately, though, that just means that if their slice of the pie gets bigger, somebody else's is gonna get smaller. So unless the whole pie is able to get larger, that's a barrier. That makes sense."]
+[1.6619952917099, 6.658731937408447, "I would say absolutely"]
+[0.09330561757087708, -0.8429539799690247, "Well, the easiest thing is, you know, and this wouldn't be all encompassing, but increase their Social Security benefits. But you know, not all of them get Social Security. So like, the last thing would be maybe it complementing their, you know, what they received through social security with some community organizations that, you know, can can make them whole or can can help offset some of the things that they they can't cover under their basic income."]
+[-3.078619956970215, -0.13586628437042236, "I mean, you could just assess each of them individually. Accessible, inadequate geriatric care."]
+[-3.0448625087738037, -0.41304731369018555, "I would say Geriatric Care has moderate accessibility and is not adequate. There's just not enough pro geriatric programs. Here, long term care."]
+[1.9035600423812866, 6.54046106338501, "And you can break it down if you you know, so I think"]
+[-2.64092755317688, 0.15269452333450317, "long term care are those people who they're not sick enough to be in a skilled nursing facility, but not well enough to stay home alone by themselves. They need some sort of support for their ADLs for their feeding for their meds. And I think that, that has limited accessibility, and it's absolutely not adequate. Like there's not enough capacity."]
+[-2.0682907104492188, 1.3430585861206055, "Behavioral health and substance use treatment,"]
+[1.0198110342025757, 2.397637128829956, "you know, I think it's accessible. Um, but I don't know. Um,"]
+[-3.279414653778076, -2.141380548477173, "for older adults,"]
+[1.0150470733642578, 2.436561107635498, "yeah, I, I know it's accessible. And I but I don't know about it, whether or not it's adequate enough."]
+[1.0224170684814453, 2.4489569664001465, "I would say it's moderately accessible and moderately adequate."]
+[3.3777823448181152, 6.5493998527526855, "Or sorry, let me say that again."]
+[0.16010019183158875, 3.4500794410705566, "And I guess changing world in just biggest challenge that older adults will face in the next 10 years."]
+[0.5643793344497681, -0.1791345477104187, "I see them becoming more isolated and lonely, because I don't think they're going to be able to keep up with the technology that's going to overtake our society. And I also think this is a pessimistic view, but our society it is is more and more violent. And while they might not be the targets of the violence I think that that's it That's a component. Okay, so basically the I said societal changes that will affect their, how they live."]
+[-0.3776529133319855, -2.9076316356658936, "I think that government plays should play a huge role in facilitating and bringing together all of the programs and groups and organizations that are either tasked with, have grants for or, or do it out of donations, all of these programs and try to then create PSAs or marketing material and, and target where the people are that would need it would potentially want or need access to those types of programs. I don't think government has the expertise to do it themselves. And I think that this is, you know, my opinion, Orange County is not a county that takes on the work itself they contracted out, which is fine. But I don't think it's enough to just contract it out, I think that you have to make sure that that the government is aware of everybody who's out there and what they're doing and help promote and market and get those services to the people that need them the most. And so using, you know, the technology Well, I think that your organization's doing with knowing where, you know, certain groups are knowing the areas where it's not just about socio economic status, it's, it's, it's it's about understanding where all of these adults or older adults are, I mean, we know that obviously, there's a lot of them in Laguna Woods and, and Leisure World, but there are pockets in neighborhoods with very large numbers of older adults. And maybe there can be some targeted PCAs are pomodoros that go out and they actually go out there. And they do the face to face work of communicating and talking to people to get them to understand where they can go for services or not just services but for assistance or whatever the programs are offering."]
+[-0.0008705511572770774, -4.859437942504883, "Last two questions, thinking about all of the older adult residents in Orange County, who is the who's getting the least amount of attention"]
+[-2.0902233123779297, -1.8128248453140259, "you know, right off just my gut with with no particular reference is single, older males. Um, and I like I just I can't tell you why I think that other than the obvious that they tend to be more isolated. And I you know, I live near one so I know like, my this man is a hermit and, you know, women are more social generally and have friends and they have more family ties. I think men are not that men can't. But older single men have art to me the what some one of the most that need that are going to need more attention. And it's those two that that they don't think they need it, you know."]
+[3.3337368965148926, 5.995647430419922, "Last question."]
+[2.309845209121704, 6.516470432281494, "I'm sure there's something that I'm just not thinking of I"]
+[-2.196800947189331, -2.144505023956299, "don't think I have a good answer for that. Well. I don't know that it's overlooked. But I think there's more. There's there's older adults that are living at home, that are probably dying sooner than necessary. Because they're home alone without proper care, and not medical care, but just proper, you know, daily care. Where if they were in a long term care setting, where they were at least being fed meals and checked on every day and offered a social, you know, hour, I think they would live longer. But I think that there's I think that older adults are dying more at home alone. Then I think that's overlooked. Okay."]
+[4.971317291259766, 3.395979404449463, "So this concludes our interview. Thank you so much for your time. And you have been incredibly helpful in our process and our research. Please feel free to reach out if you you know, have more to share. You can reach us either on our website at dance osi.com Or you can also leave an anonymous voicemail on our telephone line 949-415-6898 at any time. That was incredibly depressing. Gosh, okay. Let me see. Let me stop recording"]
+[-2.5352871417999268, -3.0506033897399902, "Alright. So the timeline, we are going to go over the questions right now. So the primary goal today is to identify what needs you think are the most important for older adult population that we serve. And we want you to think as broadly as possible. So taking into consideration older adults, caregivers, and families and their communities"]
+[-3.529121160507202, -2.2513253688812256, "as a segue one older adults, or caregivers"]
+[-2.6781558990478516, -2.979510545730591, "or caregivers, okay, families and in their communities. Okay. Yes. So for the following questions. I'm going to share my screen right now. So you can see a list of common issues and concerns impacted older adult population. So let me go ahead and share my screen. Yes. Yes, so you can take so please take a few minutes to read through this list and let me know when you are ready to begin."]
+[4.747869968414307, 8.036673545837402, "Okay"]
+[-3.4594879150390625, -3.000107765197754, "so so to begin that first question, as I Were A records we want to know, to tell us you rolled and how you interact or engage with older adults."]
+[-0.9607506394386292, -3.0181655883789062, "So my name is Scott kitchen, the President CEO of sustain SoCal, which is a nonprofit focused on economic growth in clean tech, clean tech, economic growth and the sustainability initiative, acceleration in Southern California, we have a lot of different ground, we've worked in the past with a few organizations that have been assisting in working with the elderly, to help them to sort of work toward mainly transportation issues, how to get elderly around their community. And in looking at this also some little bit on the economic security side on the food side of the equation, but that's really been about it thus far."]
+[3.5171666145324707, 4.214949607849121, "Awesome. Yes. No. Thank you. Um, so have a nice on the list."]
+[3.196650743484497, 4.909709930419922, "That's a tough one. Now see, I think, you know, looking at it only from my perspective, I think it's hard to even read, they're all super important. But what I know about, you know, thinking about"]
+[2.8202860355377197, 8.057698249816895, "Gosh, it's all"]
+[2.3288140296936035, 3.969233989715576, "they're all important."]
+[2.6475884914398193, 8.001397132873535, "Yeah, I just,"]
+[2.485172748565674, 3.8926234245300293, "I can't even I can't even rank and they're all they're all super important."]
+[-0.3920573592185974, 1.29447340965271, "In these terms were sustained. So kellermeyer organization could help I suppose. Maybe in those areas where I am where I see need is for sure answer the economic security,"]
+[-0.3747711181640625, 1.2947454452514648, "economic security"]
+[1.4338548183441162, 8.881103515625, "and"]
+[-1.6236963272094727, 0.5909461975097656, "health care access, delivery,"]
+[0.5087133646011353, 1.186322569847107, "and mobility, transportation mobility."]
+[5.616209506988525, 5.983710765838623, "Thank you so much."]
+[3.131697416305542, 4.406179904937744, "So I'm going to ask you for the next questions. I'm going to ask you for each of the needs that you just listed. I'm going to ask you the same questions for each of them. Yes."]
+[-0.9715194702148438, -1.292809009552002, "I think in particular, now it's the growing population, right. So there is a massive demand for a lot less resources right now. So we're seeing challenges, the resources that are available are being really stretched, and there aren't really enough. So I think we need to figure out ways to kind of create a, you know, a better economic security for the elderly, especially in light of the fact that there could be potential a drain on healthy though the, the rest of the money that's available from the government as well. And then regarding the health care access and delivery, same sort of situation, it's all has to do with a growing population, you know, we have every, all the resources are being stretched. And, you know, I think that people are generally speaking, busier, like, they're the kids, the families are all busier, for whatever reason, and they're going in different directions. And so it's, it's harder for them to to spend time with their elderly. So the resources, economically, the resources from the family are also stretched. Caregivers, from what I understand are also in demand and stretched, and there aren't enough of them. Nursing Home availability is gonna be a big deal coming forward. I mean, you talked about housing, etc. I mean, there's just a lack of everything, for this growing population of elderly that we're gonna be facing. Transportation, mobility is just one of these things that I see is a challenge going forward simply because we want it we want to enable our elderly to also be autonomous, let them get out and do their own thing as much as possible."]
+[-0.7230898141860962, 2.007354497909546, "Thank you for your great answers. So the following question will also be for each of them. So if you want, we can go over for each of them for all the questions. But I know you just answer the first one for all of them. So that's okay. So the next one would be what barriers exist to see an improvement in this area, like in economic security area."]
+[-0.2853616774082184, -0.8361840844154358, "Barriers and account security. I think. Well, I guess, I don't know entirely, just kind of refer to my previous answer, just simply saying that the barriers are lack of availability, demand on, you know, the resources that are out there with the growing elderly population. Right. You know, I think that's, that's a barrier that I can think"]
+[1.7322434186935425, 8.08937931060791, "of. So"]
+[-1.2347265481948853, -0.54984450340271, "access is, again, it's a challenge to the environment that we're in. So the barrier is, again, what I said before about the just a growing population. But if you look at I mean, I'll look at each one of these points here. Insurance costs, you know, from what I understand have gone up. I don't think that insurance, the government insurance or whatever, that's available, and I'm not too familiar with that. But it's, I think it's not doesn't cover as much as maybe as needs be the cost of medicine. You know, I think a lot of that service and government incentivize, but there's, I think that's also gone up available providers, again, developing providers, and most of them I saw on their caregiver caregiving and home services, followed nursing home availability. So all of these there just aren't enough. I mean, the barriers as far as I can tell that the aging population, and then who pays for all of that is another part of the barrier. Virtual health secure services could be part of the solution. There could be more growth in that area. But I don't see that as in any way. The barriers I think that's that's all I can think of there as well. The barriers to transportation and mobility."]
+[-0.7285932898521423, 2.3231775760650635, "Yes, you can go ahead and answer. Yeah. What the barriers for what you see. Yeah. And transportation, like improvements in these areas"]
+[0.14998023211956024, -2.5918385982513428, "are not super familiar with some of the busing and some of the homes and things have their own buses and transportation. But again, I know that I have an elderly friend that's in a community and it's just a challenge. Just to get access to that, that bus, and they can only go at certain times. And so she's sort of at the, you know, she's sort of restricted in terms of that. So it'd be nice if there were ways to get the older or elderly around the community kind of on their own free will, to some extent, and that that's transportation that could be coming down the road, you know, we look at autonomous vehicles and things like that. So the barrier really is just lack of availability for transportation, generally speaking for the elderly who can't drive. Right."]
+[3.498220682144165, 5.5865797996521, "Right. Thank you. So moving on. I don't know."]
+[0.04333731532096863, -0.0533917099237442, "I mean, I know that certainly, depending upon where they live in there, they're obviously how they've done in their careers or how their family's wealth is, I just, I don't know, I don't think I know the answer to that."]
+[0.07440385967493057, 0.043422531336545944, "This is a referring to, like, from different backgrounds to say like, where they leave, disability status, income education level. Um, I don't know."]
+[2.747262477874756, 5.987061500549316, "I'm not really sure what that question is, to be honest."]
+[4.076169967651367, 6.243083953857422, "Okay. Let me go ahead."]
+[2.1516308784484863, 5.721621036529541, "I would imagine there must be right."]
+[2.3944528102874756, 6.246817111968994, "I don't know, though."]
+[-0.04409828782081604, -0.08751124888658524, "Yeah, I'm assuming that's true there, too. I just don't know. I would assume. Yeah. I mean, obviously, it's, you know, they have the infrastructure, they have family, and they're like, close the family and family and get them around. Or if they're on, you know, or if they have the means that they have a driver, you know, that might help them to I just"]
+[2.712226390838623, 5.786914825439453, "don't know. Thank you. So the next set."]
+[1.205059289932251, -0.11139965802431107, "That's a good question, I think. Well, yeah, I think ensuring that, you know, we have available dollars from government to help us into this. I mean, I know that that's stretched. If there were a way to figure out,"]
+[2.5000362396240234, 7.39082670211792, "you know, you know,"]
+[-1.4043821096420288, -2.5594167709350586, "jobs for those that are elderly, that are able and want to work, that might be a very interesting thing to explore. I know, that's being explored in various areas. From the perspective of, you know, sustainability, if we have an older working force, if we, if the elderly can work and are wanting to work, I think that would be that'd be great for the whole community."]
+[-1.6172176599502563, 0.5194583535194397, "Thank you. So what would you suggest is the best way to address health care act acts"]
+[-1.7193849086761475, -0.2027035653591156, "don't really know much about the mechanisms of health insurance and cost medicine availability providers, all that. I would suggest, though, that, you know, in terms of, you know, the market, I think, I don't know, I mean, I haven't I don't know much about this area, to be honest. But I think it seems"]
+[-2.4410557746887207, -2.296977996826172, "given the growth of the elderly, the population of the elderly, it seems that if there were"]
+[-1.529866099357605, -0.15508615970611572, "just more access, generally speaking, if there were more companies more availability. That's all I can really think of that I just don't know, the mechanism by which this the care or virtual healthcare service is just not an area that I know much about."]
+[2.415585517883301, 6.646261215209961, "Well, I think that there are a lot of pretty clear"]
+[-0.046061884611845016, -2.653012990951538, "solutions that are emerging. There are, you know, we have a lot of what we call last mile transportation technologies coming to the fore. And I think that a lot of those have been dedicated toward, you know, shopping, delivery of packages, parcels, cetera, et cetera. And I think that as we start thinking about the elderly This could be an opportunity to engage some of these technologies to help them transport elderly around our community, get them kind of wherever they need to go. And a lot of that last mile or two mile or whatever, a couple miles, could be could avail themselves of this, and I'm not necessary talking about autonomous vehicles, though, you know, we'll see that probably, you know, maybe in a decade or so, but maybe less than that. But there are other technologies that are coming up that you know, with small passengers, electric vehicles, fleet type technologies that could be employed for these for elderly"]
+[-3.1776857376098633, 0.028315894305706024, "use. Thank you so much for your answers. So we can go ahead and move on to the next question. And I will read this one, I will stop sharing my screen. We don't need this anymore. Yes. So the first is geriatric care. Yes."]
+[0.9324211478233337, 2.433337688446045, "I really don't know much about that. I guess I guess in about 10 years, I will. But I don't now know how much how accessible it is. I know that. You know that I know some of the homes that they'll do the Holmes's, which seemed to be good and well run. I don't know if it's how accessible that is"]
+[1.2558046579360962, 5.6270527839660645, "for everyone. Same answer."]
+[2.7173948287963867, 5.07981014251709, "Again, I don't really know much about them."]
+[2.675400733947754, 5.157624244689941, "Again, I don't know much about that either."]
+[0.17399314045906067, 3.474287986755371, "I really just don't. So I really think will be the biggest challenge for older adults that we'll face. And the next thing is"]
+[0.300807386636734, -1.9588749408721924, "generally, and I've said this a few times, which is part of why I think sustained. So Cal has been interested and wanting to be a part of the solution is simply that there are the resources are just not quite there for the population growth in that demographic. And that covers all those areas at first, that one page you showed me, I kind of looked down there and every single one of those pretty much as far as I could tell where resources were involved is going to be extremely challenged."]
+[5.472688674926758, 6.963027477264404, "Thank you. Yeah."]
+[-1.113877296447754, -2.4652817249298096, "Again, this isn't an area that I know too much about either. And I'm not exactly sure how much they currently are in. But I know I mean, I know about various different packages and things but not in detail. My only sort of thought and I've heard on this, that there's potential of actually reducing some of those some of that spending for elderly, which seems a bit ironic in the fact that we're going to be facing one of the largest elderly demographics that we've seen in years. So the government needs to support I'm not exactly sure how I think they need to be a big part of how the solution works. I think the asking you to work in sort of on the innovative side, looking into ways to be more creative in terms of how elderly can get access to what their needs are and become more part of the community. I think that would be something that I haven't talked too much about that I would stress is that we need to really integrate our elderly into our community, you know, and, you know, easy jobs here and there are ways to kind of be more involved in volunteer roles or get them out and be part of the community. So I think being innovative around you know, community involvement would be a great way that government can be"]
+[0.07508117705583572, -4.522378444671631, "can take part. Thank you, Scott. So thinking about older adults, residents in Orange County Who is getting the"]
+[2.4522833824157715, 6.137650012969971, "I don't know. I really don't know."]
+[2.4233996868133545, 6.146422386169434, "I don't have just don't know."]
+[1.9138633012771606, 3.030103921890259, "I don't know. I really don't know who's getting the least amount of attention."]
+[-1.2852816581726074, -2.421548843383789, "Well, I'm not exactly sure who's looking at what right now. But given my interaction with agencies that have worked with the elderly, and it hasn't been anything to recently, but seems to me that what I've sort of said in terms of just giving elderly access to opportunities to be involved in the community to get out and do more where they if they want to write, I think it would be overly beneficial for our entire community. We've talked about, you know, social equity, etc, I think that's one of the areas that oftentimes is neglect is the elderly, you know, getting them as part of the community. You know, whatever it is, you know, if it's just getting on volunteering, or it's getting a small job here or there, just be able to get them as being"]
+[3.061709403991699, 4.513369560241699, "interactive. Thank you, Scott. So in addition to four, we have already talked about. So let's discuss a little more into your area of expertise. And well,"]
+[1.1232167482376099, -2.0615992546081543, "Well, you know, the one that I've spoken with that I know about is transportation. It seems to me anyway, you know, given my sort of touch with the various agencies that have been in the space, it seems that transportation is a big deal, but climate generally speaking, you know, it's it's a challenge. I'm not really sure how the elderly are being currently affected by this. But I know that we have rising energy costs, rising water costs, all the utilities are going up. I don't know. But ultimately, that's, that's going to be a strain. You know, I think, and the energy costs are going up. And we have, you know, climate change, we have, you know, seemingly some hotter days and some colder days and more rain, some days, it's becoming quite variable. Not really sure, at this point, but those are the areas that we as an organization are starting to look into and want to sort of collaborate with folks on. But the only thing I know for sure about, you know, is that transportation is an issue. I think that you know, going forward, for sure, energy and water and all utility costs are going"]
+[3.2398414611816406, 4.402076244354248, "up. So that's challenging, we would love to help. Not really sure."]
+[-1.6041057109832764, -2.227635145187378, "policy wise, my goodness. You know, I think one of the biggest things that I've seen over my last several years with sustained SoCal has just been, you know, technology oftentimes moves moves quicker than policy and legislation. So I think that if we can figure out a way to, you know, ramp policy to the point where it can the least state even with technology, or at least, or just lags slightly behind technology, so that we can avail our community more broadly, not just the elderly of some of the technologies that exist today. You know, that would be very helpful. I don't know exactly how it applies to the elderly at this point. But again,"]
+[2.3171403408050537, 4.696583271026611, "we'd like to look into it."]
+[2.388593912124634, 2.7508997917175293, "The issue of what issue I've lost track of the issue"]
+[2.128103494644165, -1.7151315212249756, "of you mentioned about what's happening about climate friendly. So how that impacts"]
+[2.0284409523010254, -1.8438868522644043, "She's going to be more impactful on climate and climate side. So it's really the usual suspects. The California Public Utility Commission, the California Energy Commission. You know, I think that,"]
+[2.6167008876800537, 7.888800144195557, "by that, what I would like"]
+[0.9881551861763, -2.0792458057403564, "to see is probably more local activity. I know that there are some of the bigger cities that have taken more actions from local agencies, but ultimately, is going to be local government, I think that will drive this. I mean, if we can get some, you know, funding side will be a challenge, like I said, Because of resources and lack thereof. But I think if we can incentivize, maybe economically, maybe there's a job situation, maybe it's a way to integrate the elderly into the community. But I think ultimately that it's going to fall on the local government to take take action, there may be some public private partnerships that could come about. And I think that would be split, particularly on the side of the housing side. And that's, I consider that to be part of the climate clean tech challenge that we face. So mainly government, but I think private side could come in and public private partnerships."]
+[-0.6300836801528931, 2.479947805404663, "And water sources. So a new work and air work."]
+[1.9223612546920776, 0.9433928728103638, "Yeah, what sources of data you use relevant data, like you find relevant for you to use in your work."]
+[1.8221861124038696, 0.9241689443588257, "See where it is. So the data sets that we gather, help us to identify trends. But then they come from all over the place, universities, agencies, governments, you know, and then within our membership, we have private, large corporations that track and look at things and ultimately, we're finding sort of gaps. So yeah, it comes from everywhere, to be honest, and then we just really focus on how we can be productive in filling the areas that appear to be needing."]
+[3.0214145183563232, 8.225676536560059, "Oh, gosh."]
+[1.4235774278640747, 0.9193956851959229, "You know, they're I guess most of them come from the research universities and the National Labs."]
+[1.3340007066726685, 1.077491044998169, "Well, you know, if you don't mind, I'll give it some thought. I'm sure there are some with my organization, there might be. We have one board member."]
+[1.9029392004013062, 1.2395762205123901, "Maybe a couple. But let me think about that. Yeah, yeah, of course. Yeah. Let us know. When you, there's someone else that we can talk to. And we've been able to share the data sources do that. You find relevance for like this kind of work. They related to climate friendly aging. That would be great as well. Yeah, sure. Yeah. Yeah. It's"]
+[2.7848823070526123, 4.942724227905273, "not an expertise of mine. Was that it's not a very super expertise of mine. Yeah."]
+[4.242359638214111, 4.200451374053955, "Yeah. Thank you so much. Well, I'm gonna follow up with you. The people like that you might take up okay."]
+[-2.8586418628692627, -2.1465723514556885, "Biomass family aging."]
+[1.2671185731887817, 0.8623560070991516, "Yeah, so I can reach out there a couple of I can think of one in particular, that might be a good person to talk to. On our board, and there are other members I'll just be thinking about, like I say, this is a an area that sustained SoCal has been sort of on the fringes up for a long time. But it's clearly part of sustainability as a whole in our region. So we would be happy to engage, you know, wherever"]
+[3.994335174560547, 5.495510101318359, "needed. Yes. Thank you so much, sir. Yeah, we've been really quick. And so"]
+[2.714552402496338, 5.152007102966309, "like I said, I didn't know that much."]
+[4.8621602058410645, 3.50956130027771, "It was good for the interviews here. Yeah. Thank you so much. Thank you so much for your time and have been like really You really have helpful and if you have anything that you want to share and if you like realize you miss something and you still want to share with us so you can feel free to reach out to me and let me now or you can contact like information i available on our website or you can leave like a voicemail anonymous voicemail to our telephone line but anytime Yeah, if you feel like yeah, you need to share something else that you can always reach out to reach out to me or maybe and yeah, I will start recording right now. Okay, so"]
+[-2.570971965789795, -3.0544044971466064, "The primary goal today is to identify the needs do you think are the most important to the older, older populations or user, those who are 60 and older, we want you to think as broadly as possible, taking into consideration that older adults, caregivers, families, and their and their communities. So I'm going to share my screen right now and show you a list of common issues and concerns that I impacting the older adults, when meaning go ahead and share my screen"]
+[3.997933864593506, 5.7181267738342285, "do u see my screen. Yeah,"]
+[3.937152147293091, 5.023881912231445, "yes. So please take a few a few minutes to go through the list and when you know when you ready."]
+[5.51549768447876, 6.388487339019775, "Okay, thank you"]
+[3.7223141193389893, 4.533134937286377, "so much. So for the follow up questions, I will ask you, they will pull from this table."]
+[3.3141961097717285, 8.177483558654785, "Oh, no, no,"]
+[3.7073049545288086, 4.589725017547607, "I will go up No, like the question the following questions I will ask you will refer to the table."]
+[3.5721044540405273, 7.162415504455566, "Okay. Yes. But yeah,"]
+[3.7511425018310547, 4.561533451080322, "I will ask you some specific question regarding the table. Yeah. Okay, so"]
+[-1.7688504457473755, -1.2382113933563232, "I live with my parents and their parents in law, um, all of them are currently in their 70s. And, you know, over the years, I have been either living with them or helping them with various duties. So it's, it's challenging, sometimes."]
+[0.20137616991996765, -4.046206474304199, "Thank you for sharing. So thinking about Orange County and looking at the list of common issues and concerns. Impact impacting like, the older adults, is there anything missing that you see"]
+[1.2965071201324463, 6.2888102531433105, "Ah, I think one"]
+[-0.21925854682922363, -1.1137282848358154, "thing is I don't know whether it's there. It's like the for the immigrants. is There a row there for immigrants, like language barriers and cultural differences. You don't have"]
+[3.8726720809936523, 5.797642707824707, "it there. Right. Believe it or not, and they're okay. We will go ahead and add that. Okay."]
+[-0.3658618628978729, -1.1964645385742188, "So, it's mainly that it's not there. Because I came from an immigrant, first generation immigrant and then I see you know, for my parents and in law there are foreigners. And you know, language is a big issue. Yeah, like,"]
+[3.713628053665161, 5.195680618286133, "fear is under Yes. But yeah, I will go ahead and add they want to just mention and also"]
+[-0.4976130723953247, -0.3347564935684204, "culture differences."]
+[5.584980010986328, 8.793719291687012, "Okay."]
+[4.226465702056885, 8.96432876586914, "No."]
+[2.458636522293091, 3.8363351821899414, "So of the needs of the lists, including the ones you, you just mentioned you added to the list. As Please, can you rank the number with the number three top from the list that you think that the most important"]
+[0.7604711651802063, -0.061363957822322845, "I think it differs depending on the year but the population I'm talking about"]
+[-3.234065532684326, -2.1660544872283936, "are for the older adults. Yeah, for"]
+[-3.0097758769989014, -1.2496020793914795, "the population of older adults, I think it's hard to rank Alzheimer's disease, dementia,"]
+[-1.7041277885437012, 1.307604193687439, "behavior and mental health and and housing"]
+[3.304532289505005, 6.169544696807861, "thinks you said so for the next questions,"]
+[-2.810643434524536, -2.9789366722106934, "I will go ahead and as the for the three needs. So you ranked the top three that you ranked, I'm going to ask you for each of them, I'm going to ask you the following questions. So for the first one is how and why are older adults are struggling with Alzheimer's disease and dementia"]
+[1.9136357307434082, 7.28561544418335, "how and why"]
+[-2.968778133392334, -1.2310199737548828, "I guess I'm not an expert on the etiology of the disease. So I think when people get older, and especially now, they compared to many years ago, wherever their older population, like average age is older, and there are multiple factors that contribute to the development of the disease. So one of the factors like actually one of my colleagues, is studying the key environmental factors, but I know there may be some other reasons too. So so but I know older people have a higher risk and increasing risk for developing Alzheimer's disease and dementia, and it could cause tremendous impact to the to the older people as well as their family and caregivers."]
+[-3.059080123901367, -1.214367151260376, "Thank you for your answer, and what barriers exist to see an improvement and this area of Alzheimer's disease and"]
+[2.3850338459014893, 6.927785396575928, "I am"]
+[-0.16602276265621185, 2.3941004276275635, "barriers. Um,"]
+[1.932509183883667, 7.010038375854492, "I guess we to me."]
+[-3.013134479522705, -1.186785340309143, "My wish list is that we understand, like fully the mechanisms that are logical reasons why people develop Alzheimer's disease and then you can develop the preventing either through like vaccines, some some sort of vaccine or sort of medicine that can cure the disease, but I don't know, I guess there's no such miracle medicine or prevention measure at this time. So it's likely that disease is multifaceted, that means that there are multiple reasons. So it makes it difficult to develop a prevention"]
+[5.409485816955566, 6.510494709014893, "tool. Thank you."]
+[2.6030757427215576, 8.7776460647583, "Ah,"]
+[-2.7773759365081787, -1.2575242519378662, "I don't know. So I'm not an expert in this area. So I guess like for higher income groups, likely, you know, the family or the children of this elderly people may make it you know, more resources to take care of those them. So, but for those that lower socioeconomic groups, they they have little resource to deal with the disease. So like the disparity issue always exists, including the Alzheimer and dementia outcomes, but I don't have much knowledge of you know, very specifics about this"]
+[2.900155782699585, 4.566878318786621, "outcomes. Thank you,"]
+[2.395421028137207, 6.205471515655518, "I don't know."]
+[0.9456242322921753, 1.2757737636566162, "Not my area. Okay."]
+[-2.714359998703003, -1.65935480594635, "Thank you. We will go here and I will ask you the same questions for the next need that you you mentioned. So, how and why I older adults is struggling with behavioral and mental health."]
+[2.14026141166687, 6.453312873840332, "So I think how I think when"]
+[-2.172337770462036, -1.0713528394699097, "And the thought of is that when you're younger, you never thought about what will happen in the next few years. So, like, when people get 70s 80s, they're like, they started to lose their friends and they, they have also lose their capabilities. things they can do easily in the past, and, and also the illnesses and diseases started to get on them. So all of those like physical illness, and so they feel uncomfortable, they feel pain, and they don't have good sleep. And also the negative thoughts, or what will happen to me, you know, if my friend passed away. And so all of those started to kick in, which rarely happened when people are younger. So"]
+[3.144104242324829, 5.799572467803955, "yeah, it's just that the time you have to count"]
+[-1.6183356046676636, -0.8143867254257202, "toward the end. So I think it's also their guilty that sometimes they need their children, or the other caregivers to help them. And they don't want to bother their loved ones, but they have to. So that helped us. And their, their life relied on the others."]
+[3.6732208728790283, 11.017940521240234, "Um,"]
+[-1.8474448919296265, 1.0728651285171509, "so I think that that's all why, you know, they may cause a lot of mental stress, hopelessness and"]
+[-1.4972021579742432, 1.3832205533981323, "depression."]
+[7.192588806152344, 4.6611857414245605, "Thank you for sharing that."]
+[1.1151703596115112, 6.4423651695251465, "I think"]
+[-1.6327619552612305, -1.8644685745239258, "I'm also reflecting on myself. I feel without a lot of patience, and tolerance on children. So like, our parents do that to us. So when we were very young, and you can you know, how kids started to learn walking, right. So, you know, from numerous failures. And there, I think it's naturally we know, working to be patient with children, we know they're going to grow up, they're going to learn how to do it. But for elderly, I feel no we don't have we don't have the same level of patience, and tolerance there. And also, no matter how we try, even surely the outcome is not that you will learn how to do it, you will, you know, that eventually the outcome is decay. So you know, the lose of capabilities. And for, for the elderly, it's like no matter how I'm going to try. It's hopeless."]
+[1.1832935810089111, 6.438467025756836, "So I think"]
+[-4.070249557495117, -1.9787240028381348, "it's very different, but I hope that everyone would know that every everyone will go through that stage and we need to be more patient and tolerant with older people."]
+[5.910425186157227, 6.760588645935059, "Thank you,"]
+[-4.216003894805908, -1.9654072523117065, "Like, are there any different experiences for the different groups for older adults from different backgrounds regarding behavioral and"]
+[2.6023380756378174, 8.774652481079102, "Ah,"]
+[-0.5011779069900513, -0.7810786366462708, "yeah, again, from my own personal perspective, I think that there is a lot of difference in terms of culture and the, the immigration status, so culturally, I know, like people who are grown up in the US tend not to live together with their children. But some other immigrants, especially some from like Asian countries. I came from China so The tradition is to live with one of your children. So, and but, but that tradition may not be blending well with the US"]
+[1.15513014793396, 5.195279121398926, "mainstream"]
+[4.43718147277832, 7.803006172180176, "mainstream I get a sorry I was clicking on something. So,"]
+[2.1873350143432617, 7.551723957061768, "they, I guess,"]
+[2.4660682678222656, 7.239571571350098, "you know, it creates a lot of complexity"]
+[2.1712887287139893, 7.518242359161377, "or it if"]
+[-0.9888535737991333, -0.9736921787261963, "if they think like the elderly population think that they would want to live with children, but then children grown up here don't think they they should you know live together and take care of the the their parents and there is this that may cause fights across generations."]
+[1.7710180282592773, 8.09242057800293, "So,"]
+[-0.5616905093193054, -2.115604877471924, "and also the, I know some people would want to live in the senior centers or like a retirement community for certain culture but not others"]
+[2.3574600219726562, 2.8163774013519287, "I think unknown is is a very big issue"]
+[-1.9033536911010742, 1.1632972955703735, "that may also lead to various behavioral and mental health problems and also physical problems"]
+[0.5410134792327881, -0.13944555819034576, "and some culture or sub populations may may"]
+[-2.4815642833709717, -1.990193486213684, "I guess, have more social interactions with their neighbors and their friends, while certain other people may have may tend to be like more more inward type and do not socialize very well and and at the elderly age that is more problematic"]
+[1.8999427556991577, 6.043325901031494, "things you"]
+[-1.9815939664840698, 1.083714485168457, "and what do you suggest is the best way to address your mental health health"]
+[1.5414097309112549, 6.168732166290283, "I think this is a very"]
+[2.5516436100006104, 0.36391499638557434, "big issue. I think this needs to be worked out with multiple stakeholders and multiple interventions or like systematic changes."]
+[2.3895342350006104, 5.675412178039551, "Ah, so, let me see if I can give some examples. So,"]
+[-1.7880637645721436, -1.838340401649475, "maybe raise awareness of the importance of the mental health problems among the elderly is and also for the entire society and initiate the programs that can can socialize the, the elderly, in their community in their neighborhoods, and, you know, create activity or senior centers that can promote the interactions activities of the seniors and also initiate programs that can do more of the prevention to to help with delaying the time to getting Alzheimer's disease or dementia and also create"]
+[-1.3994653224945068, -0.3305014967918396, "no easier work for the caregivers"]
+[3.1502230167388916, 8.903185844421387, "Yeah,"]
+[1.0475081205368042, -1.245469093322754, "thank you so much. And now we'll go ahead and ask you the same questions for the last me that you mentioned, which is housing. So how and why are older adults and struggling with the with housing"]
+[3.078331470489502, 8.504863739013672, "Um, yeah, so"]
+[1.6493386030197144, -1.4602129459381104, "I work with Santa Ana community for my environmental house disparity research. So I know during especially during the COVID time it's it's a big issue because if you have very crowded housing then someone gets there. And then the virus will be spreading more easily indoors and you get a high concentration of virus and a high risk of infection among the family members. So I know like in this Santa Ana communities, multiple generations alike are likely to live together under the same roof. And the crowdedness of housing, um, you know, can generate multiple problems. So COVID infection is one thing, more of the tension, you know, disturbance of the privacy space is another thing and that creates a lot of, you know, stress and more severe outcomes among that relationship disturbance among the family members and and also, other environmental problems such as, you know, indoor pollution, and like, you find someone's smoke, there could also be"]
+[1.2949937582015991, 5.0191497802734375, "higher"]
+[-2.0147218704223633, 1.1189924478530884, "chance of getting exposure to tobacco smoke, etc."]
+[1.998177409172058, 8.31800365447998, "So, but the problem is,"]
+[0.2868155539035797, -1.2535346746444702, "a lot of those elderly population do not have much of the earning. So, the affordability is an issue. Like for for my parents, for example, they weren't they, they, they are paid through their retirement Ben bike in China, they're in their own country, it's, if you convert that to the US dollars, it's, it's a very small amount, so they cannot afford to rent an apartment. So I have been working like living with for some years. But it's not the ultimate solution. Because as I mentioned, if you're living under the same roof, you know, you have if especially remote high generations, you know, like pupils"]
+[1.404029130935669, 5.157905578613281, "value,"]
+[-0.3135112226009369, -0.4659489095211029, "and how they view the world and how they deal with things are quite different among multiple generations, so you living under the same roof will definitely cause"]
+[2.450194835662842, 2.716977119445801, "you some troubles."]
+[1.366515040397644, -1.080428957939148, "So there, they can only afford to live in subsidized housing. But the opportunity to get the subsidized housing is is not not very high. And so I think it's it's not been available to everybody."]
+[3.5784170627593994, 6.553382873535156, "So, let's say see."]
+[2.9821083545684814, 6.052765369415283, "me something I forgot your question."]
+[-2.7381770610809326, -1.9179580211639404, "I was asking they why Yeah. Why I'm felt like the older adults are we're struggling with this feature. So yeah. You did answer."]
+[1.002419352531433, -1.3883987665176392, "Yeah. Listen is in addition to affordability, also the type of housing. So you know, when people get older, they some of them are getting disabled. And then like in when they were younger, they have no problem climbing those stairs. So at the elder age, it becomes very challenging. And so you know, it's not not every types of houses is suitable for them. Yeah."]
+[0.8399882316589355, -1.5110688209533691, "Yeah, I guess one is affordability and and the other is the location of the house. So I know so Some of this subsidized housing is built near your places where the price house price is relatively cheap, such as the locations close to the freeways and highways, there's not much of a green space. So I don't think that's good environment for the elderly population. And also, it will be good if you build such houses, close to like supermarket, close to like walking distance to this location. So that will encourage the older people to walk and to do some things on their own, which I think would be beneficial to their overall health. But if you you know, these houses are located in this and desirable locations, then that discourage them to walk and do the errands on their own. And also they actually are exposed to environmental hazards, which would be bad to their house, including air pollution and noise and other sins."]
+[10.481739044189453, 8.350083351135254, "Thank you. And"]
+[1.3560936450958252, -1.0600125789642334, "I definitely think so. Just you know, lower income people cannot have bought housing in in good location, and with those good facilities, so."]
+[1.1205663681030273, 6.4523797035217285, "I think"]
+[1.6697752475738525, -0.07138233631849289, "government here should definitely do something to"]
+[1.1943395137786865, 5.064699172973633, "promote"]
+[1.3925909996032715, -0.8795893788337708, "subsidized housing in good location and well designed"]
+[4.578050136566162, 4.702014446258545, "community. Thank you so much."]
+[3.8677854537963867, 4.466827869415283, "Now we're going to move on to the next question. We Amina as I share my screen is not going to use this anymore."]
+[3.0811800956726074, 8.381577491760254, "Oh,"]
+[3.3646090030670166, 8.402332305908203, "Oh, okay."]
+[3.628593683242798, 8.444925308227539, "Okay, yeah, it's"]
+[-2.2392985820770264, 0.2661173343658447, "like the health care that focuses on the needs as we age."]
+[2.3982529640197754, 6.191604137420654, "I don't know. So"]
+[2.173520803451538, 5.818507671356201, "help, I guess I don't have the reference to compare it was. I don't know."]
+[-2.968752145767212, -0.18580633401870728, "Well describe how accessible and adequate you think that those services are like the directrix services to health care for older adults."]
+[-1.084877371788025, -1.1697344779968262, "So I have mixed feelings. So I the only experience I have is, again, my parents and parents, you know, so for my parents, they are immigrants, and they are low income. So then they can get medical and through the medical they can access to their family doctor and then get referred to the other physicians and if needed, so I feel I'm grateful that they can be taken care of so that but they're the obstacle is that they I have to help them to prepare all the paperwork because the language is is the issue. And the other thing is that they are limited to their everything they have to go through their family doctor, so sometimes there's delay in getting really what they need. So, but that overall that is experience is great. However, for my parents in law, it's a different story, because their income is much higher than my parents. But but you know, so they're not qualified for the low income, housing insurance. But I was told that they need to pay a few $1,000 per person per month to get their hair house insurance right now. They are, they're not paying that. Because they have, they're still in the process of getting their green card. So they haven't been in the immigrant status. But I was told, even if they are going cardholders, they still need to pay a fortune to get their house insurance. So I don't know how they're going to do if"]
+[2.1851727962493896, 5.6497063636779785, "they, they will be here, because"]
+[0.41845259070396423, -0.22914260625839233, "it's just too much for them, you know, almost like all the dollars they have of each month are going to be paid to the house"]
+[0.7351254224777222, 0.7171257138252258, "insurance."]
+[0.9844430088996887, 2.0920984745025635, "Thank you for sharing that. How accessible and how adequate you think those services are"]
+[0.4055013060569763, 3.121814012527466, "How long is do you mean, is that is that like, a few, a few years"]
+[-2.680368185043335, 0.29167506098747253, "For the long term here is this refers to like other areas services, that helped me both the medical and non medical needs of people with a chronic illness or disability, who cannot pay for themselves for long periods of time."]
+[-2.126683235168457, -0.22047799825668335, "I don't I haven't worked with, you know, anyone with long term disability. So I don't know. But I overall so my parents case, I feel. It's, it's good. So my dad had a surgery some years ago. And I think there's yearly follow up for him like doing regular check and see whether he's fine. And like, It has been five or six years. Since it's surgery. He's still doing that. So I think it's good if you have insurance. But still insurance is a big thing, I think."]
+[5.497306823730469, 6.403841018676758, "Yeah. Okay, thank"]
+[0.9520697593688965, 2.02140212059021, "you. How adequate and how accessible using those services"]
+[2.5307562351226807, 5.665579319000244, "I don't know. I have no experience with that."]
+[2.5587711334228516, 8.02946949005127, "Um, I guess,"]
+[-2.00952410697937, 0.9288341999053955, "through my parents, I don't have exposure to mental health. You know, for the mental health part more, it's more about my child. So like in high schools and college and there's education about mental health, how you're going to deal with that."]
+[2.217557430267334, 6.165231227874756, "I don't"]
+[-2.188426971435547, 0.49286991357803345, "think you know, like, if I go with some for the primary doctor, I don't think they ask them questions about mental health."]
+[1.4536845684051514, 8.86278247833252, "And review."]
+[3.6467978954315186, 10.991506576538086, "Um,"]
+[-2.011997699737549, 0.544205904006958, "I don't know. But one thing I forgot to mention is that they live in a subsidized housing facility and I think I said before COVID or early in the COVID time, they mentioned to me that there there were some programs initiated by the Substance housing facility, asking them to like do a diary. You know, what, what about their feelings, emotions, and also just encourage them to record the positive things of life on a daily basis. And then after a bunch also they're going to, you know, get a reward of you know, that's good. So I feel there, there is some program there to promote the positive mental health."]
+[-2.364638328552246, 0.32474619150161743, "Yeah, but I don't know this for the clinical setting."]
+[-3.0567197799682617, -1.8971776962280273, "I never used to those. So because my parents are capable of doing everything. So at this time, I"]
+[2.395496368408203, 6.178792953491211, "don't know. Okay,"]
+[1.098734736442566, 6.454523086547852, "I think"]
+[0.11120808124542236, -3.318707227706909, "the cost of the health care, I really want like the government to ensure that everyone living in Orange County and in larger areas have health insurance, affordable health insurance, so they have a peace of mind that they are covered for any of the house issues they may have."]
+[2.2077434062957764, 5.618765354156494, "So the other son is there,"]
+[-2.788203239440918, -1.1492750644683838, "I guess go back to the diseases, Alzheimer's, dementia, and mental health problems they are facing. So the rates are really high. And I heard stories of friends and others, you know, what happened for a family with those elderly with such disease, so it's just devastating."]
+[3.9240660667419434, 7.480036735534668, "Status. And,"]
+[-2.1588714122772217, -2.928980827331543, "of course, the, you know, climate change. And I'm interested to work on, you know, the impact to the local, regional and global communities, including the elderly, because they are less capable to cope with a lot of those changes."]
+[7.17181396484375, 4.642747402191162, "Thank you so much for sharing."]
+[2.244662046432495, 4.949523448944092, "Oh, one thing, one other thing is that now everything is getting to the, I guess,"]
+[1.3284192085266113, 4.937515735626221, "electronic"]
+[-1.901053786277771, -2.0652382373809814, "So you have to, especially I think in certain populations or areas in the world, everything you do is through the phones to the computer. And a lot of those elderly populations may not have the techniques or skills to to deal with those issues. So like payment, that like, right for for my parents, I have to set up all the payment of other gas, fuel and electricity and other things. They just cannot do those by themselves. I cannot imagine for someone who do not have children or who do not have people to help them what they're going to do."]
+[10.68005657196045, 8.372293472290039, "Thank you."]
+[2.7497947216033936, 6.090133190155029, "That's a very general question. Ah, I"]
+[-2.397033929824829, -2.635248899459839, "think first of all government should put to the elderly population as their priority any of the planning purposes. So, we know that because of the you know, averaging age or life expectancy, improvement, we are getting older and older in the general population. So"]
+[2.39384126663208, 7.033237934112549, "then, then we should"]
+[-1.969751000404358, -2.754727602005005, "put this as as the priority, like when you design for the communities, you I think we tend to think about our children in our schools, but not so much for the elderly, like their activities and their needs. Okay, and how to accommodate their needs is, for instance, hospitals, and access to the facilities. So I think that's the number one thing."]
+[0.19977721571922302, 0.9338979125022888, "And also, big government"]
+[-0.9683799743652344, -0.5815016031265259, "needed to work together. So it's not just one planning department. It's also multiple stakeholders. They including the the social services, the health sectors, insurance and practitioners, and also working with public health's people, like my colleagues, and to promote the prevention and to some of the other programs that's cost effective in reducing the disease risks. And and also the other, you know, it's yeah, this this question is very general, I think of Americans, if, you know, we want to go to like each direction"]
+[2.385091543197632, 6.199438095092773, "I don't know."]
+[1.4715954065322876, -2.257380962371826, "But I tend to think about the sub populations within these two boys. Either because they have the least power, or because they have the tradition of not speaking out. So I'm thinking about, you know, the homeless people and the people who have lower socioeconomic status, as well as the population who do not traditionally speak out. I know, you know, I'm trying to use and I know, the Chinese population do not speak out. So I feel some of them are not, not well,"]
+[1.6352325677871704, 0.027383549138903618, "on the radar of the government."]
+[0.1707567721605301, -3.980031728744507, "We're sharing that. So thank you. I'm thinking about all the issues like that older adults are facing in Orange County. So what issue you think is being"]
+[-2.1919050216674805, -2.467921733856201, "What issues have been overlooked, what you share is been overwhelming. For the elderly population,"]
+[2.730725049972534, 4.990588665008545, "I guess I have limited knowledge of what has been done."]
+[2.4206247329711914, 7.884500980377197, "I guess,"]
+[2.007222890853882, 6.935586929321289, "to me, I feel"]
+[0.3380897045135498, -0.5235802531242371, "Ah, I don't know. I can only think about my own case. So I think for like undocumented"]
+[0.1424921303987503, -0.9036793112754822, "immigrants, for instance, I, you know, I have, from my research, some limited interaction with undocumented immigrants in Santa Ana. So I feel"]
+[1.2915666103363037, 3.523146629333496, "they really worry about"]
+[-0.2729477286338806, -0.8275765180587769, "using the resources that are available to to them, even though you provide those resources to them, they just worry about, hey, I have to contact with government people. And that may put me in that risk of you know, other things right. So then they then they try to stay away with any of these programs that can be beneficial to them. I think the other thing is, you know, I already mentioned the the insurance, the insurance of this immigrants, either undocumented or documented immigrants."]
+[5.614596843719482, 5.961131572723389, "Thank you so much."]
+[2.8992373943328857, 4.880525588989258, "Now, the next question will be more in your area of expertise."]
+[1.063474416732788, 5.541594505310059, "So for"]
+[1.759711503982544, -1.71256422996521, "climate change, I have been working on Um, wildfires and extreme heat, both of them can be causing a lot of harms to the older population. So for people who live in the areas with high risk to wildfires than the older population, you know, due to multiple reasons, like they have attachment to their property, and they have pets in their property, and then they don't think they are at risk or whatever, so that they may not choose to evacuate into when it is needed. Right. And also, they may, like one of our studies show too, that people living in this areas may not have like internet, so that they may not receive the information. And also they may have less capability of like physical to move themselves quickly from the hazardous area and risk. So this all put them at a higher risk and under general population for wildfire event, or, and wildfire smoke."]
+[1.8006106615066528, 8.370776176452637, "So and then"]
+[-2.5813822746276855, -2.06528639793396, "for the extreme heat, we all know that the elderly population is much higher risk caused by the extreme heat, because they cannot regulate their body temperature as well as the younger people. And a more dangerous thing is that those elderly population don't think themselves at risk. So they always think, you know, when they're questioned, they always think, okay, some other people are risk, you know, but not themselves. So then they may"]
+[1.2915148735046387, 4.849335193634033, "that increase their"]
+[1.9266512393951416, -1.576416015625, "house risk from the extreme heat. And, for instance, if we use cooling centers as a strategy to mitigate the heat impact, not only people are using the cornea centers, and elderly people also think it's not a lab trendy or not good. And it's for, you know, some very weak and people with illnesses, so, they don't want to use the accordion centers. And some people are also isolated. So the leaves are no, that's, that's very dangerous, they live alone, and they don't have the channels to receive information. So, you know, under certain extreme disaster events, then they may Yeah, might be at higher risk than the others."]
+[3.091597318649292, 0.14422155916690826, "Thank you so much, and when new or revised policies are needed"]
+[2.172356605529785, -1.7639245986938477, "for climate change."]
+[-1.7475496530532837, -3.0109152793884277, "So, again, I think multiple stakeholders need to work together. So, I think the disaster preparedness plan or climate change action plan needed to have a specific section focusing on the elderly population. And that will take into account you know, their vulnerability, their specific situation, such as living alone, such as, you know, access to the information, and also language barriers, and also tailor that to the elderly population, that they tend not to think themselves at risk. So the communication part is also important. So, you know, raise awareness education sessions, on the climate change, impact,"]
+[1.4552415609359741, 8.856902122497559, "and"]
+[-1.4984134435653687, -0.21223901212215424, "also get the preparedness plan. So it's not just awareness but also like actionable preparedness, and action plan. So, and those action plan It really needed to be practical and easily implement terrible. So it's like public health department and social services and clinical practitioners need to work together"]
+[5.589444160461426, 8.804451942443848, "on this."]
+[2.596369981765747, 8.783856391906738, "Ah, I"]
+[2.111265182495117, -1.8160247802734375, "think multiple and it is the, like public house department. I guess essentially, every government or sector, I think needed to be involved in the in the prevention mitigation stage for the climate impact, because it does affect every aspect of our life. For instance, for the wildfire, mitigation, you can involve public health agency, and EPA, and the like Forest Management Act and the healthcare sectors. Right, so all of those"]
+[1.9420298337936401, 0.9717882871627808, "Yeah, I use multiple data sources for my research. So for the environmental side related to climate change. I use NASA data, like a climate to climate parameters, and EPS data, you know, air quality, and even sightline data. And then for the health side, I work with multiple data sets, including Southern California, Kaiser Permanente electronic medical record data, you see house, University of California house system data and the birth certificate data, hospital admission and emergency room visit data. So these are our lot of data."]
+[1.4692021608352661, 8.849175453186035, "And"]
+[2.133028507232666, -1.814200520515442, "we also analyze government documents for their climate action plans and to say, you know, what are the gaps, whether there are differences by different cities, and why."]
+[3.692807197570801, 5.43023157119751, "So I will stop here."]
+[6.9667134284973145, 4.679361820220947, "Thank you so much for sharing. So, yeah, that's, that's all the questions and then"]
+[3.3330576419830322, 8.816904067993164, "yeah, I'm gonna"]
+[5.298773765563965, 3.588064432144165, "stop recording. Thank you so much. We almost like me."]
+[5.523080825805664, 6.433224201202393, "Okay, it's my failure. Thank you."]
+[-2.522256374359131, -3.166584014892578, "No, I don't think so. Great, we can get started then. The primary goal today is to identify the needs you think are most important to the older adult population you serve. That's defined as those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their communities. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. So please take a few minutes to read through the list and let me know when you are ready to begin. I'll share that list now."]
+[4.011006832122803, 5.480653285980225, "Yes, I can see. So feel free to take a few minutes to review and let me know when you're ready."]
+[3.7406249046325684, 5.68609094619751, "Okay, I think I'm ready. Okay. Definitely."]
+[0.23492872714996338, -1.4049335718154907, "So I'm here today representing the Cal savers retirement savings program, you know, which is the state relatively new retirement savings program designed for, you know, the private sector workers who work for employers that don't offer a retirement program. So, you know, we were created by law, in order to address this retirement savings access gap that exists in the state right, where we can see that nearly half of Californians are projected to retire into economic hardship, meaning that you know, retiring with an income at or below two times a poverty level. And, you know, the legislature at the time thought that one of the key drivers of that was that there are millions of Californians, they estimated about seven and a half million Californians at the time, who, you know, are working for employers that are offering some sort of retirement saving. So in order to bridge this access gap, they passed the bill that created the CalSavers program, which, you know, not only authorized the creation to calsavers program, but also requires that employers, you know, that certain employers facilitate their employees access to the program, they don't have, if they're not, you know, sponsored retirement plan, so basically creates this mandate on California employers. So that being said, obviously, you know, our focus is on the economic security of older adults, right, helping people or encouraging people and giving them the tools necessary, as early as possible, so that they could say for themselves, build up the next day, and hopefully, you know, be able to sort of to retire with some economic security and dignity, and use those resources to address some of the other, you know, common issues or needs or concerns that that you guys are mentioning here on the list."]
+[10.644822120666504, 8.457208633422852, "Thank you."]
+[1.7288607358932495, 6.656912803649902, "I would say from our perspective, no."]
+[2.4482223987579346, 3.8218419551849365, "Okay, thank you, and of needs on the list, Please rank the top three that you feel are most important. Right, well, let's see."]
+[-0.05003245547413826, -0.7724829912185669, "I would say Well, again, you know, from our perspective, to helping people to build their, you know, their economic security in retirement. You know, I'd probably say top three, for a program like ours would be, you know, economic security, housing, obviously, that's one of the big, biggest, you know, one of the largest common expenses that that focus, especially, you know, older adults have, and then healthcare, of course, health care access and delivery, I'd say, you know, those two probably being the two biggest drivers of income insecurity or, you know, economic insecurity for older adults."]
+[3.1194024085998535, 4.463935852050781, "Thank you. And so for the next few questions, we will be going through each of these three needs that you've identified. Right. Well,"]
+[0.31807687878608704, -1.1557223796844482, "as I said earlier, you know, we've identified this huge access gap, you know, with folks who are who are, you know, given the tools to, to save for retirement, right. The research shows that the folks who have access to a payroll deduction savings program are 15 times more likely to be saving and on a path toward retirement security. So, you know,"]
+[2.3161444664001465, 7.298178195953369, "if if,"]
+[0.24594181776046753, -1.0175296068191528, "you know, folks aren't given the tools, the education resources that they need to, you know, be able to prepare themselves financially for their retirement, you know, they'll they'll be at a disadvantage. And obviously, those that disadvantage, the access gap tends to affect, you know, poor folks, right, lower to moderate low to moderate income workers are more likely to not have access to a means to save for retirement. Workers of color, right, two thirds of our estimated eligible population are workers of color. Two thirds of them work for small businesses. I feel like I've gotten off track."]
+[4.3494768142700195, 6.592282772064209, "Sure, no worries. Right."]
+[0.1442040652036667, -1.41755211353302, "Right. So I think I think that's a that's, you know, a key driver of it. So, you know, as, as Americans are, you know, in California, in particular, are, you know, healthier, and living longer lives at the same time, they're dealing with this rising cost of housing and health care, and their, you know, their everyday needs, even at grocery. So, you know, the lack of preparedness, that that we think is, in a large part is driven by, you know, the lack of, of a lot of folks to access the tools that they need to save for retirement has sort of created this situation where, you know, older adults are ill equipped for their retirement years. And we're hoping to address that by addressing this access gap."]
+[0.24815993010997772, -1.315523624420166, "So as we work to make sure that more California workers have access to the tools that we know, work to get them saving on and on a path toward retirement security, that's, you know, definitely one barrier that we're working to address. But then, you know, financial education, financial literacy, trust of both, you know, financial institutions and government institutions have an effect on, on, you know, people's, you know, willingness to participate in programs like this. And then also, you know, the weight of everyday living expenses, right. I'd say those are probably the biggest barriers right now. Thank you."]
+[1.9524242877960205, 5.937782287597656, "Different definitely."]
+[0.20318114757537842, -1.0414732694625854, "So, you know, as I mentioned, you know, we estimated the eligible population for our program, so the people who were, you know, most likely to work for employers that, that didn't offer retirement benefit. You know, again, two thirds were people of color, bout half or Latino, you know, two thirds and work for small businesses. So if you, you know, spent your career working for a small business, you were less likely the access gap often tend to affect, you know, with, with less education, right, folks with with only a high school degree or less than or, you know, with with a high school diploma or less than high school diploma are less likely to have access to workplace based savings program, and, and, you know, that access gap shrinks with with, you know, higher educational attainment. So, yeah, there are definitely, you know, certain demographics are affected by the problem more than others."]
+[10.595209121704102, 8.491620063781738, "Thank you."]
+[0.2603343427181244, -1.2753057479858398, "Well, you know, again, from our perspective, it was it was really addressing that access gap, right, making sure that that regardless of those conditions, and that no matter where a person works, they should have access to, you know, to some way to save automatically from your paycheck. So whether that's, you know, with their employer signing up for calsavers, or whether it's, you know, their employer going out in the private market and starting their own retirement plan. You know, our goal or The you know, the legislators go when they pass the bill and created our program was to ensure that as many working Californians as possible, have the tools, you know, easily available at work to get themselves editing and all the passwords, retirement security."]
+[10.714462280273438, 8.384355545043945, "Thank you."]
+[0.3685246407985687, -1.4381471872329712, "Right. And again, this, you know, isn't so much our area of expertise. So, you know, I would just say, you know, from, from our perspective, you know, the, with the rising cost of housing in our state, combined with, you know, the, you know, the the fact that there are so many Californians who aren't prepared when they reach retirement age, to make up for any lost income as a result of either retirement or the inability to work, that, you know, that contributes to a situation where folks are having difficulty, you know, maintaining"]
+[1.346921682357788, -0.5093937516212463, "housing security."]
+[-0.09360449761152267, -1.266191005706787, "You know, again, just just answering from our perspective, we're hopeful that, you know, when people are able to, you know, build more resources over their working, or their working years, that they'll be better able to absorb the increased cost of living that they might experience when when they reach retirement age or, you know, when they, you know, become older, older adults."]
+[0.15231740474700928, -0.9207553863525391, "Right. So again, from our perspective, because that access gap, you know, it does affect more demographic, or certain certain demographics more than others, then, yeah, we would assume that, that yeah, they're the folks from those demographics when they reach retirement age or or, you know, their older adulthood might experience those problems more than more than others."]
+[5.598565578460693, 6.799509048461914, "Thank you. Well,"]
+[-2.3121156692504883, -3.2350339889526367, "you know, again, you know, I'm sure there's tons of policy proposals that other interviewees have have suggested, and that I would probably advocate for in my personal life. But, you know, speaking as a, as a, as a government official representing this program, you know, from our perspective, where our hope, again, is that by getting more older adults prepared, you know, for their, their older adult years, throughout their working years, that we'll be able to, you know, relieve some of that pressure that that older adults are facing when they when they reach retirement age."]
+[3.0908265113830566, 4.576236248016357, "Thank you. And now we're getting on to the third topic. Okay, you can just answer however you feel is appropriate."]
+[-0.059505727142095566, -1.2857705354690552, "Right. And again, you know, that that just goes to the rising costs. And, you know, when you combine that with with certain folks, you know, inability to prepare, properly, or enough for further older years, it definitely creates a situation that, you know, create some pressure for for older adults who have a budget who are living on a budget."]
+[-0.2612485885620117, -1.4250894784927368, "Alright, so again, from our perspective, right, we're hoping that that by giving people the tools that they need to save that, you know, they'll be better equipped to, you know, handle some of those costs when they reach their, their older adult years."]
+[5.465217590332031, 6.934038162231445, "Thank you. Yeah,"]
+[-2.088639259338379, -0.9650272727012634, "We would we would, you know, imagine that, that those demographics are probably affected by the, by the, by the rising costs of healthcare more than others. Thank you. So, you know, again, we're working to, to help make sure that, you know, folks are given the tools that they need to prepare themselves for their older adult years by addressing this access gap that exists"]
+[-1.1622200012207031, -4.021918296813965, "in the state. Thank you. So I have a few more questions. But that is it for the list. So I will just stop screen sharing now. The following questions are more geared towards Orange County specifically. But feel free to again, answer however you feel is appropriate. And if you don't really know or don't feel like you are the best person to address it, you can feel free to skip the question. So the next question is, can you please describe how accessible more than adequate, the following care services are in Orange County, starting with geriatric care."]
+[0.8028209805488586, 3.1226508617401123, "I wouldn't be able to make an assessment,"]
+[-2.3920109272003174, 0.9031065702438354, "no worries. And the next few are for long term care, mental health and behavior, substance use treatment, or human and social services."]
+[-0.35019734501838684, -3.996182680130005, "Yeah, I probably wouldn't be able to speak to those, especially, you know, the unique situation that exists in Orange County would be outside of my exhibitions. No worries, thank"]
+[1.5533218383789062, 7.150129318237305, "you."]
+[-2.3198795318603516, -3.1112985610961914, "You know, I'm not sure I'm the best person to answer that question either. Because, again, you know, speaking as a, as a state official representing representing the program, I would need to focus on, you know, the specific, you know, issue that we're trying to address through through our work and program, which is, you know, trying to make sure that that more more older adults are, are, you know, better prepared for their for their retirement here, financially."]
+[10.699559211730957, 8.393693923950195, "Thank you."]
+[0.009844359941780567, -1.7280827760696411, "So that's a great question from our perspective. So I think that, you know, the calsavers program, I think, provides, like a really good, you know, example of, you know, smart policies that the government can enact to help to, you know, make life a little bit easier for older adults. You know, we're also a good example of public private partnerships, right, where were overseen by a transparent, you know, public board, but we're run by, you know, the day to day operations and investment management is done by by private sector, financial firms. So, I think that, you know, there are a lot of opportunities out there examples like calsavers, you know, where you're identifying an access gap, or identifying, you know, in an issue that older Americans are, or older Californians, older Orange counties are, are experiencing, and then creating public policy to, you know, directly address those those access gaps. Or, you know, the situation that exists for older adults."]
+[0.14992865920066833, -0.671843409538269, "Thank you. I wouldn't be able to answer that question. I don't think you answer the question either. I'm sorry. No worries, no worries. So in addition to what we've already talked about, we can dive a little deeper into the area of income security as we age. Yeah, sorry, go ahead."]
+[0.19122540950775146, -1.3540689945220947, "Yeah, no, I mean, you know, that's, that's an interesting question. And it's a tough one for us to answer because we're, we're a relatively new program, right, we've only been up and running since 2019. And when we look at the population that we're currently serving, you know, our feasibility study had identified, you know, not only those demographics that I mentioned earlier, that, you know, were more likely to suffer from this access gap. But also, younger adults actually are the ones who are who are more likely to be working in places that don't offer a retirement program. And that has turned out to be the case for us, too. So more than half of our current participants right now are under age 45. So, you know, it's, it's hard for us to say, at this point, you know, what direct impact we're having on, on older adults, but, you know, we're excited about the fact that, you know, so far, we've already got, you know, more than more than 54,000 Orange County participants in our program who have collectively saved over $43 million, they probably wouldn't have been saved, you know, without without this program. So, you know, even though our demographic that we're serving right now, tends to be younger, you know, we're hoping that by by by encouraging folks to start saving when they're younger will have an impact on you know, not only The current generation as they start start aging, but also creating sort of a generational change in terms of, you know, saving and and you know, long term financial security that we're excited will hopefully benefit, you know, older, older, California and for generations to come."]
+[0.2611554265022278, -1.2085492610931396, "I don't think you know, we have any from, from our perspective, at least, as it relates to, you know, to Cal savers, we actually just passed a new bill last year that expanded our mandate. Previously, the mandate only apply to employers with five or more employees. Now, it's down to employers with one or more employee. So and, you know, given the fact that the smaller the business, the more likely it is, they did not have access to your retirement program. You know, we estimate that that's going to bring on an additional over 300,000 eligible employers statewide, and about three quarters of a million eligible participants. So again, just continuing to work on this access gap and making sure that, you know, folks, regardless of where they work, where they came from, you know, what size business they work for, that they'll be given equal access to the tools that, that, you know, we know, they need to get to get saving on passwords, retirement security. Thank you,"]
+[0.14488357305526733, -1.847853660583496, "I think that it, I mean, it's going to sound terribly egotistical, but, you know, we, we like to think that we're going to do a pretty good job in addressing and addressing some of it right. But it's not, it's not we're, you know, we're obviously not, you know, the silver bullet, right. There are other smart policies that could be made to, you know, relieve some of the pressure that that a lot of Californians are experienced, especially in their adult years. But, you know, we're, we'll be working hard to make sure that as many Californians as possible argument, it's one thing to prepare themselves for their adult years."]
+[0.28333765268325806, -1.4340932369232178, "Let's see, you know, I guess the most relevant data that we, you know, use right now is, you know, data that we have about California employers, right, that's how we identify, you know, who the employers are, who are out there, how many employees they have. So, you know, that's how we determine whether or not they are subject to our mandate. You know, census data, data about national trends in retirement savings, and income security, and in older adult years, are obviously extremely valuable to us data about how how private sector retirement plans work, you know, the costs associated with with, you know, not only maintaining those programs, but also the cost that gets passed on to the participants. So that we can make sure that we are in line with, with, you know, the general industry trends and making sure that, you know, we're remaining competitive and most importantly, giving, giving our savers the best opportunity to, you know, build a larger nest egg. And then, you know, information, especially from from local communities about, you know, which communities within the Orange County need the most support in terms of, you know, not only access to the, to the retirement savings, but also getting the education that they need to understand why this is important. And help alleviate, you know, this, this knowledge gap and trust gap that sometimes prevents people from taking advantage of programs like this. So, you know, that's why we're always really excited to get connected with local organizations that are doing, you know, work on the ground, in communities across the state, because those are the folks especially when they're working in, you know, financial coaching, financial inclusion, stuff like that, because those are the best partners that we could, you know, potentially work with to make sure that folks in Orange County are aware of this program and you know, feel comfortable participating in when they get access at work."]
+[1.4001988172531128, 1.2226574420928955, "Or maybe the community partner we Yeah, so we"]
+[1.7695237398147583, 0.6692652702331543, "get it from Multiple sources. So we get it from episodes, you know, data about, you know, you know, local information about, you know, specific demographics within certain geographies like Orange County, that we would get from from local providers. We get it from some academics, and you know, from like, I want to say philanthropy, but that's not the word that I'm looking for. But like Foundation, and stuff like that. And then other data we get from government sources, right, like employer data we get from EDD. And we get information about which employers are already sponsoring retirement plans from the federal government. So yeah, there's there's multiple sources, you know, depends on the data that we're talking about. But what is most interesting, and I think relevant for me, especially with my work is doing the outreach and education for the program is that, you know, that local level demographic data, and then figuring out who the community partners are, so that we could work together to make sure that that, you know, folks take advantage of these tools. When they're offered, it works."]
+[5.459701061248779, 6.932312965393066, "Thank you. Yeah."]
+[0.9696733355522156, 0.6573034524917603, "You know, off the top of my head, I can't think of anyone. Obviously, don't know, your full list. But you guys, you know, seem like you too are experts in this. And and I've actually pulled together, you know, organize a really diverse group of stakeholders. From what I can see from what I read on read on the website."]
+[4.78798246383667, 3.236421823501587, "Thank you. Oh, absolutely. Yeah, please do. Great. Thank you. So that concludes our interview. Thank you so much for your time, and you've been incredibly helpful to our research. If you find that you have more to share, please feel free to reach out to us. You can email me or you can contact us on our website. That's www dot advance oc.com. Or you can leave an anonymous voicemail on our telephone line at any time. I will stop the record"]
+[3.661447048187256, 15.544710159301758, "Yeah."]
+[0.48752346634864807, -1.4716339111328125, "I think that, you know, certainly just starting with the easiest, which is social, economic, you know, if you're poor, you don't have a lot of places to get out and go to, and it costs money and gas, if you're rich, you know, you live in, you know, a cool, high rise senior apartment living in South Orange County that cost $12,000 a month. And as a result of that you have very different aging experiences."]
+[-1.9508390426635742, -1.6951818466186523, "I think the best way to address mental and behavioral health, again, is to provide services closer to the people who need them, especially in socio economic deserts, if you will, I mean, think about the, the, probably the millions, but certainly 10s of 1000s of seniors here in Orange County who cannot drive or have low levels of access to just going out and having an afternoon bowling or playing a card game at a local center or something like that, for them to have, you know, we need to reach out and engage and pull them in, because mental and behavioral health is certainly my PhD is not in aging and so forth. But as one who observes and has family members, who are aging as well, the more community engagement, the more engagement there is, the better the behavior, mental health outcomes."]
+[-1.0625280141830444, -2.736375331878662, "I think some of the same themes are critically important here as well, access, that means everything from just being able to drive to somewhere or have someone come and check in on visit on people. I mean, I think the worst stories that all of us ever hear are so and so fell down and broke his hip, and he couldn't get to the telephone, he didn't have a life alert on and laid there for two days or worse case, you know, someone died, and no one knows about it for a couple of days. So I think having a better alert system, you know, some way of people partnering with a cadre of seniors in their area, so that they do have access to services, and someone is checking up on them. I mean, seniors, or at least the ones who have come here to North Orange County continuing education, many of them come for enrichment classes like to take an art class, you know, to maybe start a beginning session of a new language, those sorts of things. And I applaud them because they have made the effort to register to get up to get going to dress to look professional. But more importantly, to take the time and effort to engage and learn and interact with a community of people learning as well as engagement are the keys to, in my opinion, better mental and behavioral health."]
+[-1.334824562072754, -1.6615053415298462, "How do they know about services, and I hear from my colleagues, you know, in the county, oh, my gosh, we have this program, we have this service, you know, we're offering this situation or activity or lesson or whatever, at this center, and so forth. So I think the county and social services are, are well aware of some of the barriers that we're talking about. But the people who need to consume them are not aware. So figuring out, they are not on Instagram, possibly not on Facebook. So driving someone to a website is not necessarily the most effective way. So I leave it up to the professionals. Each and every organization has a public information officer. They have a public relations and communications office. We can figure out how to sell cars to people or it certainly insurance and scammers are excellent at getting through a to people, so maybe learn some lessons from, from the experts who are able to climb over those barriers and get access to people so that they know about the really cool opportunities services, especially in mental and behavioral health. There, there are ways to get that information out not my expertise. But certainly the expertise of folks in the county in the areas that I've described."]
+[1.720542073249817, 8.080327987670898, "So"]
+[0.45669546723365784, -2.5223193168640137, "I would say, I would say, so everybody has to go to the grocery store as an example. But rich people go to the grocery store much more frequently. And I guess I'm making an assumption. And it's a closer experience to them. We're all aware of food desert realities. And I think, again, that is attributable to socio economic pockets. So it's harder for people to rent just do a quote unquote, drop by a grocery store, because the grocery store is not close by. And so my sense is providing those opportunities that are more local, certainly, in terms of access to just good food, that would be a cool thing in and of itself."]
+[1.1747221946716309, 1.1918326616287231, "I think I've you know, kind of attended to that and some of the other and answers to other questions, which is communication, access engagement, and bringing the services more closely to boots on the ground in the community type of experience."]
+[0.5370575189590454, -3.319173812866211, "I think, you know, certainly, in Orange County, it's just access to transportation, socio economic drawbacks, especially right now, when we're facing inflation. And there is an extreme fear among older people right now that they're going to lose their social security. I talked to someone last night, who said, I am afraid that the Republicans are going to take away my social security. And we all have assured her that that was not eminent by any means. I mean, I can't predict the future. But I think that that sense of anxiety and fear is becoming a source of certainly detriment to behavioral mental health, but it is also proving to be a barrier."]
+[0.376800537109375, -1.2901984453201294, "I think the number one is many people live on fixed incomes, they may have not had an opportunity to participate in a in a pension program, as well as you know, 401k situations, I don't think that I'm straying much from the facts. I wish I could pull up a quick infographic, but many of the things that I'm talking about today disproportionately impact single older women, those who've been divorced or are divorced, men seem to make out a little bit better because they've been the head of household. And they have had, you know, full time jobs for many, many, many years, while women especially in the 60 plus 65 plus 70. Plus, in particular, were not part of the workforce as a result, they're social security check is a smaller, they don't have access to their husband's pension fund, nor access to the 401k. So a disproportionate amount of impact on socio economic, mental and behavioral health is accruing to women. As more of them, seek shelter in their cars or or losing access to housing."]
+[2.460360527038574, 7.442962169647217, "You know,"]
+[1.6601217985153198, 6.659236431121826, "I would say so."]
+[-1.9834916591644287, -2.373767375946045, "I guess, you know, working with within the county structure and our state and structure, if one of the results of this interview and the query that is producing the data, leading to just two decisions, you know, data driven decision making. So if this data leads to decision making, it should be readily apparent that the data that certainly I'm referring to, as well as the experience and analysis in play, hopefully can drive policy decisions and that policy decisions, drive budgetary expectations, and, and execution, if you will. So using the last example as the case in point that is, older women who are single, and they're especially in their 70s. It's a mental and behavioral health tool. Yeah, it's more than just sitting around watching things. It's again, a mental and behavioral health tool in terms of mental stimulation as well as social engagement. So that it's the whole plethora of skills that we've talked about today. For those to be top of mind, especially for women. In the in the funding priority, there's plenty of money, I know we're going into recession ish type of budget deficit spending here in the state of California, that will trickle down to counties and localities. In the meantime, the funding formula should be based based on data. And that's what you're collecting. And I think it will reveal a preponderance of disproportionate impact for women in the socio economic especially negative side of that, especially as they age."]
+[-2.868535280227661, 0.24590416252613068, "A geriatric care. B long term care. And then human and social services."]
+[4.231162071228027, 8.97194766998291, "No."]
+[1.0850350856781006, 2.71699595451355, "I would say it's pretty much not adequate. I mean, I guess if you're looking from one to 10, I would put it at like an eight, pretty much not people are not aware of, but it's not adequate. And it's certainly not accessible."]
+[-2.7678780555725098, 0.22824904322624207, "Okay. And then long term care."]
+[1.1829173564910889, -0.9875341057777405, "I would, I would, I mean, if you're wealthy, you know, you can pay that 6 7 8 9 10 $14,000 a month to live at ages or Covington or, you know, Leisure World or whatever. So it's, you know, those, those are different levels of access. But if you're someone who we'll say has a total all and monthly budget of let's just say, three to $5,000 housing is an extreme feeling of scarcity, I would imagine I think."]
+[-2.137718677520752, 1.1422295570373535, "And then mental, behavioral health and substance use treatment isn't isn't accessible and adequate."]
+[-1.5909039974212646, -2.0039920806884766, "I would say it's not accessible and certainly not adequate. They don't. I mean, unless they're on the streets, which is absolutely horrific. But it's not like, you know, mental behavior, substance. All of those things that you were just talking about, are available even in senior centers or senior apartment buildings. I mean, the I find it hard to imagine that those kinds of services are available or adequate in any kind of scalable fashion."]
+[-0.3156174421310425, 0.4984835982322693, "And human are social services."]
+[1.998329758644104, 6.081575393676758, "Exactly the same."]
+[5.575607776641846, 8.794952392578125, "Okay."]
+[5.594727039337158, 8.816526412963867, "Okay."]
+[0.7042214870452881, -1.1384893655776978, "Well, that's where the bulk of the meaningful money can come from private entities. You know, whether that's a housing complex or so certain, certainly, health care, if people have a lot of money, they're going to be able to stay in their house, maybe downsize but pay off a house subsidized or gain access to behavior, physical and mental health. But if you're in a modest, static, stable income, even that seems adequate. Those those sources are going to be stretched if not become increasingly insecure, including housing is number one, number two, transportation. And number three is just socio economic security. That is food, clothing, and of course shelter, as I as I just mentioned."]
+[0.1290407031774521, -5.02637243270874, "And thinking about all the older adult residents in Orange County, who was getting the least amount of attention,"]
+[-0.03452180325984955, -0.9199650287628174, "I would say that socio economically challenged, be that from any demographic group."]
+[1.4764808416366577, -1.0666574239730835, "I think it's not being overlooked. But it needs to be clearly at the top of the list, which is housing insecurity along with that is food insecurity."]
+[1.8527427911758423, 6.390182971954346, "I don't think so."]
+[4.710355758666992, 3.1468029022216797, "Okay. So this concludes our interview. Thank you so much for your time, you have been incredibly helpful, you know, and being gracious with me today with all my technological issues. But then still helpful for our research. If you find you have more to share, please feel free to reach out to us. Our contact information is available on our website events oc.com. Or you can also leave an anonymous voicemail on the telephone, and our telephone number is 949-415-6898. And you can leave at any time."]
+[2.9247186183929443, 4.692735195159912, "Okay, well, if I I'm curious and would be interested in what the outcomes of your findings if you don't mind sending those along when they're concluded."]
+[5.312257766723633, 3.6057519912719727, "Yeah, I'll stop recording now."]
+[-2.64237117767334, -3.199934244155884, "Okay, so in a minute, I'm going to share with you on my screen a list of common issues and concerns impacting older adults. If you're driving, I can read them out to you. If that, yeah, I can do that. Yeah, so. So the primary goal today is to identify what needs you think are most important to the older adults populations that you serve. And for older adults, we mean those who are 60 years and older. And we want you to think as broadly as possible taking into consideration older adults, their caregivers, families and the community. Okay."]
+[-0.9313094019889832, -3.4334137439727783, "Sure, my name is Erica Dan Zack and I am currently employed by Cal Optima health as a Director of Program Management in our Enterprise Project Management Office. But for the purposes of this interview, I'll be interviewed as an individual and my professional capacity as a gerontologist, I hold a Master's Degree in gerontology. And prior to my current assignment at Cal Optima, I served as the Orange County Office on aging director for both the office on aging and veteran services."]
+[-1.438651204109192, 1.133891224861145, "Great, thank you. Okay, so I'm gonna start reading off the list to you. Okay. So the list is read in alphabet quarter, Alzheimer's disease and dementia, behavioral health and mental health, cancer, caregiving, communicable diseases, community and family safety, diabetes and obesity, digital divide,"]
+[-1.1272300481796265, 0.9865720272064209, "diet, fitness, nutrition, disability, economic security, emotional wellbeing, environmental concerns, health care, access and delivery, heart disease and stroke. Homelessness, housing, pain relief, physical comfort, personal care management, respect, respiratory conditions, tobacco use, transportation and mobility and unintentional injuries."]
+[3.7033531665802, 5.361819267272949, "I just read to you"]
+[-1.0818268060684204, 1.123361349105835, "know, that's pretty comprehensive. You know, I know it's an alphabetical order and not an order of priority, but definitely happy to see that. Nutrition is considered, and also transportation. Also housing or affordable housing, access to health care and the digital divide are kind of what bubble up to me is highest priority."]
+[2.5593559741973877, 3.9770917892456055, "Oh, good. I'm glad that you were thinking that way. Because I'm going to ask you Next, identify your top three."]
+[0.49386054277420044, -1.3384637832641602, "Well, based on experience, I would say that, you know, while working at the office on Aging, we always tracked unmet needs. And year after year, it was always affordable housing, transportation, and nutrition."]
+[3.1580398082733154, 4.469989776611328, "Okay, great. Okay, so I'm going to ask you the following questions for each of those three things, and we're going to take them one at a time."]
+[-1.1503461599349976, -0.8452118039131165, "I think that it's always been an issue, especially in a high cost county like Orange County, but even more so in recent years as a result of the pandemic and just the economic pressures. So, you know, for the office on Aging, it was always our mission to support seniors to age in place and to be able to support their independence in their home for as long as possible. But when that became is not possible anymore. The options were either to hire a caregiver, which is not covered by any sort of insurance or Medicare benefit. Unless you're very, very low income and fall within the medical guidelines, in which case, you may be able to get linked up with In Home supportive services, although that's very limited. But most people can't afford to hire or privately pay for a caregiver to come into the home to support their independence. So then families often look to placement in long term care facilities like assisted living or skilled nursing facilities. And again, those are very limited because skilled nursing facilities have very strict requirements in terms of what makes you eligible, right. And insurance, most of the time just covers limited stays. And then for assisted living, that, again, is private pay. And unless you're, you know, in the top percent of income earners, most people can't afford to privately pay for assisted living. So it's not only a challenge to keep up with maintaining your own residence, but then when that's not possible anymore, the the other options are just really, really expensive for most seniors."]
+[0.9828870296478271, -1.4914377927780151, "I think some Well, simple supply and demand, of course, so affordable housing units do not match the demand for them. There's always been extensive waitlist for affordable housing units, senior apartment complexes. So definitely the need to construct more housing units at affordable rents are one factor. Think another barrier is just senior friendly communities. You know, most of the senior apartments are embedded in communities and neighborhoods where you have those that are working and active and, you know, don't really need the conveniences or accommodations that senior living might"]
+[1.7145307064056396, 3.9282562732696533, "require."]
+[1.0137354135513306, -1.289665699005127, "Yeah. And do you feel that there are different experiences for different groups of older adults on the issue of housing."]
+[-0.6500948071479797, -1.157400131225586, "And my experience, I've seen some cultural differences, certainly among the Asian populations. There's a value system with our older adults in the family and keeping grandparents and aging family members among the mix in the primary home, right. But for other cultures, that really is embedded so much in keeping the seniors part of the primary home."]
+[-0.8327829241752625, -1.9545141458511353, "Oh, I wish I had the answer. I really do. But I think that it's not a one size fits all for sure. And being able to communicate the assistance that is available in ways that makes sense for certain populations to to ensure that equity even you know, not and it's not just translating materials on housing brochures or social services and supports, but being able to connect with seniors where they're at and being able to bring services to them in their native language and be able to assign care navigators or even you know, community health workers that might be able to work one on one because it can be a very overwhelming system to navigate for anyone but for i for older adults that are already challenged with either you know, technology barriers or language barriers. I can imagine that it's especially difficult."]
+[0.5118004679679871, 1.3143422603607178, "Okay, so now we're gonna move on to your second item, which is transportation and mobility."]
+[0.23751643300056458, -2.8395678997039795, "So again, I, you know, it's been an issue for a number of years, I think. on a macro level, Orange County, unlike other major metropolitan areas, we don't have a mass transit system. So you rely on your car at every age group relies on their car to get around. But for seniors who may be facing a new diagnosis of Alzheimer's or another dementia may be at risk of losing a driver's license. If they are not able to drive and don't have the ability to operate a vehicle, we don't have I think sufficient alternate transportation options that are specifically geared towards seniors. And Orange County have very, I mean, it's not as as geographically spread out as some other counties, but we're pretty large county geographically, and we have some rural areas that aren't in proximity to a bus stop. And so access to fixed route transportation, as well as, like ADA paratransit services that need to be within so many miles of a bus stop. There's gaps in the county where those services just don't run. And so being able to provide adequate transportation for seniors that make sense that's accessible, that they can rely on to get to medical appointments on time. Mental health appointments, physical health appointments, even rides to the senior center for socialization, I think, definitely need to ramp up with the aging population."]
+[0.20730265974998474, -2.4716074466705322, "Yeah. And what barriers do see exists, that would not allow us to see improvements in transportation for older adults."]
+[0.5031792521476746, 1.052223563194275, "The high cost of transportation. And I think"]
+[0.0044833640567958355, -2.6114516258239746, "what comes to mind is, I think of younger generations being able able to kind of navigate like rideshare services, Uber or Lyft, or things like that. I don't know that older adults feel as comfortable ordering a ride on an app on their phone, you know, or that family members would even feel comfortable to put their 85 year old mother in an Uber with a stranger. So but, but to have services like that, that are customized, to provide that door to door, and even assisted transportation. And I think that a lot of transportation services have drivers and vehicles, but they don't necessarily have people that are trained to assist older adults that may have mobility issues, or need assistance getting in and out of the car or in and out of a wheelchair and taking, you know, inside the entrance of a of a medical building, per se. So that would be another barrier."]
+[3.7628402709960938, 15.496759414672852, "Yeah."]
+[0.6831231117248535, -2.8434898853302, "I would say that the county has done a pretty good job with regionalizing transportation services. So and I know each city has the ability to apply for transportation dollars to put into like senior mobile mobility programs, but not every city prioritizes that with that funding source. So I mean, you could be sort of a victim of where you live if your city isn't investing that way. So there could be some inequities there. And then, again, technology barriers and language barriers, if that's the direction that transportation services are going, I could see that being a barrier or challenge for certain populations."]
+[3.4146602153778076, 9.0463285446167, "Yeah, yeah."]
+[0.6245874166488647, -2.9147608280181885, "Well, we need more funding, that's for sure. Because they don't know All of the transportation services that we have currently are meeting the needs or can definitely size up to meet the growing demand. And I think that there probably needs to be more coordination with Orange County Transportation Authority, the city's the county. There's not I don't think there's one solution for something as complex as transportation. Yeah, yeah."]
+[-1.097305178642273, 0.6337395906448364, "Okay, it's now we're gonna move over to nutrition."]
+[-0.7291860580444336, -2.1920461654663086, "Oh, that's what this issue has definitely evolved. I think, like pre pandemic versus post pandemic, or even during the pandemic, I should say. The funding was always level and so the services were always level. And so year over year, we could expect that a certain amount of meals would be provided to a certain amount of seniors on an annual basis throughout the county. And no one really came on or off the program unless there was attrition. So there was always long waiting lists for services, like home delivered meals, because of a fixed amount of funding and resources. And so in order to be eligible for home delivered meals, you had to meet certain criteria that prevented you from being able to shop and cook your own and prepare your own meals at home, or have some sort of functional disability that prevented you from shopping or preparing meals at home, or some other co occurring conditions. So there was very strict criteria. And and there still is, to some extent, but I think that that got a little bit more flexible during COVID. And then, of course, there's the lunch program at the senior centers, where seniors could go and congregate and enjoy a nutritious meal, but also get the benefit of socialization, right. So when COVID hit and all the senior centers shut down, those congregate lunches turned into just grab and go meals. So seniors were able to go grab, you know, X amount of frozen meals that they needed for to get them through the week. And then they could come once those meals were consumed and grab and go another batch. And there wasn't a whole lot of criteria around that other than you had to be a senior. And you had to attest that you weren't participating or receiving any other nutrition benefits from anywhere else. But the demand for that just exploded during COVID. Because I think seniors had a lot of fear about going to the grocery stores and exposing themselves to to COVID. And so they just felt more comfortable being able to get those needs met and on a grab and go basis. And there was a lot of fear around supply chain issues and food scarcity and all the rest of it. So it just kind of blew up in terms of demand. But I think that it showed that the demand was always there, there was always a need. It's just that it became more available with COVID Really funding where we could really increase the amount of meals and services being provided. I don't think that I don't think that seniors were not hungry one day and hungry. The next I think the need was always there. And it just COVID kind of uncovered all of that right. And ended with home delivered meals, same thing. I mean, you had to have that criteria that I said in the beginning, but with COVID There was a lot of flexibility where seniors could receive home delivered meals, just by being aged 60 and over. And that was really to ensure their safety and make sure that they stayed safe at home and got their meals delivered to them rather than having them exposed going out in public or going to the grocery store, you know, Costco warehouses or what have you. So. So I think once all that COVID, relief funding has quieted down, the need is still there. And so, I, this is kind of at the point that I was leaving the office on aging. But I'm, I was hopeful that the state heard the voices of each of the counties and saying that we've just kind of uncovered this sleeping giant of a need. And we need to make sure that we have sustained funding and resources to be able to continue to provide the services at that level."]
+[0.20121973752975464, 1.3004624843597412, "Yeah, it's quite a neat, I remember seeing the long lines of folks, and then just the fear of going out, right."]
+[3.33284068107605, 8.739483833312988, "Yeah. Yeah, absolutely."]
+[-1.1260679960250854, 0.8263750672340393, "What, what barriers exist to seeing improvements in nutrition, but I think we're talking about food insecurity as well, right."]
+[-0.8290139436721802, -2.3530640602111816, "Yeah. And I would have to say that this food banks are part of that equation, too, not not just the providers that had county contracts to provide elderly nutrition services, but the food banks were definitely impacted. And even some supplemental food programs. Through distributions that were popping up, all throughout the community, were always busy. I even saw it in my neighborhood, you know, at the mall, up the road, they would block streets and people would just lift the trunks of their cars up and, and have food dropped in. So yeah, I think it was definitely eye opening the what a huge need. And now today, looking back, we still have inflation to deal with so high cost of groceries, a gallon of milk is not what it costs, you know, four years ago, or even three years ago. So for seniors on a fixed income, I think that that's especially challenging. Not that's certainly a barrier."]
+[3.426384449005127, 9.08864974975586, "Yeah, yeah."]
+[-0.7519617080688477, -2.146998405456543, "I think so. And I don't know that I mean, you know, if you're, if you're hungry, you're hungry. But what I saw was a lot of creativity around or flexibility I should say, around menu offerings. For government funded nutrition programs, it always had to adhere to very strict dietary guidelines with you know, sodium and vitamin C and the all the nutritional components that make up a meal. And it was really nice to see some flexibility from the state and the federal government during COVID to be able to ease up a little bit on those restrictions. And number one, because you couldn't guarantee with supply chain issues that you could get certain ingredients and so sometimes you just had to put a meal together with what what you could get right. But also the flexibility allowed for some cultural menus that weren't available under traditional programs. So we were able to see contracting with like Vietnamese catering companies or Vietnamese restaurants and be able to provide food that Vietnamese seniors enjoy. And and same with like the kosher meals and hello meals. Middle Eastern menus and just a lot more creativity going on with seniors. So yeah."]
+[3.2295429706573486, 8.810917854309082, "Yeah, so complicated."]
+[-0.593622088432312, -1.7964682579040527, "I think just exactly what I just said the sustain funding to be able to meet that need that was uncovered during COVID That isn't going to go away. And then also being able to continue with menu flexibility and nutritional flexibility so that we can see some of that creative menu offering and variety with food choices."]
+[-1.1429256200790405, -4.101219654083252, "Yeah, yeah. Okay, so now I'm going to segue into a whole nother section of questioning has nothing to do with the list that I was referencing before. I'd like to ask you to describe how accessible and adequate the following care services are in Orange County. The first one will be geriatric care."]
+[0.9289019703865051, 2.4440982341766357, "How accessible and what was"]
+[0.9848178625106812, 2.5225627422332764, "Oh, accessible and adequate."]
+[3.7250843048095703, 15.44714641571045, "Yeah."]
+[-3.0799152851104736, -0.5771070122718811, "Um, I would say inadequate and difficult to access. Scale like, Yeah, I mean, geratricians are few and far between, I think most older adults are resolved to stay with a primary care provider that is just, you know, general family medicine to find a specialist in geriatrician is very few and far between."]
+[3.7420406341552734, 15.522917747497559, "Yeah."]
+[-1.1258492469787598, -0.7823654413223267, "Yeah, and that has to do with cost long, long term care is extremely expensive, unless you have long term long term care insurance, which is also very expensive. Most people don't. I think the average cost of an assisted living facility is six or $8,000 a month. And that's probably for like a shared room. If you wanted something private, it would be probably along the lines of like, eight to $10,000 a month for something nice. So that that's, I mean, just sheer math, only a certain percentage of the population can afford that. And in terms of there being a sufficient amount. I mean, for the people that can afford it, I'm sure they would think so. But for Yeah, for the for the general population, or for those that are low income. I would say that the options are very slim. There are some long term care facilities that have like medical beds. And now that I work for a MediCal managed care plan. I know more about this from the inside. But again, the requirements are very strict. They're very limited. And there's still a lot of people that need that that either can't get in or don't qualify, because it's it's just far too strict."]
+[3.4352383613586426, 9.082734107971191, "Yeah, yeah."]
+[-1.9540724754333496, -1.8940099477767944, "For older adults, specifically, I think, again, that's probably poor poor unfortunately. I know that the health care agency has some specialty programs for that, but for the most part, there isn't. specialty programs that are geared toward older adults. specifically, that they're forced to be directed to mental health and substance abuse programs that are geared toward the general population."]
+[3.444671392440796, 9.104923248291016, "Yeah, yeah."]
+[-1.4038575887680054, -0.9986239671707153, "Yeah, I mean, I say medium because there's so many great programs that are that exist. But one of the barriers is just lack of awareness that they even exist in the first place. And I mean, I can't tell you how many older adults or family caregivers would reach out to like an office on aging call center or other service Adult Protective Services, and say, Oh, my gosh, I wish I knew about you sooner. I wish that I had reached out sooner, I just didn't know that this type of service even existed. So that I mean, that's, that's heartbreaking. But then again, you only you only start seeking services when you need them when you're at that point in your life, right. So caregivers don't reach out until they become caregivers, or until they encounter a situation that they need help with, with an aging parent. But mean, they haven't crossed that bridge yet in their lifespan. So"]
+[3.450176239013672, 9.09583854675293, "yeah, yeah."]
+[-2.6992146968841553, -1.2771925926208496, "Well, I'm gonna kind of go back on the original priority list that I called out, because when I think about 10 years from now, I think Alzheimer's and dementia is going to be a real big issue for our, our county, our society. We've We've come a long way and medical advances to try and keep physical bodies working well, but I think Alzheimer's and dementia, we have yet to find or kept up with the pace of those kinds of advances. So with the aging population growing, we know that those with Alzheimer's and dementia are also going to grow. And when we talk about all those other services that aren't adequate, like long term care facilities, caregiving social services, that's scary to think about. Because that's going to present a huge gap."]
+[-2.964994430541992, -1.2520970106124878, "Yeah, though, I think there was a recent feature in the register about how many people they expect to have Alzheimer's or dementia in the future, maybe like, half of all older adults or something like that."]
+[3.9259345531463623, 7.838545322418213, "Right. All right. Yeah. Yeah."]
+[0.7982050180435181, -2.2412030696868896, "That's a tough question. That's a tough question. I don't I don't know that the government is the answer alone. I think that it's a cross cutting issue that affects communities"]
+[-1.08151376247406, -2.6987783908843994, "all over and I think that I think that the government's involvement in providing adequate tax dollars and funding to programs for seniors that cannot afford for private pay Services"]
+[1.0400019884109497, -1.6787821054458618, "is a benefit for everyone in the community. Right, because housing housing is health care and I'm new, having properly nourished seniors that are taking care of affects everybody in the society. Right. So I think that I don't ever criticize the the lack of government involvement or support. I just unfortunately, the funding has been flat for many, many years. And so as the population grows, so, too, has the funding for for the programs that exist."]
+[0.10474143177270889, -4.955868244171143, "Right, right. And thinking about all the older adults in Orange County, who is getting the least amount of attention."]
+[1.093184232711792, -2.6023659706115723, "I think those that are isolated. Those that we don't know about our I think are the scariest. Because those that are already plugged in and engaged with senior centers, community centers, they have social support through their church or family, friends, people know about them. So they know when something's changed, or there's been a decline, you've got eyes on those, but for for seniors that are isolated, particularly like our homeless population, I don't think that our shelters are adequate, are adequately equipped to care for seniors and people with disabilities. I think, for homeless and Housing Support Services, to have seniors in the same type of housing setup as families with young children probably isn't the best mix. So I think those that are already isolated, already vulnerable, I think it could be a really scary situation."]
+[3.715937614440918, 15.406414985656738, "Yeah."]
+[-1.9458736181259155, -1.89899480342865, "I don't know if it's being overlooked. But I certainly hope that it's getting the attention that I think it needs. And that is addressing technology barriers. I think what again, that was a big issue that COVID Put a big magnifying glass over. Because never before was our world more reliant on technology than during the pandemic. I mean, that's how we did our work. That's how we communicated with our doctors, our mental health clinicians, our family, our friends, everybody turned to technology to be able to stay connected. So for seniors that don't have access to technology, either. They don't have Affordable Internet access, or they don't have devices, or they don't know how to use the devices that they have. I think that that could only create further isolation, which breeds you know, mental health issues, and then you're not seeing your doctor as often as you need to and not being connected to family and friends. And so I would like to see more investment and prioritization around addressing the digital divide."]
+[-1.971177577972412, -2.7744579315185547, "Yeah. Okay, so now I'm just drilling into your former role as the Director of Office on aging."]
+[-0.8332673907279968, -2.32399845123291, "I think that the the outcomes that we were looking for with the funding that was received for the programs that we were mandated to provide, also that they were effective to the degree that they could be with the funding that was available. I I think that the transportation for the senior non emergency medical transportation program was an excellent model. And I would love to see that continue and be expanded because it was a great transportation solution for seniors to be able to get to medical appointments, pick up prescriptions, You know, that type of thing. So that was a great and that that always yielded really great customer satisfaction. Families love that program seniors love that program. And you really felt like this was making a difference for somebody. The elderly nutrition program I think worked really well. There wasn't anything else like it being offered in the county in terms of home delivered meals or being able to go to Senior Centers for a hot meal and socialization is kind of it. So yeah, that definitely worked well. And then I would say that the information and referral call center being available, it's kind of like a 211. But with a specialty and older adult and caregiver resources really worked well. Because seniors prefer, I think, to talk with them a live person, and be able to bounce ideas off of and kind of get some options with resources. So to be able to talk to a live person and not have to kind of click through a menu or navigate a website, I think works really well."]
+[3.2739505767822266, 8.869575500488281, "Yeah, what wasn't working as well."]
+[2.4794187545776367, 2.9976260662078857, "From my vantage, I didn't really see any programs that were broken or not functioning."]
+[-0.9733462333679199, -0.5343925952911377, "And I think to that one of the beauties of the state funding is that it wasn't so prescriptive, but allowed for us to be able to customize things to be able to meet our own community's needs. So then we pass that flexibility and creativity on to our contracted providers, and they came up with some really great models. So for example, they bundled case management, and in home assistance with their home delivered meals clients, because if you're already frail, and you qualify for home delivered meals, chances are that's not the only need you have and so to pair them up with a case manager at the onset, that could coordinate other services and needs for them as well as get you know, homecare in I thought that that works really well. But I don't know that that model exists in other counties, right, because they may decide to kind of separate that out. So"]
+[3.363136053085327, 8.69493579864502, "yeah, yeah, yeah."]
+[3.2742700576782227, 8.530278205871582, "Ooh."]
+[-1.713611364364624, -2.4549014568328857, "It's hard to think that I feel I've only been in my current assignment for like 10 months, almost 11 months, but it feels like a lifetime ago. If I was in the office on Aging, I'd be like, we need this now today, but I'm a little more removed now."]
+[-0.8590608239173889, -2.7733755111694336, "I mean, I can't think of like if I had a magic wand I mean, I can definitely think of like model programs, model model, senior centers, and certain regions or zones that are working really well and thriving. It would be so nice to be able to see that offered county wide. I look at like the Leisure World model the Laguna Laguna Woods village model in South County and think what a great microcosm that they have a combination of long term care and active communities and peer support because you're living among people in your age group. You've got all the The activities at your disposal and you can choose to participate and be involved at whatever level you want. You've got social services on site, transportation, I mean, it's just such a mecca for aging in place, and how wonderful that would be if that was available county wide."]
+[-1.0157043933868408, -2.756284475326538, "Yeah. I mean, we talked about this a little earlier about government's role, but outside of government, or even including government who are what entities that is best suited to address the needs of older adults."]
+[-0.24794252216815948, -2.5250725746154785, "That's always a tough one. Because when you think about like, the senior centers are all independently owned and operated by the city. So the city would have to be involved. And then when you think about government funded programs from federal funding or state funding, well, that flows to the county level. So the county would definitely need to be have a seat at that table. And then you have network of nonprofits and community based organizations that are actually the boots on the ground doing the work, because even the county wasn't providing any direct services. I mean, other than the call center, all of the services were contracted out to community partners. So it really is a true partnership that is going to resolve this. It can't be one person. I mean, I get that there needs to be kind of like a quarterback. But it was never I don't think the vision or the design for for government or for one entity to be the solution."]
+[3.5136749744415283, 8.163844108581543, "Yeah, yeah. No, I get it."]
+[-1.4070260524749756, -2.3550093173980713, "Yeah. Yeah, for sure. And for seniors to like that there has been this trust to with government, they're not always ready to, you know, go into social service building or a public assistance building and get help, but they may feel a lot more comfortable going to their local community resource center or food bank or church or, you know, I mean, there's just a level of comfort there. So we wouldn't want to be the answer for seniors."]
+[-2.0603201389312744, -3.438408136367798, "Yeah, yeah, for sure. I mean, we're talking to about 100 different stakeholders in this initial part, with the interviews, then we're going to go and do focus groups with almost 20 Different targeted priority populations, including incarcerated and the unhoused. And then and homebound seniors as well. And then we're going to do a provider survey of folks that are hired professionals working, you know, with older adults, and then we have a community survey that will follow that, as well. So, you know, the county is, is really going all in, you know, to do this very thorough assessment. You know, and we would really appreciate it, you know, any kind of referral to anyone else you feel we should talk to in this process."]
+[-1.5508970022201538, -3.040584087371826, "Yes, yes. Well, you know, the office on aging is part of the steering committee for this. We can't talk to her because it would be a conflict. But we've talked to other members of her executive team at the office on aging."]
+[-0.04073918238282204, -3.6071114540100098, "Yeah. Oh, good. Okay. Yeah. Yeah. Good. That's great. No, it sounds like all bases are covered. i It's awesome to see this work getting off the ground. It was I was involved in the very early stages when we were thinking about a county wide needs assessment for the aging population. And really, it came from the state's master plan for aging. We wanted to put together our own master plan for aging in specific to Orange County. So I just love that this work is getting off the ground because I wasn't able to stick around to see it through but it's just nice to know that it's happening."]
+[1.5782560110092163, 1.3138751983642578, "Well, you're a part of the effort. Now so we'll be sure to keep you abreast of the developments. And if there's anyone else that you can think of or any other new organization you think we should connect with for any of those other study instruments, please feel free to reach out at any time."]
+[4.786640167236328, 4.137933731079102, "Oh, thank you so much. It was nice speaking with you, Katie."]
+[4.826185703277588, 4.755390167236328, "Same here. Okay. Well, I wish you a wonderful evening. Thank you so much for making the time."]
+[4.918318271636963, 5.614675998687744, "Thank you. Take care."]
+[4.822796821594238, 5.130507469177246, "Take care. Bye"]
+[2.233609676361084, 6.193892478942871, "I do not, okay."]
+[-2.6423962116241455, -3.2095906734466553, "So the primary goal for today is to identify what needs you think are most important to the older adult population you serve. That's defined as those who are 60 years and over. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I am going to share my screen so you can see a list of common issues and concerns impacting older adults. So I will share now"]
+[3.4776272773742676, 6.8893327713012695, "I can, yes. Okay."]
+[3.7107276916503906, 6.379772186279297, "Yeah, no, I can see it. Okay, great."]
+[3.9515466690063477, 4.931614875793457, "So please take a few minutes to read through this list. And let me know when you're ready to begin."]
+[1.5772019624710083, -2.6523056030273438, "I think just starting off with how FAM adds to this conversation, housing, affordable housing for seniors, we see a tremendous amount of need when it comes to being able to maintain housing, housing, with fixed income, and so that would be a priority area, but also speak to homelessness, the increasing average age for people who are experiencing street homelessness is also on the rise. And taking into consideration the actual physical age of the person, given the circumstances of being on the street and the more rapid aging, their physical and their physical condition is known as homelessness is a big one. And then I don't see it on here, I do. Transportation."]
+[10.6592435836792, 8.439538955688477, "Thank you."]
+[-1.0147351026535034, -3.252302408218384, "Sure. So I'm the CEO for Family assistance ministry, and then we provide systems to move people through their, from their state of crisis into stability, providing them with support and their case management, coaching, financial literacy, financial aid, food support, nutrition, aid, and housing, and emergency shelter."]
+[0.1428949236869812, -3.9521923065185547, "Thank you. The next question is thinking about Orange County and looking at a list of common issues and concerns."]
+[1.413074016571045, -2.2638561725616455, "You know, just one slight deviation between homelessness and housing, shelter, emergency shelter or recuperative care that might fall into well I guess it could fall into caregiving or health care access, but it's not specifically outlined. So I'd say if I was to add one, it would be that, shelter emergency shelter navigation center. Okay,"]
+[2.4986753463745117, 3.747560977935791, "thank you. And I know you listed a few already but of the needs on the list, including the ones that the one that you just suggested, Please rank the top three that you feel are the most important."]
+[-1.3320930004119873, 0.8067901730537415, "Top three, housing is number one. healthcare access and delivery is number two."]
+[0.5407668352127075, 1.1879630088806152, "And because transportation is number three,"]
+[3.107529401779175, 4.520084381103516, "thank you. So we will go through a series of questions for the three areas that you have identified."]
+[1.1586596965789795, -0.8983384370803833, "Well, I'll do the, I'll do two perspective on it, number one with limited income and potentially increasing costs, right. So it doesn't always spends a lot to have enough income to support the increase in costs. And so it goes into second piece which is the general housing affordability and the lack of true affordable housing. So I think it's both an income as it's driven by income, and resources as well as the landscape and the shortage of affordable housing that exist."]
+[10.722358703613281, 8.384544372558594, "Thank you."]
+[1.060119867324829, -1.3328619003295898, "For sure, thinking about the requirements to access affordable housing, it is a bit of a survival of the fittest, you've got to be super persistent in order to gain access. And that means  definitely, and identifying different processes and being able to follow the different processes to gain access to affordable housing. It's, it takes a certain level of privilege to be able to do that both physically and mentally, not work wise, you know, it's much more supportive of a process if you have somebody who will be around or guide you through the process or help you navigate. So there is that plus, if there's any barrier that's presented due to cultural background or language limitation, there's not a whole lot of accommodations that are created within the system to access affordable housing."]
+[7.148568630218506, 6.172297477722168, "Thank you for sharing. And what do you suggest is the best way to address this need and issue"]
+[-0.6744040846824646, -2.7599549293518066, "build more affordable housing throughout the county, don't concentrate the need, or concentrated poverty and have it integrated within communities that are a variety of socio economic backgrounds. So county wide strategy, more affordable housing. And then also, I think that there's a lot of value with the older adult population to also pair people with socially competent navigators and support team members to help them through the process people who understand the process and can take someone and support them through."]
+[3.2607967853546143, 5.249781131744385, "Thank you. So moving on to the next topic."]
+[-1.8864762783050537, -0.27352604269981384, "I think it's the frequency and the complexity of accessing medical services primarily, can be a challenge. prioritizing what is most important in a given point in time, focusing much more on the reactive nature, I think of health care and addressing acute care, versus what could be more preventative care, just given the overall investment in engaging with the healthcare system."]
+[-1.8288592100143433, -0.11455550789833069, "It's so broad, I think that the kind of per visit, payment structure for the healthcare system may promote more visits, versus the focus of the outcome that they're seeking to achieve. So I think it's driven primarily by the payment structure for health care."]
+[7.174257278442383, 4.64732027053833, "Thank you for sharing."]
+[-1.9699629545211792, -0.03254801407456398, "It's been my experience that yes, that is that is the case, oftentimes driven by healthcare insurance provider, or lack thereof."]
+[7.154361248016357, 6.199319362640381, "Thank you. And what do you suggest is the best way to address this issue and need."]
+[10.592517852783203, 8.491140365600586, "Thank you."]
+[0.20086468756198883, -2.680095911026001, "So being able to access safe and reliable transportation, I think that there has been some efforts to create more flexibility Within the transportation itself or the public transportation that's offered, access has been one services that's highly utilized by the folks that we see at FAM but it doesn't really allow for a lot of that independence that people are seeking, you know, it's on schedule. It's with other folks. Uber ride sharing has been successful as route as well, but not without assistance, and so I'm not sure."]
+[0.42102503776550293, -2.581258535385132, "I think the transportation is much more about the cost of it. I know that certain, depending on the level of need, certain folks will qualify for the ride share, but not others. And so it seems to be a decision based on the monetary exchange. Thank you."]
+[0.4646089971065521, 0.5717424750328064, "I will say yes, and much more driven by the ability to use technology."]
+[1.252794861793518, 1.5528695583343506, "And I would say that we're creating a path for that simple to access a service much sure what that will look like. That's the biggest challenges, it just becomes so complicated."]
+[4.890239715576172, 3.4949967861175537, "Thank you. So that is it for the needs section of this interview, and I will stop screen sharing."]
+[2.626882314682007, 4.839333534240723, "I would say this is probably outside of the scope of what we provide. So not a lot of familiarity. Okay."]
+[-0.4304582178592682, -3.9306094646453857, "Not highly accessible, and again, focusing on the South Orange County region."]
+[-0.7121460437774658, -1.1881498098373413, "Yeah, I think when we see clients and older adults in need that come to us with the decision of staying within their current housing situation and need, oftentimes driven by financial needs, may weigh the reality of additional care that may be necessary. And so then the pathway to compensation and getting them on a plan made and apply that they need longer term care. And so being able to connect them to a resource locally, so that they can stay within their community has been very challenging."]
+[10.700307846069336, 8.397790908813477, "Thank you."]
+[-0.5694029331207275, -4.067615032196045, "Similar response. Yeah. You know, if we can find a provider, and they're typically not located in South Orange County. Okay. Thank you."]
+[-0.6815617084503174, -3.823212146759033, "What's funny that we are one of three organizations, social service organizations that provide care in South Orange County around accessibility and housing. So I would look at the Advance OC, see per capita what that equates to, but it is. It's low."]
+[10.69460391998291, 8.401179313659668, "Thank you."]
+[0.5185243487358093, -0.11267043650150299, "I think the technical divide and technology divide will continue to be that that wedge will continue to grow. I think that runs into the opportunities to access transportation and support. I think if the lack of affordable housing continues to grow at the rate that it has. We'll see some additional consequences to that as well. And an access to nutritious food. You know, we've seen that and the disparities and access to that as well. The direct correlation with health, the health outcomes."]
+[-0.46992430090904236, -3.1858487129211426, "Thank you. And in your opinion, what do you think the government's role should be in meeting the needs of older adults in Orange County"]
+[-2.477327346801758, -3.0628952980041504, "adequate amounts of safety net resources, increasing SSI increasing opportunities to to purchase food and not making folks rely on additional systems that are also funded by the government. streamlining that resource to not really force older adults to navigate through complicated systems and really be limiting adequate care."]
+[0.11056650429964066, -0.9455727338790894, "Um, that's a tough one to say, because it's going to be the folks who are not engaging with systems, and are the folks who are figuring it out or not figuring it out. I think that we have a population of undocumented people that are here and have been a part of the workforce and are now aging. And I didn't know if we're, I don't know if we know them."]
+[7.173210144042969, 4.646873474121094, "Thank you for sharing."]
+[1.5058348178863525, -1.0688751935958862, "I don't think it's being overlooked. It's something that's not being given the attention that it needs and that's around affordable housing. Okay,"]
+[1.622226357460022, -0.9041897654533386, "thank you. So, in addition to what we've already talked about, let's dive a little deeper into your area of expertise. So thinking about I know you mentioned affordable housing a lot."]
+[1.3188362121582031, -1.090169906616211, "Yes. kind of goes back to affordable housing, we work with older adults, it's in the symptoms that they're experiencing because of affordable housing. So yes, I would say that the core is affordable housing."]
+[5.4751877784729, 6.422401428222656, "Okay, thank you."]
+[1.1201941967010498, -1.3560543060302734, "I think some of the demonstrated, the projects that have demonstrated success have a social service integration as a part of it. That allows for more than social emotional connection within the community, but also true support and transportation and more of a whole person approach to the delivery of the services on site. So I think that that is how it's working. And people people stay and you know, seem to more positive outcomes and folks who are heavily rent burdened or unable to maintain or overcrowded and when we think about intergenerational housing as well and what's what does that look like there's the benefits, but then there's also the responsibilities that are connected to that type of setup. So certain things to consider save quite affordable housing, by definition and then you have housing that is made affordable by the circumstances."]
+[3.0754435062408447, 0.1259414255619049, "Thank you, and what new or revised policies are needed."]
+[1.7317259311676025, 8.049398422241211, "So"]
+[1.4067109823226929, -0.5434138178825378, "building"]
+[0.8075931072235107, -1.7806415557861328, "anything in California is a challenge and tremendous amount of  pressure to seek one. Now, there are additional costs for developing So fees in California projects ensuring that they they do work and enticing developers to take on projects with senior housing. There's there's so be opposition, and by people who don't want anything built, and we still need the support of the local council to approve the projects, and then you've got the density on these products as well, with senior housing. It's been my experience that parking has not been as much of a concern. So you can bring with those waivers that make it more feasible."]
+[-0.1739462912082672, -1.0444083213806152, "If we're talking about the policy issue, the ground folks like Housing California, they do a great job at supporting with with housing development, I think, do you see us as a good one also to align around this place around social determinants of health. Now, although housing today's made me much more aligned with health, it's still categorized as a social determinant."]
+[10.648589134216309, 8.44796371459961, "Thank you."]
+[-1.7152459621429443, -0.14577196538448334, "We use data around the health system, the frequent utilizers of the emergency services, calls for service data that indicates poor health. And then looking at how, you know, how does that align with the resources that we have to offer. So if it's a matter of needing additional care when discharged, and they're in a situation where their financial burden that we will be able to step in and build that bridge from, like in that crisis to more stability."]
+[10.722230911254883, 8.372879028320312, "Thank you."]
+[-1.7105915546417236, -0.17008836567401886, "You're talking to the hospitals. Yes, I would think through also the impact for the updated, updated Senate Bill around discharge for the emergency departments. And that criteria to identify any additional social determinants of health that would need to be addressed before or during discharge, that would be an important correlation."]
+[0.9054605960845947, -1.7689210176467896, "To the government, it's important to consider as well, because we do as communities have to prepare for our, our, our aging population, and so what are what is being done to help support that, you know, my loss would be build more affordable housing, for sure. But there are other ways to also help prepare."]
+[4.905679225921631, 3.3290340900421143, "Of course. Okay. Great. Thank you. So that concludes our interview. Thank you so much for your time, and you've been incredibly helpful to our research. And if you find that you have more to share, feel free to reach out to us. Our contact information is available on our website, which is just www dot advance oc.com. And you can also leave an anonymous voicemail on our telephone line at any time. So at this time, I will stop the recording"]
+[-2.594956159591675, -3.102757453918457, "Okay, so the primary goal today is to identify what needs you think are most important to the older adult population. And we define that as older adults 60 years and older. Now, the adults that you serve now we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families in their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults."]
+[4.372340679168701, 5.185296058654785, "Please take a few minutes to read through this list and let me know when you are ready to begin. And of course, let me know if you need to enlarge or move up and down or however you like."]
+[-3.4108963012695312, -2.9955968856811523, "Okay, okay, great. So far record, can you please tell us your role and how you interact or engage with older adults."]
+[-0.7147881984710693, -3.009110689163208, "So I work in an organization called Justice in Aging. We are a national legal advocacy organization, whose mission is to use the power of law to fight senior poverty. We engage in several different types of advocacy on behalf of older adults, low income older adults, including impact litigation, technical assistance to service providers and people in the Aging and Disability Network. And we also provide trainings to that network as well. We do not provide direct representation to older adults. So my work is informed through a policy and systemic advocacy lens. It is not based on individual client representation. The only time we would represent older adults is in class action or systemic litigation. And my work for the past two years has been in part to help the state at the state level the master plan for aging, I co lead the equity in aging advisory workgroup, which assists the California Department of Aging on implementation of the master plan with a focus on equity. I can keep going, but I think that probably is a good start starting point."]
+[10.688223838806152, 8.421638488769531, "Thank you."]
+[-0.226740762591362, -3.2234668731689453, "So I don't know where it would fall. But I do know that in particular, for given the communities that live in Orange County, we know nationally and internationally that there is a significant amount of racism, that older adults of color continue to experience in many forms, but especially in healthcare access and delivery. So maybe that gets to the access to culturally and linguistically appropriate care. But I think it's it's a related but different issue. So I would think about discrimination. I would think about both race based discrimination but also ageism, and the ways in which it's hard for people to older adults to find employment. So maybe that's economic security. So I I feel like there's a there's a category here around protecting the rights of older adults that is missing that could encompass anti discrimination health care, anti discrimination, employment, etc."]
+[2.538972854614258, 3.8837039470672607, "Yeah, all of this on this list, hey, Please rank the top three that you feel are the most important."]
+[-1.1742491722106934, 1.0594446659088135, "This is hard. So I would probably pick economic security health care access and delivery. And was one more community and family safety. And the reason why I was also I can, coming in a close fourth and fifth, our housing and homelessness. But I think the answer there is economic security. Because I see those as related. So if you are economically secure, you have access to safe and affordable housing. So those would be my topic, it would be the health, economic security and Community and Family Safety."]
+[-2.565112590789795, -1.9307376146316528, "I'm gonna dive into a little bit deeper of all of the each of the three topics that you just identify. How or why are older adults struggling with this issue."]
+[0.49112796783447266, -3.287069320678711, "Orange County, much like the rest of the state is a very expensive place to live. And for low income older adults, who rely on a fixed income and largely rely on a combination of government benefits and other assistance. They have difficulty making troubles making ends meet. And that means sometimes not being able to pay for basic necessities. That means sometimes to my point about housing, that means potentially their housing is in jeopardy, it means a lot of older adults end up cutting pills, right and making sacrifices in terms of health care, because they're afraid of costs so that positionality puts older adults across the state, but especially in Orange County, because Orange County is so expensive, in a particularly vulnerable situation. So the more resources in support that we can provide, that would allow older adults to achieve economic security. That would be sort of answer number one on why that issue is so important."]
+[-0.5245918035507202, -2.1772053241729736, "Oh, gosh, there's a lot. One is budgetary constraints. So, you know, we are in a world where it's a fixed pie, unfortunately, both at a local, state and federal level. And what that means is that a lot of other issues end up you have to make some hard decisions about who gets what resources, unfortunately, that combines with, I think, a notion that a lot of policymakers have, where they're not thinking actively about the needs of older adults, we have we as advocates for older adults have not done a very good job in telling the story. And so what that means is when and organizing, quite frankly. So we don't have a good ageing organizing base to be able to fight for more income supports at a local, state and federal level. I think in part there is and this is probably consistent across all three that you'll ask me about, but there's in part ageism, that is baked into how people are thinking about these programs, and whether they're thinking about these programs, and whether they think those programs are worthy of support. You know, I think that what we're talking about is access and increased eligibility to government benefits programs. And there are a lot of stereotypes about who are on those programs, and who benefits from those programs. So those would be some of the barriers. I also think it's a really complicated policy question because there There's local county level support. There's state support, and there's federal support. And all of those are different actors trying to provide some meaningful level of assistance to older adults in terms of their economic security. And then I think it's also just important to mention that we are in a very politically sensitive time and politically charged time, which means that a lot of things that should have bipartisan support don't, and it's hard to get people across the aisle to agree. And that's really more on a national level, but it's one of the barriers that impacts people from getting what they need."]
+[0.29538166522979736, -3.209277868270874, "Right. So that's, you could probably spend an hour just talking about that. So, you know, I, our policy work focuses mostly on low income older adults. If they are otherwise healthy, in a medical sense, and they have secure, you know, income with a pension and investments. And they own their property, they might even own multiple properties. income supports is not an issue. But for folks who are low income for and we know, those are disproportionately people of color right. For disproportionate populations, that becomes even more of an issue. And I think it's important to articulate that, like, the low income piece means that we're talking disproportionately about older adults of color. And that in communities of color, there are disproportionately higher rates of disability, all those three things are connected, they're not causal, but they're disproportionate in each of those. So we're talking about various, it's probably important to paint like a very clear picture of who we're talking about. And I would imagine in Orange County, where you have really affluent communities, and you have communities that have less resources, that divide becomes even more apparent. I'll also say, and this goes to another issue is like, both across the state and in Orange County, is we have a number of immigrant, older adults. If you are here without status, it is even harder to achieve economic security. Because there are policies in place that actually prohibit you from qualifying for the types of services and supports that would give you more economic security."]
+[0.14760008454322815, -3.72166109085083, "Oh, gosh. Because the root causes of the problems are so complicated, I think it requires multiple solutions. But the clearest solution to me is increasing the economic support for low income older adults in Orange County. And you could do that through a mix of federal state and local policies. But ultimately, that would be both giving more support and increasing who qualifies for that support."]
+[-1.5890417098999023, 0.6414921283721924, "And then move on to the second issue you identified, which is health access and delivery."]
+[-0.7025630474090576, -1.2271400690078735, "So this issue is, you know, one of the reasons why I picked income before was because many low income older adults are on fixed incomes right there on a they get 800 something dollars from Social Security for their SSI. And that is a very specific issue that older adults face and people with disabilities. on the healthcare side, we know that as you age, your health needs typically increase. So we're talking about a population when we're thinking about them being low income, we're talking about a population that has higher health needs. higher health costs. And they experience, unfortunately, multiple systems of care. Because we don't have universal health care in this country, we have a very fragmented delivery system, which means that someone could be qualifying for Medicare, they could qualify for Medicaid or medical here in the state of California. And they might qualify for some other benefits, too, that are related to their health. All that means that we're leaving a population of low income older adults to navigate a very complicated landscape of delivery. Does it include food and nutrition, all those things are wrapped up in health. And there's lots of different systems that are trying to provide care. And that's ultimately if you're eligible for that, right. So the reason why it's important is there's increased health needs across the population. And the way that we're trying to meet the care for these people, is very complicated. It is not simple, and it's not user friendly."]
+[-0.6641384363174438, 2.3651528358459473, "And what the area exists to see improvement in this area."]
+[-1.779853343963623, -0.5765452980995178, "So I had mentioned, you know, the primaries, the way that we think about health is through Medicare and Medicaid, or Medicare medical, I'll start with Medical. Well, because that's state specific. And there's lots of barriers, you know, there's barriers to people applying for medical because they're afraid of a state recovery, for example, which is a policy that allows the state after you pass to come and collect, recoup the costs of your care from your estate. And there are federal limits to that. But that's a policy that a lot of people are really scared about, and they don't enroll in MediCal because of that, which then means they're paying out of pocket for health care costs. And that impacts their economic security, right. So on the medical side, there are policies in place that prevent people or scare people from being enrolled. Similarly, even when you are enrolled, there are a lot of issues around can you get the care that you need. You know, depending on where you are in Orange County, there may be providers. And there may not be providers who provide the services that you want or need. And that's I think it's important to think about health in lots of different ways. So here, I think there was a separate, maybe there was something separate on mental Oh, behavioral mental health. So I think of all those as the same thing as like part of the big umbrella. Do you have a dentist, all those different pieces. And that can be really hard to piece together as an older adult, because you're navigating lots of different people. Because you have both Medicare paying, you have medical paying. So and the other piece of this is long term services and supports, which I think is listed."]
+[-1.1331738233566284, -3.8647396564483643, "Maybe it's not listed, I would add that under health care access and delivery is access to home and community based care. People for the most part, do not want to go to a nursing facility. They don't want to leave their home. That's a broad brushstroke. And there are some exceptions to that general sentiment, but most people don't want to go to nursing facility and we know that upon admission. The health outcomes generally are worse when people enter nursing facilities. So it's really important that people get the care they need at home. And some of that is telehealth. So there's a note here about virtual healthcare services. But that's also you know, someone coming to help you with activities of daily living. That's also someone coming to do your laundry, cook your meals, do all the things that you would need help doing. So I think it's so when we think of about Home and Community Based Care, there are a lot of issues accessing that in the state and in Orange County, you might be able to find a dentist, you might be able to find a mental health specialist, you might be able to find a primary care physician. But you might not be able to get someone to come help you with activities of daily living. So that becomes increasingly a large barrier. And then I would cite before what I said about we're leaving a population that tends to have lower health literacy to navigate a very complicated set of programs."]
+[-4.035022258758545, -1.8214808702468872, "And then, are there different experiences for different groups of older adults from different backgrounds, like where they live disability status and education"]
+[-0.3923107087612152, -1.4917175769805908, "Um yeah. So I would cite you, I would point you to the Commonwealth report, the Commonwealth Fund issued a report last year around discrimination in the US healthcare system, that older adults of color, I think they said I can't remember if they said 60 and up, or 65 and up. Enough experience. And it's pretty systemic 30 40% of older adults of color report being discriminated against in healthcare settings by their providers. And similarly, there are providers who are who discriminate against older adults based on their age, older adults report not being taken seriously being treated as children having their complaints around health care not taken with the same weight. So all that comes to a head for folks. And then I would say if you're lower income, it's going to be harder for you to get the care that you need, even if we have some supports in place to try and get you that care. And if you live in particular, in areas that are not as urban, it is harder to find those providers. And it's harder to get transportation to those providers if you can't otherwise get yourself there. So all that is exacerbated when we think about the who. And those barriers are not experienced in the same way by the same population."]
+[7.178133964538574, 6.155816078186035, "What do you suggest is the best way to address this issue."]
+[-0.43095242977142334, -1.8230657577514648, "So like income and economic security, there are a lot of root problems. And it's really complicated. We're not going to be a universal payer system anytime soon. But what I would suggest is similar to the income supports is that we need better and more culturally appropriate care for older adults in the healthcare system. That includes one that is anti racist and anti ageist. It means that they can get the providers that they need in the time and language that they speak. We need a better care infrastructure for older adults in Orange County."]
+[-1.2495636940002441, 0.6920667886734009, "Moving on to the third topic that you identify, which is Community and Family Safety."]
+[-0.15217478573322296, -3.6909162998199463, "Yeah, so I saw it in here. The reason why I picked it was because I saw that one of the examples was elder abuse. And this is a big issue that older adults experience in Orange County, but also outside of Orange County is potentially being taken advantage of by people they know, both in a financial sense and also not having their wishes respected when we're thinking about healthcare outcomes or other situations. So this is a really big barrier for folks. And it relates to problems that we've talked about before around. Like, it's one of the ways in which ageism, is commonly manifested in our society is the improper treatment of older adults through elder abuse and fraud and other things. Elder abuse, neglect and exploitation, I think it's the word that you use. So this happens too often, unfortunately, and we don't have a great system in place to handle reports. And I will also say this kind of relates to health too. And maybe actually this could be a separate. I'm just seeing Oh, well, I think it's maybe we'll get to it when we talk about different groups of older adults. But I think it's particularly tricky for older adults who have cognitive impairment. It ends up being this really complicated. He Said, She Said, and we don't have a good system to honor and recognize the wishes of the older adults, especially when they're in then when they might lack capacity to be able to make those decisions. Like, it's Some days, there are good days, and there are bad days. So our system is not really built in a way to prevent the elder abuse that we want to prevent, while also recognizing and honoring the wishes of the older adult. There's other stuff out, I'll wait for the other questions to"]
+[-0.7450099587440491, 2.2331326007843018, "answer the rest of the three, still gotta ask them to what barriers exist to see improvement in this area."]
+[-0.19643229246139526, -3.5357506275177, "I don't think there's a one size fits all on the question of elder abuse and elder justice. We want the older adults to come up with and be able to lead what that looks like for them. And it's going to look a little different depending on who that older adult is and what community they're in and what they're comfortable with. I'll also say I picked this one, because I think that, and this is skipping ahead to the next question about different groups of older adults. But I picked this one because I think we sometimes think of older adults as a monolith, and one group. But that actually doesn't recognize the diversity within the older adult community in a place like Orange County. So I would say concerns around immigration, fall under Community and Family Safety, am I going to get recorded to ice is my family member gonna get reported to ice that falls under Community and Family Safety, I would also say things around police. And I think you call it public safety here. We have lived through some really awful and continue to live through some really awful instances of police and state sanctioned violence against primarily communities of color. And so we have older adults who are handling all of that, right, who have to worry about whether their child or their grandchild is going to make it home at night. So that it was hard to pick three, but it's why I think it's so important is like, there's the elder abuse elder justice piece. And then there are also these very rich, diverse experiences within the older adult population that fall under this notion of community and family safety. And we don't have an infrastructure to provide them those things."]
+[-4.084326267242432, -1.92849600315094, "And of course, either different experiences for different older adults have different backgrounds."]
+[-0.3810453712940216, -3.323580265045166, "So I think, folks with cognitive decline, and that is disproportionately black and Latino, older adults, they have higher rates and higher rates of undiagnosed Alzheimer's and cognitive impairment, actually. So it's higher for them, the more complicated for them. It's also more complicated for immigrant older adults, as I said, as well as black and brown older adults, because they're worried about police violence. I also think, you know, one connection that I want to articulate here is like, we think of we might think of APS Adult Protective Services as a neutral, you know, sort of government service. And there are instances we know of where older adults of color are hesitant to contact APS because they are afraid that APS will then that will trigger a call to law enforcement. And there's a lot of distrust against law enforcement in communities of color. So and then you you tap in like, how are we doing for older adults who don't speak English. That's a whole other, you know, we don't even have a great system for those English speakers, let alone folks who don't speak English or don't speak English or have limited English proficiency. So if again, it's just like health and income, it's going to be harder for folks who experience structural discrimination."]
+[3.0265843868255615, 7.3652873039245605, "Oh, God, I wish I knew."]
+[2.761093854904175, 6.045914173126221, "Okay, you may not have the answer."]
+[-1.947300910949707, -2.701227903366089, "I mean, I will say I think part of it is crafting community solutions that are grounded in what older adults want. And that's going to depend on each older adult, but we need to take time to listen, we need to take time to think about prioritizing their wants and wishes and needs in developing solutions. But I think it gets really complicated because that bucket in particular touches on so many different areas."]
+[-1.1677294969558716, -4.016067981719971, "Okay, moving on to the next question or next set of questions. First one is geriatric care. I'll just read off all four of them, we can come back to them. First one is geriatric here. A second one C long term care, C mental behavior, health substances, substance use treatment. And the the fourth one, it will be a human or social services. So geriatric care. And again, the question is, if you can describe how accessible and adequate these care or services are in Orange County,"]
+[-1.026839256286621, -4.0002522468566895, "I don't have Orange County specific information. But I know across the state, that there are lots of gaps with all four of those types of services. And nationally, we do not have a healthcare workforce that is trained in geriatric care. There's just we have a shortage. Similarly, one of the other things that you asked about was long term care. Like if we think about long term care as an umbrella, not just nursing facilities, but getting help with care at home, it's really hard to get that care. You have to even if you qualify, you have to jump through a lot some hurdles. And then the last one was with mental health, like behavioral health care,"]
+[-0.003575569251552224, -1.9640278816223145, "That one I won't I won't speak to as much. But I will say I think what we've seen in our state, and specifically in Southern California, is that we have a crisis among our older adults, both because of COVID-19. And what that's done, and how many people quite frankly, in that generation have died because of COVID-19, or our link at or dealing with long term effects of long COVID. And there was the shooting in Orange County at the church. That Taiwanese church, I think it was the shooter himself was an older adult, and the victims were older adults. Similarly, in Monterey Park, same thing. And what to me that suggests is that people are not getting the mental and behavioral health support that they need. When I think about the issue, you know, to me, I think about well, we're not going to change the Second Amendment. We're not going to change the Supreme Court's thinking around access to firearms, and we can't change Congress with we can change Congress by our voting but that's about it. But we can make sure that people get the care they need. Both of those older adults in Southern California were screaming out for had had lots of mental health needs. And what happened to me suggest that they do didn't get what they needed. So I'll say I'll say that much. And I think it's important to say because that at least one of those examples, both of them are Southern California, but one of them was in Orange County. So"]
+[0.3890962600708008, 3.5703177452087402, "biggest challenges can be multiple."]
+[1.1002041101455688, -1.9213711023330688, "So I think we're gonna have challenges with workforce, in having the number of people to provide the care and services that we need, or that older adults need. And that we'll have problems with the economic security of those older adults. And that we are increasingly in a dark kind of moment in our state and country like issues of climate change will impact older adults. And oftentimes, they're going to be the ones that are least resourced and positioned to respond. There was a really interesting article that The New York Times did, after Hurricane Ian in Florida, that talked about how many of the victims both the people who died and the impacts of the hurricane were hardest hit on older adults, older people in Florida. And I worry that as we go through extreme drought and extreme rain in this state, that that will be a very big challenge for them. And so I talked about workforce issues, income supports climate change. And then healthcare, like making sure that they get the care they need. It's going to be a continual problem in the next 10 years. I also think I was just one last thing is, as that population grows, that's part of the issue is that our system is already broken, and can't respond quickly enough to the growing population that's out there that needs the services."]
+[4.086377143859863, 6.424781799316406, "Go ahead."]
+[3.8748719692230225, 7.8919758796691895, "Right. Okay."]
+[1.683989405632019, 0.07023034989833832, "Well, the government's role should be you know, you can, you can answer however, what you want. Yeah."]
+[-0.8591246604919434, -2.6955788135528564, "So I think the government plays lots of different roles, they can make it easier and more user friendly. For older adults to access programs and services. They can do a better job on outreach and education, to make sure that older adults in their communities know about the services that are offered and build relationships with those older adults. So they trust public officials. And they also have an enforcement responsibility. Because the government is paying for these services. If there is discrimination in health care if there is discrimination in elder abuse, they have a responsibility to enforce local state federal laws and ensure that people are getting what they need free from discrimination."]
+[-0.03115611895918846, -4.819679260253906, "Thinking about all the older adults in Orange County, if you can, who is getting the least amount of attention"]
+[-2.5727906227111816, -2.1246426105499268, "interesting, I would say probably older adults who are numerical minorities. So that would include, for example, LGBTQ older adults, undocumented, older adults. Older adults of color and older adults who have are experiencing cognitive impairment. Again, a lot of overlap between those populations or among those populations. And I will also say older adults who don't have advocates. So that would include family members who can advocate and help them figure all this mess out. It would include people who, you know, like sometimes in these, they have a case manager or a social worker, but I worry most about the people who fall into those buckets that I previously named, who don't have someone helping them. I think those people often are completely forgotten about and are really unconnected to the landscape that we have to provide services for them."]
+[1.42409086227417, -2.540983200073242, "Yeah, older adults experiencing homelessness, or housing insecurity, that is such a big one. And we aren't talking enough about how across the state but including in Orange County, the fastest growing number of people experiencing homelessness are older adults. You can age into help into homelessness, meaning that you were previously homeless, and you just became older. And or you can be housing secure, but then as an older adult, lose access to your housing. And what we're seeing is it's both of those right, that are happening. But in particular, it's the second group of people who are losing, these are people who already are in housing, and we have set up a situation for them, that puts them out on the street. So I would say that's both a group that we're not thinking about too much. And I would also think about them as an answer to your this most recent question."]
+[2.307696580886841, 2.790026903152466, "The issue that's being overlooked."]
+[-2.687045097351074, -2.046541929244995, "housing, housing security, among older adults. I think is a is a really big one. And that we know falls on people who you were asking earlier about different groups of older adults, right. So it, it's disproportionately black and brown people and also people who have mental health issues that are aging that are in that group of people. So"]
+[3.4492263793945312, 5.305695533752441, "I just have a few more questions to, to wrap this up."]
+[-0.2591165602207184, -3.4382755756378174, "I'll say I think what's working is that. Trying to be thoughtful about the answer here. I think what's working is that we increasingly are seeing attention to issues of equity and inclusion, and recognizing that, that has a legitimate part in these conversations. So I think what I said earlier about older adults not being a monolith, is increasingly a more widely accepted notion. So I think that's a good thing. And certainly a shift even from four or five years ago, in terms of how we're thinking about these issues. That same success makes me worried because in many areas, including, I will say probably more politically conservative areas of Orange County, we have seen significant backlash to issues of equity and inclusion. So while on the one hand, it seems like many of us are becoming more comfortable thinking about those issues. That's not everyone and it's met with some significant resistance. I'll Also say for thinking about older adults themselves. You know, I have, I've heard stories both in Orange County and out of Orange County where older adults themselves might have might hold discriminatory views. And that's really challenging because you are, you both have to continue to provide services, because they you know, regardless of how they might view a particular subject, and it's challenging in, in addition, because the environment in which they grew up in a social context in which they grew up in is very different than the one that we have right now in 2023."]
+[2.9571807384490967, 0.045322589576244354, "And when new or revised policies are needed,"]
+[0.8639997839927673, 0.20022638142108917, "specifically on the equity and inclusion piece, or on,"]
+[2.769605875015259, 4.820728302001953, "yes, this, your expertise,"]
+[1.6277261972427368, 6.397944927215576, "so I think what"]
+[0.3361774981021881, -2.667487382888794, "we need is in all the policy solutions that we can then so what I would really encourage, for example, Orange County, as they think about their own master plan, is for each of those goals. For each of those initiatives, they should have specifically how the policy will improve or advance equity, and how they plan to measure that. at a statewide level, we have some of that, depending on the measure, depending on the initiative, and sometimes we don't, but I think it helps center it in a way that makes it very obvious. And that makes it easier for you to evaluate whether you are meeting that goal. I'll also say that requires good data collection and good data analysis. And I would encourage the county to invest heavily on that piece, because that tells you where you are now. And then it allows you to figure out what the right goals are moving forward. And whether you've met those goals. That is a really important step in thinking about equity, you have to understand which it sounds like the county is already doing through its stakeholder process and everything. But I would say like, Really take your time to unpack that. And in each goal, make a very clear articulation. I wish we had done more of that at a statewide level. We did some of it depending on the initiative, and then we didn't pending on other initiatives. And I think that was a lost or missed opportunity."]
+[-0.5528287887573242, -3.0028932094573975, "I don't know if there's one entity I think there are it will require lots of different entities because the issue of equity and inclusion is so broad, and impacts so many different communities in many different ways that you need a coalition. You need people who work with immigrants, you need people who work with law enforcement, you need people who work with those who are homeless, all at the table to address those issues of equity and inclusion, because it's going to play out differently. I mean, that's the whole point of equity and inclusion in this like, there is no universal experience. So there has to be a broad coalition of people. And I think that's an opportunity, quite frankly, for people in Orange County, who might not work with older adults directly. But maybe they work for example with the Korean community, or they work with the Taiwanese community in Irvine, or you know, like, there's very specific Vietnamese in garden grove like there are very specific communities in Orange County. It's also an opportunity for them to think about the older adults in those communities. We provide services to the Vietnamese community that they're not thinking about. Well, that's true. What are their specific concerns, how does their age impact what they're bringing into the office to work on. So I think there's an opportunity in all the master plans to build broad based coalition's and get people who are not otherwise thinking about aging in their work to come to the table and think about the older adults that they work with. You okay."]
+[1.6705145835876465, 0.5982885956764221, "So obviously, census data is a big one. The state has a has multiple dashboards. So there's a dash and equity dashboard. There's also at DHCS. There's an LTSS dashboard, that is helpful. And then I'll say on the health side, there's really good data out of the UCLA CHIS survey. And I'm trying to think if there are any other obvious ones. Those are the big ones for now."]
+[-1.0584909915924072, -3.7151927947998047, "I think it would be interesting for you all to connect with either a local or state disability advocacy organization, because that's been one of the ongoing balancing acts in the at the state level is how do we think about aging and disability, but also make sure that we're not conflating the two. So there's local advocates in Orange County would encourage you to reach out to them if you're not already. I would be more than happy to put you in touch with state folks too."]
+[3.7295565605163574, 15.04393196105957, "Absolutely."]
+[4.702404975891113, 3.159543752670288, "What this concludes our interview, thank you so much for your time, you have been incredibly helpful to our research. If you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website, www dot att soc.com. And you can leave an anonymous voicemail in our telephone line anytime. Or you can just reach out to me."]
+[4.7064595222473145, 4.930910110473633, "I was gonna say I know I knew Tammy so thank"]
+[5.3342485427856445, 3.6329474449157715, "you let me just stop the recording for now. See no boy. Oh my God, he's fine. Here we go. Yeah, you guys"]
+[-2.5705723762512207, -2.982240676879883, "So the primary goal today is to identify what needs you think are most important to the older adult population user. Those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families, and the community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through this list. And let me know when you are ready to begin and I will follow up with some questions regarding that list"]
+[4.663251876831055, 5.4254069328308105, "So this is the I tried to fit this in while one page, so feel free to let me know if I shooting larger but up or down or however that makes you comfortable. So just take your time reading through this."]
+[3.4368793964385986, 4.151811599731445, "And let me know I'm reading through this list and determining which ones are"]
+[3.4547548294067383, 4.711933135986328, "just just read them and I'll ask you a set of questions okay."]
+[4.747742176055908, 8.037135124206543, "Okay"]
+[-2.6058223247528076, -1.2438122034072876, "Yes, I am the program director of our Alzheimer dementia program at OMID, which we sort of outreach to the community, we educate them on brain health and caregiver classes. And at the same time, we sort of invite people to do free memory screenings. And in this process, we will determine whether further steps need to be taken based on the score that these elderly populations are receiving, to connect them to their primary doctors or to a neurologist, and then we provide case management for them. And then we assess their needs, such as what it is that you're inquiring about. And once we assess their needs, then we have our case managers connect them to social service linkages as to as needed, and also allowing the caregivers to get involved with the health of their loved ones. So that this way a load is taken off of their shoulders, but also educating them how to communicate more effectively with their loved ones. And also to determine whether the caregivers also are in need of self care and therapy, and so on. So it's sort of a family disease, Alzheimer's, dementia, and we try to take care of all the individuals in the family. That's one part of the work that I do. I'm also in charge of the reporting aspect of our isoa program. Prevention and Intervention program with the seniors where we again, it's very similar, we outreach to the senior community, anyone over 60. And we provide positive living positive aging, self care classes and all sorts of classes for the elderly. And along this process, would we also determine whether individuals are in need of services based on our outreach, and then we also again, provide them case management where we sort of before they go into deep into depression or any sort of mental health challenges, we sort of prevent that from happening and provide them the services they need, whether it's housing, health care, transportation, any other needs that they have. And then we sort of stay with them on this path for anywhere between 3 months to a year. Once they get them going and they're back on track and especially connecting them to Social isolation groups so that they're not isolated, and then be discharged as cases."]
+[1.3922077417373657, -1.048997402191162, "No, it's pretty inclusive with all the needs that are out there. You know, one of the major needs is transportation, which I see here. Food is a second housing is another top three,"]
+[3.907970905303955, 8.078583717346191, "I won't get into that. No."]
+[2.40920352935791, 5.263525009155273, "No, I don't see. I mean, it's pretty well covered."]
+[2.4612441062927246, 3.81217622756958, "Okay, so the next question is, of the needs on this list, please write the top three that you feel are the most important."]
+[0.6370287537574768, 1.006081223487854, "housing, transportation."]
+[-0.3895937204360962, 1.275846242904663, "When we say economic security that applies to so under economic security, I would think food security would be under that. Also being able to provide so I would say as a package economic security."]
+[3.2059624195098877, 4.573986053466797, "And I'm going to ask you some sub questions for each one of the three that you just shared."]
+[0.6520053744316101, -3.3023879528045654, "One because they like their independence and or don't want to be living with their family members, their children, it can become very toxic, the environment of the home when they are living with their children, and their grandchildren sometimes. So they like their independence, and it gives them a peace of mind to be independent. In order for them to be independent, they need separate housing. And because of the high cost of rent and housing in Orange County, it's very difficult to find housing that accommodates their income, or and there are really no section eight openings anywhere, it's very difficult to find those as well."]
+[0.5505114793777466, -1.70106840133667, "Well, the cost is definitely a barrier, the average low income housing for a senior they have to pay a minimum 1000 to $1,500 a month for a one or two bedroom apartment. So where are they going to get this kind of money to begin with and if they are on SSI, so social security, supplemental income, the maximum that pays for each person in the family would be anywhere thing I believe has been 1002 to $1,200 or so. And they have to qualify for it. And there is a process of applying for it. And who's going to do that for them. So all of these we do as case by our case managers help them out with all this paperwork, which is very helpful."]
+[-0.6477478742599487, -1.1192502975463867, "Well, ethnicity plays a huge role. culture plays a huge role. I know what the Hispanic community, the elderly is very much protected, I want to say because it's part of the culture to keep the parents at home, no matter how long. But on the other hand, also there is the issue of not providing the needs that they have. Because they don't see that my mom needs to go to the doctor, my dad needs to go to the doctor, they don't need mental health. If they are dealing with dementia, it's ignored because of the lack of education. So that community is dealt with in that way. So we have this struggle with Hispanic community at least as far as our organization has. Even if they are diagnosed with dementia, not steps are taken towards taking care of it or slowing it down or anything like that. As far as the Persian community is concerned. They are really willing to To get the education, they come from mostly educated backgrounds. And the idea to live independently is very big for them, they don't like to be dependent on their children. So that's the experience that I have. As far as the other cultures, again, it varies between the two that I spoke about depends on the family and the kind of relationships people have. But generally speaking, I find that older adults are a lot more"]
+[-1.1939876079559326, 1.3640326261520386, "happier when they are when they have their independence."]
+[-0.3563971519470215, -1.086964726448059, "I think the housing housing is number one, because it allows them puts them at ease, that lowers their anxiety levels, anxiety can turn into depression and isolation. So it's a huge preventative measure, but then to not go there, to those places. So providing them housing, providing them food accommodation, and, you know, just a very healthy income, like a supplemental income that will allow them to, you know, access their basic needs, we find that people are very, very happy. And also finding them community, senior communities, where the same language is spoken within that community. And we've seen how they flourish how they come out of their shell, we have two examples of that in one in Woodbridge manor in Irvine, there's a Persian community, the large Persian community, living in that community and they socialize, they don't feel isolated, they're very, you know, healthy, even if they are dealing with personal issues. But because of that socialization, and being part of the community, it's very helpful to them. Another one is in Aliso Viejo at Liberty, there's a very low 80% of the residents are Persian Farsi speakers. So I mean, I go there quite often I see Oh, my God, it's like a city. Everybody engages, they barbecue, they go to events together, they trans, they help each other a lot when it comes to their needs. So that is definitely one of the ways to brand to prevent this from happening. So creating community centers that the mother language is spoken."]
+[0.025847868993878365, -2.621724843978882, "Well, you have all these different transportation, or whatever organizations that we refer to like access age well, but the problem with those is that, first of all, they need to speak English in order to access them. Secondly, they're not always on time, sometimes they don't even show up. So they're not very dependable. You can only use them to get transportation to for doctor, medical reasons. But these people are in need of socialization. So when you don't give them transportation, they're isolated, if they're not living in those communities that we were talking about before. So when you give them the transportation access, I remember, maybe I want to say about a year, year and a half ago, Uber was offering seniors a free ride for about a six month maybe four to six month period. It they loved it. They went out they used to go to the park to parties socialize to the doctor, it was very very very resourceful for them."]
+[-0.754535973072052, 2.28118896484375, "What barriers exist to see improvements in this area."]
+[-0.3809852600097656, -1.4634175300598145, "Language timeliness and dependability and also limited limited access to where they want to go to the"]
+[0.8497262597084045, 2.2979586124420166, "the limited Yeah, I guess limited access to their location, which they want to go to. They're very restricted with that."]
+[-4.166690349578857, -1.9053186178207397, "Are there different experiences for different groups of older adults from different backgrounds."]
+[-1.4182415008544922, -1.0098752975463867, "Oh, no, I think overall, they probably have the same experience with access unless they have caregivers who give them rides, it's different. But again, their caregivers are mostly the children who work full time. So even though some of them are living with their caregivers, but the caregiver, they're really isolated, because all day long, they're alone. And they're all socialized. And when the kids do come home, and their caregivers do come home, there's really no communication, there's not a lot of shared love, let's put it this way. Because they're exhausted, they're tired. They've had a  full day. And they don't want to deal with, you know, their elderly parents. So that is definitely. And they don't want to take them places."]
+[-1.1738331317901611, -0.7264379262924194, "I think I know IHSS as provides caregiver. Source sources of caregivers. But here's the situation, the children who are the caregivers are providing housing for their parents. So they have a really a right to collect, because they're spending the night with them, they are providing a lot of the services that their parents need. But also on the other hand, I think, perhaps if there was a budget, where IHSS would provide a caregiver who would be able to come in for, let's say, bathing them, taking them places, taking them to their doctor's visits, and so on. That would be ideal. services that their children will not be able to provide for them. And moving"]
+[-0.0290051382035017, -0.7423129677772522, "on to the third one economic, economic security, again, how or why are older adults struggling with this issue."]
+[0.25882962346076965, -0.8477253913879395, "Because a lot of them have never worked in this country. So they don't have social security income, their only income is on. And a lot of them if you if you do have a green card. If you're a resident, but only have a green card, you're not qualified to get money through SSI, once they become citizens. They're pretty good about knowing how to apply for it and getting the resources. But again, it's not enough to cover everything, all their needs. So they have to depend on their children, they become a burden on their children. And that creates a lot of conflict and stress."]
+[0.5367857217788696, -1.0181478261947632, "Well, I think the major catalyst in the economic crisis part is the housing. If that is provided I think, the remainder of the income, the SSI income is sufficient enough for them to be able to survive on that money. But housing is a big issue. So if housing is provided, I would definitely say this problem will be resolved."]
+[-0.3339841961860657, -0.9917671084403992, "Yeah, I think you know, with as I said before, but the Hispanic families, they okay with keeping the extended family at home and living with they sort of accepted that there's a two bedroom apartment and I can have seven people living in this two bedroom apartment. They don't. They don't struggle with that. It's amazing. They're very resilient when it comes to that. But when we see other ethnic backgrounds, let's say Persian community, that's the majority of the biggest community we work with. They struggle with that everybody has to have their own bedroom, everybody has to have their own space. And if you're getting into my space, then there's conflict and so on."]
+[1.1253530979156494, 5.3520355224609375, "With the"]
+[-0.45473459362983704, -0.6982465982437134, "Persians are very spoiled, I do have to say that."]
+[-0.9841415882110596, -1.3862621784210205, "Again, you know, housing, providing housing, in a community where the language is the language of their mother and basically, or another great thing that has happened in the last two years is that a lot of daycare health service. Organizations have opened up that pick up the seniors in the morning, provide them breakfast and lunch at this, these daycare centers. And then what they do is they transport them back to their home. So they really don't feel as isolated anymore. They're socializing during the day. And they're not as much of a annoying factor in the home when the kids come home. Because they've already had a full day they're socialized, and then are tired and they want to go to sleep sort of. So providing these kinds of daycare centers would be ideal to keep the parents busy. And these daycare health centers also provide case manager and some of them, some of them provide case management."]
+[-3.2594683170318604, -0.12300065904855728, "Great, okay, we'll move on to the next set of questions. And the first one is geriatric here. Let me know if I need to read a definition of this"]
+[-2.796903610229492, -0.3682115972042084, "for the elderly, right. Care. So just to clarify, it's a care for the elderly, right."]
+[-3.3881676197052, -0.3554110825061798, "Yeah, I'll just read that. So geriatrics, geriatrics is a branch of health care that focuses on our unique needs as we age. Just as pediatricians specialize in health needs of children. geriatricians and fellow geriatric health professionals specialize in the health needs of older people."]
+[-3.154451847076416, -0.5435900092124939, "I don't know too many. To be honest, there's a lot of family practitioners who don't specialize in geriatrics. Out of 10 farsi speaking doctors that I know of, who are family physicians, probably one of them has that specialty. And the rest of them are just family, even though they the majority of their patients are seniors, but they don't specialize in that area. Oh, sorry. I think there's a need for it for sure."]
+[-2.7352585792541504, 0.3019793629646301, "When you say long term care, what do you mean by long term care."]
+[-2.6352226734161377, 0.23940616846084595, "So we're defining this as a variety of services, which help me both the medical and non medical needs of people with a chronic illness or disability who cannot care for themselves for long periods."]
+[-1.4596235752105713, -1.8531036376953125, "I'm not at all familiar with any, it's very hard to access them. You have to I mean, we've had individuals who were physically not capable of taking care of themselves. They were becoming homeless, and they could not find a place to move into, because they were not officially disabled. And they didn't have that recognition by the state or by the county. And even if they were still pining a place for them is very, very difficult. Because they don't want to go to a rehab center. So it's like these long term facilities are really non existent."]
+[-2.058041572570801, 1.3090617656707764, "How about mental or behavior health or substance use"]
+[-2.0661840438842773, -0.11831028759479523, "There are a mental health we are a mental health ourselves. So we provide the services to the community and we have services in different languages. So it is available, and it'd be seeing a growing number of organizations providing those services and the counties really working with us and referrals and everything, which is great."]
+[-2.047645330429077, 1.3513975143432617, "Um, mental, mental, behavioral health or substance use"]
+[-2.225022077560425, 0.7307143211364746, "substance abuse treatment. There are facilities with substance abuse, which is again, a culture based rehabilitation sites, but they're extremely expensive. And some of them don't take insurance. So that's a problem."]
+[-1.296193242073059, -3.6981921195983887, "Do you know of any service or services or programs in Orange County that provide mental or behavioral health care to older adults,"]
+[-3.1505086421966553, -2.1730921268463135, "not specifically to older adults."]
+[-0.2885684072971344, 0.5534155964851379, "You mean the actual government agency social service agencies,"]
+[-0.3810913562774658, -4.1057024002075195, "In Orange County, specifically, human."]
+[1.0331974029541016, 2.2219901084899902, "It is, if you know the language, if you know the phone numbers, if you have the connections, if you have the network, it is accessible. But if you're out there on your own now if you're tech savvy, yes."]
+[1.3465921878814697, -0.6964835524559021, "finding housing, food security."]
+[0.5435556173324585, 1.145364761352539, "Accessing transportation, again, going back to the top three really continue being the biggest problem because I don't see any of these posts going down"]
+[1.7928025722503662, 6.703848361968994, "by any means."]
+[-0.5601875185966492, -2.4645516872406006, "government role is to expand services that are already providing to the senior community."]
+[0.09703204035758972, -4.9470133781433105, "Right. Okay. Okay. Yeah. And thinking about all the older adult residents in Orange County, who was getting the least amount of attention."]
+[1.1370397806167603, 6.401127815246582, "I think the"]
+[-0.27828747034072876, -1.5402618646621704, "middle eastern population is getting the least attention. Because they sort of have been compacted into with other ethnic backgrounds, they don't have their own separate identities. So there is no budget assigned to them, there is no funding assigned to them. And as an agency, ourself, we struggle with that because our population has largely been forced to speak in population, but because they're not recognized as a separate ethnic group. Therefore, the funding has not been there to provide them services that perhaps the Hispanic community gets as a lot of funding for the Hispanic community has a lot of fun funding for the Asian community. But when it comes to the Farsi speaking community, it's very, very rare that there's no particular funding for that."]
+[1.622348666191101, 0.06442084163427353, "by the government, however you like to answer that I"]
+[-1.2046408653259277, -0.9259281158447266, "I think there is a need to provide help to the caregiver community. Whether it's financial help, or just taking the load off their responsibilities, more funding should be there for the caregivers. Again, housing for seniors that are able to live independently is also there's a need for that. And again, transportation is also very important for them to be able to access the their needs."]
+[-2.9949653148651123, -1.2667226791381836, "Now, just one last set of question for you. So in addition to what we have already talked about, let's dig a little bit deeper into your area of expertise. So thinking about, you know, what we have, it's the How to reimagine dementia in focus. That's your area of expertise."]
+[3.4867804050445557, 7.972282886505127, "No, no, no, no."]
+[-1.0059460401535034, -1.311589241027832, "Okay, so when it comes to mental health and reducing the stigma that's attached to mental health and dementia falls under mental health, or any other other mental health challenges, I think what's really working for the Persian community is education, and outreach. It has really worked for us in the last 10 to 13 years since we were founded. And our focus has really been on education, because it's the only way people will consider even getting the help that they need. So that has really worked for us what has not worked is you cannot put all ethnic backgrounds under one umbrella. Every culture has their own needs, and their own way of approaching mental health. And so therefore, you need the native language speakers to outreach in those communities. You need to provide incentives to these different community members for them to sort of participate and get the help that they need. Because a lot of them, I don't want to use the word ignorant. But there's a lack of education there. And it's very how hard to sort of, you know, reach deep into the communities to make them understand that if somebody is dealing with dementia, or early onset memory loss, you have to get help for them can't just let it get to where you know, this person is going to be a danger to themselves or to other people."]
+[-1.1698936223983765, -2.252427339553833, "Well, boy, I'm not a politician. But I would definitely say we need to have more education in our schools, when it comes to mental health. I think a lot of the younger population needs to feel familiar with the needs of the elderly, so that they're more compassionate and understanding, especially if their caregivers, teaching them how to communicate better, how to be more effective when it comes to communicating with the elderly population, because I hear a lot of grievances from the elderly populations to all my grandchildren are ignoring me, my children are ignoring me, they don't understand me. So that really will help with the elderly is mental health, under stress and depression and so on. So education and the younger populations, for them to understand the needs of the elderly population and their loved ones. So policies, you know, providing funding for curriculums, you know, in colleges and schools. policies, such as providing more they health care, communities, for the elderly, in different languages, with their own social groups, is very, very helpful. I know there are some, but it's very hard to get into them. They're very limited and transportation is hard to get to them. So there's so many barriers."]
+[2.6698927879333496, 1.6762821674346924, "You mean the government entity or private"]
+[-0.39334484934806824, -2.5531187057495117, "I think a lot of smaller nonprofit organizations already are doing the work. And they have the expertise. So I don't think big agencies like OC health and health care agency need to get involved because they don't have the expertise. Each of these small nonprofits already have their niche populations. They're already been working with them. They already have the data. They already have the experience. They just need funding to expand their programs. And I'll give you an example with our own Alzheimer's dementia program, we're running out of funding in the next few months. So the funding needs to be there to sustain these programs, these pilot programs that have been initiated by these small nonprofits."]
+[1.8041315078735352, 0.7472808361053467, "While we collect our own data, we have collected a lot of sort of surveys, throughout educational programs. We have numbers when it comes to our case management. We collect that data, we collect data through our memory screenings. So we have different sections that we collect data on based on the type of work that we do."]
+[4.216493129730225, 4.500907897949219, "Is there anyone else you think that we should talk to"]
+[2.0526480674743652, 5.594105243682861, "No, not necessarily just anyone."]
+[-0.32062581181526184, -2.5141491889953613, "I mean, I would suggest program directors that all these non small nonprofits who are dealing with these smaller populations,"]
+[0.5593299269676208, -0.18892131745815277, "minority populations,"]
+[-0.7098243832588196, -1.2895359992980957, "because I think the white population has less limitations than the minority populations, because they don't have the language barriers. They're more knowledgeable When it comes to accessing health and resources. It's the minority populations that don't have this information. I mean, literally, I know Hispanic families who travel over the border, to get dental work done, where they can get it done here, and they have Medi Cal. That's the sad part. But a lot of providers are not taking them on because they're not network and network with Medi Cal. So a lot of the senior population who's on Medi Cal is not given the providers, they don't have access to the providers, because the providers don't want to be part of the network, because the money is so I mean, I understand both sides, because I'm also working in the provider industry, I know how much money they get paid, which is minimal, for all the work that they do. It's not about the minutes that they spend with the patient. It's their overhead, their utilities, their rent, all of that should be considered. As you know, yourself, the elderly population is growing very rapidly. The population next 10 years is going to probably double, if not more."]
+[3.310060977935791, 5.9506683349609375, "Hey, coming to our very last question. Of course."]
+[1.2307209968566895, -0.19913731515407562, "I knew the answer to that, and you can help us find the funding so we can sustain our program are already doing."]
+[4.97314453125, 3.405219554901123, "Right. Well, well, let's talk about that. So. But this concludes our interview. And I want to thank you so much for your time, you have been incredibly helpful to your research. If you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website www.advanceoc.com And you can leave an anonymous voicemail on our telephone line at any time. And what I tell everyone is that of course you can reach out to me if you think of anything else that you wanted to add or just Hey Tammy, you should do this. Let me stop the recording."]
+[-2.4502944946289062, -3.5505452156066895, "Okay, great. In a moment, I'm going to show you a list of common issues and concerns impacting older adults. And I want you to take a look at it. You don't have to memorize it, it'll stay up for the remainder of our interview. But I want you to go over it take some time to read it through and then I'll start the interview with that okay"]
+[4.74534273147583, 8.030402183532715, "okay,"]
+[-2.7207090854644775, -3.1642282009124756, "Okay, thank you, welcome. Okay. So once again, the primary goal today is to identify what needs you think are most important to older adults,"]
+[-2.658076286315918, -3.010089635848999, "especially the ones that you specifically serve. And in our case, we define older adults as those who are 60 years and older. And we want you to think as broadly as possible, taking into consideration older adults, their caregivers, their families, and the community. Okay."]
+[-0.7368099689483643, -3.3242852687835693, "Yeah, so I have two roles. My full time job is as the executive director for United and homelessness with Orange County United Way. My other role is a volunteer role is I'm the vice chair of the continuum of care board for Orange County. So I have some knowledge of homelessness affecting older adults from both of those roles."]
+[-0.4981536567211151, -3.196152687072754, "But we are not an older adult specializing agency. It just so happens that we have had older adults that we have assisted through our wealth involvement with SSI program, just a landlord incentive program, helping people who have experienced homelessness get access to apartments, out in Orange County through our network of property owners."]
+[1.6890660524368286, -2.3740012645721436, "Yes, yeah. Yeah. So I can probably speak more to systems and homelessness than I can to actual direct experience working with the population."]
+[0.006921245250850916, -3.9838593006134033, "Okay, so thinking about Orange County as a whole and looking at this list, right in front of you."]
+[1.6269261837005615, -2.615617513656616, "I don't think so. But again, I am not an expert at older adults. And so this is where I'm hoping I could be helpful. And I certainly know homelessness, and I know the homelessness sector. So I'm hoping that's where I can be be helpful for you. Oh, absolutely. And feel free to say, you know, I don't have enough information to comment, if that's the case. Okay, great. So"]
+[2.6241605281829834, 3.883023262023926, "of this list that you see in front of you. And given your perspective, what would you say are the top three"]
+[0.6018242835998535, -3.3446967601776123, "But from my perspectives, the only parts that I would really hear about would be connected to housing, homelessness, and then an alongside that economic security, and so people just not having enough income having a fixed income that doesn't allow them to be able to continue to survive in Orange County as our living costs increase. Yeah."]
+[3.161235809326172, 4.611082077026367, "Okay, so I'm going to tackle each one of those"]
+[3.4073758125305176, 4.558135509490967, "And then follow up with questions for"]
+[1.596526861190796, -0.7161271572113037, "each of those. So let's start with the first one, which is housing you mentioned. And you notice that we'll separate housing from homelessness as two different kinds of domains."]
+[0.5843387246131897, -1.8632029294967651, "The the biggest things that that I hear about are older adults who have a fixed income. So retired, you know, they're no longer working, and the cost of housing increases. So, you know, the landlord raises the rent. And they're no longer able to afford that rent increase, and how the cost of housing has been rising very dramatically in Orange County over over the years, but particularly the last couple of years, rent has increased at an amount that has been very, very challenging for people with a fixed income to be able to afford. And so putting older adults into a really difficult position of today years, their income towards their housing costs, or do they use it towards health costs, food, other things like that. And so I've seen a huge rise in the number of older adults who are looking for homelessness, prevention services, and rental assistance to be able to remain in their home."]
+[1.1169469356536865, -1.2778335809707642, "Those are the main areas that I see when it comes to housing. Great. And what barriers exist to seeing improvements in housing for older adults."]
+[1.254181146621704, -0.7625811696052551, "There aren't any rental assistance options."]
+[-0.15924470126628876, 2.410703182220459, "That that is the biggest barriers that there"]
+[1.2319564819335938, -0.8682830929756165, "there is a there aren't any funding, there isn't any funding available for rental subsidies to help keep older adults"]
+[1.324521780014038, -1.0587644577026367, "sustained in the housing that they're currently in, unless they're able to access some kind of tenant based voucher, but the waitlist for tenant based vouchers are extremely long. And it can take years before your name might appear at the top of the list. Yeah."]
+[2.756040096282959, 4.991971015930176, "We don't have enough information. Okay."]
+[1.2277472019195557, -0.7125144600868225, "rental subsidies, so being able to meet that gap between the person's income and as rent is raised."]
+[1.3867195844650269, -0.9674586653709412, "So having rental assistance to be able to help people stay in the housing. Many people have been in that housing for many, many years they've been"]
+[1.2203786373138428, -0.8591755628585815, "successful there, and that's their home and no longer being able to afford it."]
+[0.537388801574707, 3.636554479598999, "Yeah, challenge. Yeah."]
+[1.7635995149612427, -2.352750062942505, "Okay, so now we're going to shift into your number two, which is homelessness."]
+[1.3697527647018433, -1.1397359371185303, "They're struggling with it, because they have fallen into homelessness. So they had to leave whatever their housing situation was."]
+[0.4697131812572479, 3.4546689987182617, "The struggles"]
+[1.6314122676849365, -2.588848829269409, "with homelessness is that the homelessness sector is not set up to care. Well, for older adults."]
+[1.6247708797454834, -2.610400438308716, "We are seeing a huge rise in older adults experiencing homelessness. So there was a big jump between our 2019 Point in Time Count on our 2022 Point in Time Count. And I'm not sure if you've asked for any data from the homelessness management information system around the number of older adults who have entered into that system over the years."]
+[0.6776799559593201, 1.8341047763824463, "That would be another great place."]
+[-2.8296239376068115, -2.4212236404418945, "You've probably already done like Katie, but if you have that might be that would be a really good dataset for you to look at. The number of adults that have come through"]
+[1.675025463104248, -2.628570795059204, "have been signed up in HMIS, who have entered the homelessness sector in some way shape or form and that number has been rising every year. The National Research Dennis Culhane is the leader the lead researcher in the country around older adult homelessness and it has been rising over the over a few years and is expected to continue to rise"]
+[1.4926891326904297, -2.5213136672973633, "In the homelessness sector, as I mentioned just isn't set up our shelters. You know congregate shelters are not ideal for people who are older."]
+[0.8073322772979736, 2.176020622253418, "You know, accessing beds that are"]
+[0.9948131442070007, 2.5743470191955566, "high enough and easy enough to get in and out of is a challenge."]
+[1.495646595954895, -2.4644412994384766, "You know, a congregate shelters is a challenging environment for anybody, but particularly if you are a holder, and if you've never experienced being homeless before, that can be a very frightening environment to be in and a very challenging environment, if you have any kind of cognitive decline. That's, you know, it's coverage shelters are not an environment that's conducive to healing."]
+[1.4630756378173828, -2.501883029937744, "And we don't have many non congregate shelters in, in our county. And we certainly don't have any non congregate shelters that specialized with older adults. So the challenge that I see in front of us is that we know that the number of older adults experiencing homelessness is going to continue to grow and it will start growing exponentially. And the homelessness sector needs to get ahead of that to be prepared for a good response for those who sadly, will fall into homelessness. And we also need to have a much better response on the homelessness prevention side of things to be able to try to keep people housed, so they don't fall into homelessness."]
+[1.364054560661316, -2.365122079849243, "And then, you know, emergency shelters are just sort of that band aid to try to help somebody resolve the homelessness crisis. But for older adults, you know, we're not looking at a population whose income is going to increase, we're not looking at a population who are likely to go back to work to be able to increase their income. And so we need housing solutions that are specific to this population. And we just don't have enough of that either. I think we have one, development of permanent supportive housing for older adults, the City of Anaheim led the charge with that one. And that's that's it, to my knowledge, we don't have anything else. And that development is full, there are no vacancies, they're"]
+[0.7493728995323181, -1.2082247734069824, "going to need here, hundreds of units of permanent supportive housing to be able to help resolve the crisis for this group of people. And it's going to need to be specialized to their medical needs. So their unique medical needs as well. Yeah, yeah."]
+[1.3130207061767578, -0.13037435710430145, "think there isn't there, there aren't specific funding streams available to create"]
+[0.9624575972557068, -1.588021159172058, "supportive housing solutions for older adults. And so developers are faced with a, you know, a challenge, if they have a project that's ready to move forward, there isn't anything to incentivize them to make it specific to older adults, I would imagine it would also be more expensive to create housing solutions for older adults with the medical or potential medical needs and accessibility components to creating that kind of housing. So the new kind of incentives to help developers be more to help it be more financially viable to create that kind of housing would be good."]
+[-0.15965449810028076, 2.404103994369507, "Other barriers would be"]
+[1.6200790405273438, -2.4023921489715576, "a lack of attention or realization that this is the fastest growing population among our homelessness community, and that"]
+[1.2202402353286743, -1.3351905345916748, "we're not doing enough about it. I think people just don't know. And there needs to be a lot more awareness around this to gain public interest and public support. So that could be the creation of more housing, because creation of housing is going to take next three to five years before this will come online, and then another bear. And so that's another barrier is the timeframe to build that kind of housing. And then that means that we need something in the meantime, we need to be getting creative. We need to be looking at motel conversions or mall conversions. We need to be getting really creative about how to bring housing online for this group of people in a much faster way than the traditional permanent supportive housing model."]
+[1.7078197002410889, -2.6610543727874756, "And are there different experiences for different groups of older adults when it comes to homelessness."]
+[-3.273561954498291, -1.6919021606445312, "For those older adults who have that significant medical challenges"]
+[3.6978776454925537, 15.121068954467773, "Yes."]
+[-2.9855527877807617, -0.7715368866920471, "And I know of older adults that are living in their car dealing with cancer."]
+[1.4789409637451172, 8.829362869262695, "And so"]
+[-3.9664297103881836, -1.9145687818527222, "yeah, for older adults who have got those significant health challenges, I would say that that is a different experience than those who are healthy."]
+[1.7757126092910767, -2.2723264694213867, "And the those who have got those significant health challenges are certainly going to find interfacing with the homelessness sector much more challenging, because it's just not set up to meet those kind of medical needs. And certainly anybody who's got"]
+[1.7250500917434692, -2.324950695037842, "health challenges, if they are also experiencing homelessness, there's just that that's just an almost impossible situation to try to"]
+[0.31478792428970337, 2.778935194015503, "resolve health crises, while not having a stable place to live is incredibly challenging."]
+[1.5491114854812622, -2.5163872241973877, "Yeah. And I will say the other part connected to this is that we don't have any hospice care for people who are experiencing homelessness, regardless of what age they are. But anybody who is in the situation where they need hospice care, and they have been living outside for some time or in their car in or unstably housed, we don't have any hospice care for people who don't have a permanent address."]
+[2.1753768920898438, 6.248433589935303, "they don't."]
+[0.5630274415016174, 1.6468411684036255, "they stay where they where they are."]
+[-1.6522138118743896, -0.5715239644050598, "Yeah, yeah. Yeah, it's, it's tragic. Yeah. Yeah. Wow. So in the hospital, you know, we're just costing everybody much more money than it would be if we were providing hospice care to meet their needs. Yeah. Yeah."]
+[1.4758070707321167, -2.509004831314087, "We think we need to have across this sort of spectrum of the homelessness response, we need better diversion. And prevention options for older adults experiencing homelessness are on the verge of experiencing homelessness, the ideal would be to divert people away from the homelessness sector to begin with, so they wouldn't fall into homelessness."]
+[1.2884379625320435, -2.3319482803344727, "We know that won't work for everybody. So our emergency shelter system, you know, we're big County, we've got 34 cities, three different service provision areas. But it would be wonderful if each service provision area had a solution for older adults emergency shelter, that actually, you know, a specialized shelter or a specialized part of a shelter that was able to meet the needs the physical needs of an older adult population while working on some other kind of solution. And then also, we, you know, to be able to help move somebody out of a shelter, we need those housing options that are specialized to the needs of older adults."]
+[3.7326784133911133, 15.52873420715332, "Yeah."]
+[-0.5155016779899597, 1.408547282218933, "Okay, so So now, I want to segue over to your number three ranked item, which is economic security."]
+[0.8472806811332703, -0.3151049017906189, "I have limited knowledge here. Um, so I'll I'll speak to what it is that I'm aware of, which just is that is that fixed income again."]
+[0.7632492780685425, -0.28752249479293823, "And so having a fixed income, while"]
+[0.7616636753082275, -0.6623557209968567, "the cost of living increases on has been increasing pretty dramatically puts people in a very precarious situation."]
+[3.421804904937744, 9.059154510498047, "Yeah, yeah."]
+[1.0692936182022095, -0.49766311049461365, "A lack of funding."]
+[1.227251410484314, -0.7310677766799927, "lack of funding to be able to have some kind of rental subsidy."]
+[3.711129665374756, 15.516053199768066, "Yeah."]
+[3.6539440155029297, 15.556160926818848, "Yeah."]
+[1.6436800956726074, -2.3044371604919434, "Do you find that people who are economically in fall into homelessness mostly"]
+[1.3403041362762451, -2.6633188724517822, "we have a the primary drivers for homelessness across the board. I don't have the data specifically for older adults, but I would, I would say it's a very likely guess. So that's the same reasons across the board. But the primary reasons people fall into homelessness here in Orange County are economic issues."]
+[0.5998881459236145, -1.3287270069122314, "Is that people can't find work that provides enough money for them to be able to rent somewhere, or they can't find housing that's affordable. So those two are obviously completely interconnected. But you know, wages haven't increased at the same rate that housing costs have. And so that hits anybody if there are older adults that are working, that would certainly be an impact to them. And then older adults on that fixed income, obviously, are really really struggling as the cost of living increases all around them, but their income doesn't. Yeah."]
+[3.786665678024292, 15.461853981018066, "Yeah."]
+[1.2297848463058472, -0.778462827205658, "Sounding like a broken record here, rental subsidies."]
+[5.592522621154785, 8.786792755126953, "Okay."]
+[1.7173449993133545, -2.310009479522705, "You know, if they fall into homelessness, is there a way for them to be able to be reconnected to worse,"]
+[2.4469451904296875, 5.727245330810547, "I've not seen that in my experience."]
+[1.7627145051956177, -2.414302349090576, "Because homelessness is incredibly"]
+[1.727403998374939, -2.6221375465393066, "taxing on somebody's physical and mental well being. There's a lot of information out there that that talks about an I don't have it had I apologize, Katie, but people experiencing homelessness age at a much more rapid rate. So that would certainly be something"]
+[1.6648753881454468, -2.679730176925659, "worth looking into. But somebody who's out on the streets who's experienced living outside or in their car, and they might be 55, but they present with the health challenges as somebody who is in their 70s. So the homeless population are aging, just due to the stress and the anxieties of living outside. It causes that physical and mental decline to happen much sooner than it does in the house population. Yeah, yeah. I can see that for sure."]
+[3.7442266941070557, 4.296658515930176, "Okay, great. So now we're done with this list. So I'm gonna stop my screen sharing. And now I'm going to go on to"]
+[-2.833526134490967, -0.15427963435649872, "a conversation around how accessible and adequate various different care systems are. If you feel comfortable responding, please feel free if you can also take a pass on it as well."]
+[1.6882492303848267, 4.304142475128174, "We have to pass."]
+[1.7075278759002686, -2.472764730453491, "I'm gonna pass on that one, too. I just have knowledge of a very few cases that I wouldn't want to use to speak to the entire system. No, yeah. When you're working in the continuum of care with homelessness."]
+[2.430589199066162, 6.846664905548096, "I am not but I haven't been on the frontlines for a long time."]
+[-1.4560039043426514, -3.4686777591705322, "Yeah. So that doesn't mean that they don't exist or that perhaps those on the frontlines would. My role on the on the CRC board is we're mostly responsible for the distribution of HUD funding and state funding. To service providers in Orange County. We certainly we don't fund mental health services through the COC. We do. We fund rapid rehousing and permanent supportive housing."]
+[-1.4720737934112549, -3.364722967147827, "Some emergency shelter activities. But yeah, we don't fund mental health services. So I that's just outside of my realm of expertise. Yeah, sure."]
+[1.6373225450515747, 4.282385349273682, "Pass As well, so sorry, no, no problem. And once again, we're gonna be talking about this population. You know, I mean, if you feel comfortable responding if you can pass,"]
+[0.18333448469638824, 3.4694557189941406, "you know, time. What do you first, the biggest challenge for older adults"]
+[-0.40098315477371216, -4.1250901222229, "in Orange County"]
+[0.5017713904380798, 3.0426385402679443, "in 10 years, I would say it will be the silver tsunami of homelessness. Yeah."]
+[1.5436928272247314, -2.602853775024414, "I think in 10 years time, we are going to have seen a significant rise and older adults falling into homelessness. We're already seeing it. We're seeing it in, in affluent cities like Newport Beach. We're seeing it all throughout Orange County."]
+[1.2730932235717773, -2.1714022159576416, "And I would imagine that in 10 years time, if we don't start to take this seriously, and if we don't start to allocate funding and resources, to be able to stem the tide, that we could indeed have this silver tsunami of homelessness, on our streets, in our shelters, and in our hospitals, as well, but people don't have anywhere else to go. Yeah. And in your opinion, what do you think the role of government would be in meeting"]
+[-0.0020952934864908457, -3.65834641456604, "Yeah, whichever, whichever. But this is a county report. So maybe, maybe county first."]
+[1.6502577066421509, -2.3280279636383057, "We know that it costs more to let people fall into homelessness, regardless of what population they are,"]
+[1.3679194450378418, -1.5190457105636597, "then it tends to help keep people stably housed. And so to me,"]
+[0.981770396232605, -1.8720327615737915, "I would love to see the county government looking seriously at again, broken record rental subsidies to be able to help keep people housed to keep them safe and secure in their housing."]
+[0.8809172511100769, -1.4105368852615356, "And with that, it will lead to come a lot of creativity, you know, does that look like some kind of shared housing model if perhaps the older adult has got, you know, extra rooms in their home to be able to increase income in that way and being able to incentivize, you know, the older adult to have somebody move in with them."]
+[1.2649480104446411, -0.6615300178527832, "And funding a program, you know, to be able or an organization to be able to oversee a program like that. Getting creative around, providing those rental subsidies."]
+[0.9286892414093018, -1.4497759342193604, "And then being able to make sure that older adults have got access to the care and support they need to be able to maintain the housing situation that they're in."]
+[3.4291207790374756, 9.090242385864258, "Yeah, yeah."]
+[0.08603756129741669, -4.937534332275391, "And in thinking about all older adults, all older residents in Orange County, who is getting the least amount of attention"]
+[1.736720323562622, -2.7180278301239014, "it's not going to surprise you say, older adults experiencing homelessness. Yeah. Yeah. And I think, especially, you know, we have, when we look at this, we talk about two different sort of subpopulations, amongst older adults experiencing homelessness, you have the older adults who have been living outside for some time who have just been aging living outside. And then you have older adults that fall into homelessness for the first time as as an older person. For those people, it's incredibly shocking and jarring. And I think I spend a tremendous amount of shame attached to that. But what we're often seeing are these are older women whose husband has passed. And they're being left in an incredibly precarious situation."]
+[1.287255883216858, -2.4798526763916016, "And there is not enough. You know, they have been deeply overlooked. But they are they are in our homelessness sector. They are experiencing homelessness all throughout Orange County, affluent cities, not so affluent cities, it doesn't. It doesn't seem to matter. And they just people don't know about that aren't aware about that. And I think if people were they would be moved and motivated to help. Yeah."]
+[3.796515464782715, 15.43747615814209, "Yeah."]
+[3.2955691814422607, 8.516797065734863, "Oh, Same thing."]
+[1.5040385723114014, -2.050200939178467, "Yeah. Yeah. You know, when people think about housing and homelessness, they see these headlines with all these millions and billions earmarked for housing and homelessness. Do you feel that because they're seeing these sort of lines, that the issue they feel like the issue is"]
+[1.6010489463806152, -2.360328435897827, "I think it's it's challenging for people if they live in a location where visibly, they're not seeing homelessness changing. So if they live in an area where they are seeing encampments, I think that's a challenge for people to think that things are being effective. And there certainly"]
+[1.6740251779556274, -2.345719575881958, "there are solutions in the homelessness sector that we know work, there are best practices that we know work, including permanent supportive housing."]
+[1.256589412689209, -2.598496913909912, "But sadly, yes, there are millions going into homelessness in Orange County there are there are not billions going into homelessness in Orange County."]
+[-0.44633325934410095, 0.3238287568092346, "But the amounts are misleading. Yeah."]
+[3.3688302040100098, 8.968935012817383, "Yeah. And so recognizing that,"]
+[1.0062215328216553, -0.2502800524234772, "you know, whatever dollar amount is being talked about being able to connect that to the geographic area"]
+[1.644347071647644, 3.5006279945373535, "that is being allocated to"]
+[0.32997259497642517, -1.8856149911880493, "you know, we there, there isn't enough funding to match the needs. And so that I think, is challenging when people see, you know, money being put towards something. And it can seem like a large amount of money, but in certain areas up and down California, that amount of money is not actually proportionate to the need that we have."]
+[3.76723051071167, 15.500670433044434, "Yeah."]
+[1.739227056503296, -1.0649574995040894, "Okay, so now I'm going to drill into your specific area of expertise, housing and homelessness. mention some earlier but I'd love for you to expand on it."]
+[3.395728826522827, 8.546425819396973, "Yeah, yeah. Yeah."]
+[4.227366924285889, 7.2361063957214355, "Isn't working."]
+[1.0814478397369385, -1.5948303937911987, "I would say the Anaheim permanent supportive housing for older adults is an example of something that is working in our community."]
+[0.6527968645095825, -2.416015386581421, "And we need we need a lot more of that needs to be reproduced at scale. And at various locations throughout the county. Yeah, that would be an I believe it's called Esperanza. That would certainly be a an example to look at."]
+[1.0402395725250244, -2.853661298751831, "Yeah, yeah, there, they would be a great contact and Grace director, or Karen Cardwell."]
+[-1.3519235849380493, -3.0780582427978516, "Thank you, of course. I didn't mean to interrupt. No, no, that's okay. The other agency that I think of in our community who has some specialized in older and slightly specialized in older adults will be wiseplace. And Brateil Aghasi is the CEO of wise place, and they have done a lot of work with unaccompanied women. And they have done a tremendous amount of work with older women who are unaccompanied. So she would be a really good person to talk to to get into that there's like specific so of what they've done or what they've seen and what the needs are. She would be a great person to talk to. We spoke there last week, I spoke to her."]
+[1.347535490989685, -1.0037163496017456, "And they're building they're building credit supportive housing, so it's really,"]
+[4.3130574226379395, 4.193314552307129, "yes. Okay, perfect. Glad you got connected with her."]
+[2.37074613571167, 5.517660617828369, "So those are the sort of two examples."]
+[0.6453862190246582, -0.6193222403526306, "But aside from that, I'm really not sure what else is working for this population. Do you think the, the, the committee that you're on"]
+[-2.3182601928710938, 0.24479849636554718, "I can't remember what it's called. Yeah. The continuum of care. Yeah."]
+[-1.7734711170196533, -2.774045944213867, "So this last year, we did allocate a seat on our CRC board, for somebody representing older adults. That was the first time that that's happened. And that was something that I have to advocate for and felt very strongly about because we have not had sort of a focus group looking at that."]
+[1.510480523109436, -2.79890513420105, "So we actually have somebody with lived experience of homelessness as an older adult who has been appointed to that safe. So a gentleman called center Bob is what he's affectionately known as, Robert Morse is his name. But if you wanted to talk to somebody who has lived"]
+[-3.87526273727417, -2.083401679992676, "experience as an older adult,"]
+[1.3723863363265991, -2.907892942428589, "you know, going through homelessness here in Orange County, he would be a great person for you to talk to, he'd be able to give you that firsthand knowledge of, of what it was like. And he remains very connected to the homeless community. And so could speak to what's happening right now. But he would be a probably a really good person for you to talk to, to get that true insight. Right."]
+[1.0606244802474976, -3.042285442352295, "And then, also appointed to the board was Kelly, Bruno Nelson from Cal Optima, and she's actually getting her PhD, in older adult homelessness, so she would be another really good person. Yes. So you should talk to Kelly."]
+[0.9182587265968323, -3.0576984882354736, "Yeah, she would be a great person for you to talk to. And I know that Cal Optima has got some pretty innovative things in the works to help come alongside older adults with housing crisis. So she would definitely be a good person to talk to."]
+[4.7503862380981445, 8.032907485961914, "Okay,"]
+[2.9910366535186768, 0.0759321078658104, "what new or revised policies are needed."]
+[1.6803401708602905, -2.2475059032440186, "Think in the homelessness sector, one thing that could be good, or even."]
+[1.6764850616455078, -2.627903699874878, "See, I don't think we have enough data. And I know that doesn't directly lead to a policy. But it helps us get there, I don't think we have enough data around how many older adults are experiencing housing insecurity and our risk of falling into homelessness. And HMIS data can gather people that actually become homeless, you know, and have gone to an access point or have ended up in an emergency shelter or enrolled in some kind of, you know, homelessness assistance program. But the number of phone calls, for example, from people who are, you know, trying to figure out how to make ends meet."]
+[-1.378183126449585, -2.7354233264923096, "I don't know if 211 has got access to that kind of data. But as I've been sort of talking to people, you know, senior centers get calls for help for people who"]
+[1.4504936933517456, -0.9413795471191406, "are really struggling, but I don't know, if we have as a community, we have access to enough data to know kind of what the scope is that we're looking at in terms of housing insecurity,"]
+[-1.3879170417785645, -2.430742025375366, "for older adults. And so there could be potential to look at, you know, policy, or presenting some kind of procedure for when calls like that are received, to try and to gather more information. And being able to ask the right questions to get the right information. I think you have a similar campaign that Orange County Veterans Military Family collaborative, it's a mouthful, put together, let's call it ask the question. And so that's just a much broader question, to be able to act to kind of get a conversation going, that can give you a lot more information about the situation. And so I wonder if there may be"]
+[1.00121009349823, -1.8550602197647095, "And I've heard from friends that, say, Meals on Wheels that if you ask anybody, you know, or you're an older adult, if they are experiencing housing insecurity, they will say no."]
+[1.3073108196258545, -1.1316256523132324, "But without realizing that if they weren't getting their help with food, that they wouldn't be able to afford their housing. And so they are in fact, housing insecure, but they're not they're not making that connection."]
+[3.712594747543335, 15.51603889465332, "Yeah."]
+[2.394224166870117, 5.544198513031006, "Let's say it does not enforce your hypothesis."]
+[-1.64321768283844, -2.6162824630737305, "I think the policy would then be leading towards a better triage system for when older adults are presenting."]
+[1.3536559343338013, -1.1258047819137573, "You know, with housing, insecurity and being and then funding for better resources to be able to address that housing insecurity so that we can get ahead of it as opposed to waiting until somebody falls into into"]
+[1.669030785560608, -2.2320761680603027, "Homelessness and then having to resolve it there, which is going to be much more expensive for taxpayers than if we could get ahead of it. Yeah, yeah."]
+[-1.3444442749023438, -2.6768970489501953, "I would say 211, as the sort of porch portal for many calls that are received"]
+[-1.43148934841156, -2.7499825954437256, "senior centers, I would imagine would have access to a tremendous amount of,"]
+[1.5963585376739502, 1.4408962726593018, "you know, phone calls and people."]
+[1.5920872688293457, 1.1687613725662231, "You probably need to do like a community wide campaign for a while, like to try to"]
+[2.1502816677093506, 4.849155902862549, "ascertain what it is that we're really looking at. Yeah."]
+[3.5562050342559814, 7.666505336761475, "Yeah. Okay."]
+[4.394458293914795, 7.213003635406494, "Great."]
+[0.05346926301717758, -2.665527582168579, "I think that the other action that I would really like to see is a specialized focus group really coming together at the, or a commission from the county,"]
+[1.6616026163101196, -2.630845069885254, "looking at homelessness for older adults."]
+[2.0928823947906494, 2.424184799194336, "And solutions for this because I know that we have"]
+[-1.2809568643569946, -2.8757920265197754, "the Council on Aging, like so I know, we have, right we have specialising in homelessness and we have specializing in older adults, but we don't have a place for those to crossover and what needs to happen. And that's something that"]
+[1.254792332649231, 6.500986576080322, "I hope"]
+[2.9618632793426514, 4.421578884124756, "will happen very soon, because we need it. Great. Okay, I can actually recommend that we do one during this assessment,"]
+[5.114932060241699, 6.067271709442139, "in particular, so thank you for raising that. That's definitely a possibility."]
+[4.706037998199463, 3.5015714168548584, "Okay, great. You've named quite a few. So thank you so much for that during the whole interview, I've written them all down."]
+[0.9945165514945984, -3.0970239639282227, "I don't know if you've connected with Natalie, who is the head of homelessness for Newport Beach. But she's been another person, who's been on my radar, she has mentioned that she has been encountering, you know, a growing number of seniors in Newport Beach, experiencing homelessness. So she would be a good person to talk to on this side. And she's out in the field, you know. So she would again, have a lot more of that hands on knowledge around what it's been like to help people access systems. Yeah. So she would be another really good contact."]
+[1.4150152206420898, 6.151060581207275, "It starts with a B."]
+[4.255366802215576, 4.002343654632568, "And I could provide you with Oh, yeah. That'd be great contact information. Yeah. So I'd say among the ones that you've you've mentioned."]
+[4.515004634857178, 4.000539779663086, "You know, I know many of them, but Natalie will be one that I would like to get in touch with Santa Bob would be"]
+[1.095109462738037, -2.5978736877441406, "and grace or Karen. Yeah. All over Anaheim housing would be great. Perfect. We have already looked into Kelly Bruno Nelson."]
+[4.577944278717041, 4.060774803161621, "You but I, I always think about calling her Kelly Bruno Mars."]
+[3.1778151988983154, 5.381024360656738, "I think I have to like, stop myself before I go there."]
+[1.141729474067688, -3.011091470718384, "But, yes, we have spoken to Kelly. I didn't know she was doing her PhD on older adult homelessness. But that She is yes. Yeah. Yes, I would really appreciate that. And I'd love to talk to them, especially on her views around Newport Beach. And because then that makes it very systemic, then it it becomes more or less of an issue about"]
+[1.2308533191680908, -0.916860818862915, "you know, poor areas, right. Not being able to afford the house cost of living. The cost of living."]
+[4.289900302886963, 4.12916898727417, "Yeah. Yeah. And she will be able to give you I think, you know, and I know you're writing a report, but she be able to give us some stories, you know, of specific people that she has come alongside."]
+[0.4337211847305298, -3.4629416465759277, "Yeah, from Newport to be able to share some of that. But yeah, I'll put you in contact with all of those people. Thank you so much. I really appreciate it. And if you think of anything else that we should know about or other people that we should talk to, please feel free to reach out. This assessment is going on for the entire year, and actually it's"]
+[0.8228402137756348, 3.3083484172821045, "February of next year."]
+[2.4765825271606445, 4.767806053161621, "And just let us know if anything comes onto your radar. Yeah, we know of it. Actually, we"]
+[1.9137529134750366, 0.9783108830451965, "I check it all the time. And it goes, we we manage that data website for."]
+[1.5983411073684692, 0.6708540916442871, "And so we reference the dashboard that goes up to the state."]
+[-0.34884995222091675, -4.085151672363281, "And we collect that data. And, of course, we're in touch with Karen over at 211, because she collects that data for Orange County."]
+[3.039311170578003, 5.800113201141357, "Yeah, yeah. Yeah. But yeah. The last in time count."]
+[0.9247116446495056, 3.2076473236083984, "The last one was 2022. Yeah. Yeah. Probably won't know. It'll be next year. 2023. Yeah, they we got off kilter in COVID."]
+[0.6960322856903076, 3.162471294403076, "But yes, it should. It'll be 2023. Okay. Okay, thank you. Well, thank you so much for your time, I really appreciate it."]
+[3.029285192489624, 0.024397889152169228, "Once again, we have an open door policy. So just reach out to us if you have additional information."]
+[2.365420341491699, 6.829196929931641, "If you have"]
+[2.53110408782959, 7.398988723754883, "you know, doing that."]
+[2.4858779907226562, 7.442701816558838, "You know what's"]
+[1.6021960973739624, -2.6327133178710938, "perfect. The other piece that just popped into my mind, and I don't know if you're connected with Doug back on this is that the commission to end homelessness has got authorized a survey to happen among people experiencing homelessness who are unsheltered. And so just making sure that you've got that connection to that dataset, and you'll be able to pull that for older adults, because that, again, is direct feedback from people experiencing homelessness, that their interactions with the homelessness system. Yes. That was mentioned a couple days ago, in our call with the county. perfect good. Yeah."]
+[4.756599426269531, 4.768135070800781, "Okay. Well, thank you and have a great three day weekend. I hope you do have Monday off."]
+[4.420634746551514, 4.614891529083252, "And hopefully we will see each other at some point, you know, in person. Okay. Thank you."]
+[4.346503734588623, 4.236464500427246, "Thank you, and I will see you on email when I get you introduced all these people. Awesome."]
+[4.640202045440674, 6.137684345245361, "Of course. Thank you and good luck."]
+[4.5451154708862305, 7.591387748718262, "Okay, Helen,"]
+[-2.848994493484497, -2.959796190261841, "in a minute, I'm going to show you a list on my screen of common issues and concerns impacting older adults, they will be listed in alphabetical order in no particular order ranking. So if you could take a minute just to look over the table, and whenever you're ready, let me know. Okay."]
+[-0.8658872842788696, -3.0938124656677246, "Well, I have a decade, several decades of experience working in this community. Currently, I am working for an organization that's implementing a number of programs providing housing and support for older adults and vulnerable populations. It's called advocates for human potential and they are managing billions of dollars of California funding. A lot of it focused on solutions around housing and support for older adults. Oh, wonderful. Okay."]
+[3.8586080074310303, 4.360373497009277, "Okay, so now I'm going to share my screen and share with you that list I was talking about."]
+[3.042813301086426, 6.758093357086182, "Not that one, this one. Okay,"]
+[5.577868938446045, 8.800681114196777, "Okay."]
+[3.3850083351135254, 8.627984046936035, "Yeah, it's a bit pale, but okay. Yeah."]
+[4.692455291748047, 5.389648914337158, "Sorry about that. Trying to fit everything on one screen. Take your time and read it through. And"]
+[3.962226629257202, 5.353801250457764, "whenever you're ready, let me know. What is the I will"]
+[2.6283111572265625, 3.4142208099365234, "Yes, I will be asking you to rate your top three issues from this list. Or if there's anything missing from this list, you can add it to this list."]
+[0.15442755818367004, 2.7407283782958984, "Oh, wow. And then it says injuries is that the last"]
+[-0.03986562788486481, 2.254315137863159, "unintentional injuries, car accidents, falls,"]
+[4.545223236083984, 7.882308006286621, "etc. Okay,"]
+[4.457071781158447, 5.442330360412598, "I can zoom in. If you want me to scroll, I can do that."]
+[3.6594808101654053, 4.316257476806641, "Now I can I can read it. I actually came up with my own list as I was thinking about getting on this call, so"]
+[3.227778911590576, 8.385315895080566, "Oh, lovely."]
+[1.9521855115890503, 1.00290846824646, "And, okay. You got one. Yes. One thing that's missing, though, uh huh. Data Data Collection."]
+[5.40327262878418, 6.293440341949463, "Oh, well, thank you so much."]
+[4.133214950561523, 7.676434516906738, "All right."]
+[4.009011745452881, 3.9649548530578613, "Did you happen to read the the report from the"]
+[1.9278980493545532, 0.9823572635650635, "Yeah. Yeah, the 18 sources that just resonated with me, because I'm working in a data world. So"]
+[3.8073248863220215, 7.879578590393066, "right, right, right."]
+[4.39156436920166, 7.183333873748779, "Okay, wonderful."]
+[1.2195459604263306, 7.728139400482178, "Well,"]
+[0.053311362862586975, -3.981193780899048, "I think the answer would be different, depending on whether I was looking at it from an individual's perspective or from a system perspective. I think from the system of care, the disconnect between issues around health care in general health care access and solutions in the system of care around behavioral health, Alzheimer's and dimension dementia. You know, I think that's a that's a huge issue is the disconnect between those issues, and then based on my experience in working in homelessness, affordable housing, and would be another major one. So it's really an inter section between some of those issues that I think are the big issues in Orange County. Yeah,"]
+[-2.147479772567749, 0.24725139141082764, "great. So I'm going to ask you a series of questions on those, let's say four things that you just mentioned. And you know what, we'll go through them one by one, and you'll get to, you know, share your knowledge and expertise on each of those areas. So let's tackle health care access first."]
+[-1.8350715637207031, -0.7637455463409424, "I think it depends. So how old they are, I think solutions are more readily available once people reach some of those milestones of age 65, you know, availability of Medicare and other resources. But if you are considered an older adult and have significant behavioral health issues, you can't access easily the same system of care that you might have been able to access. So that would be just one example of a disconnect. And I think most people are not fully aware of what community resources there are, and also their ability to pay for it. I think there's a big disconnect there between what's available through a Cal Optima type program. And what might be available to someone who qualifies in terms of age for Medicare plus can afford to pay based on their Medicare income for a supplementary program. So I think it's not a simple answer. But there are many barriers to accessing health care across the system of care."]
+[-0.9164566397666931, 2.0342953205108643, "Yeah, well, you mentioned barriers, and, but in terms of the system of care, and improving the system of care, what what barriers come to mind for you."]
+[-0.990982711315155, -3.460402011871338, "I think, accessing the information about what's available and who to talk to about it. And there's also the digital divide in terms of accessing information, but you and I might just text into a search engine and find answers to not everybody can do that, particularly people who have grown up in the Orange County system of care and don't have access to an iPhone or other digital technology to get those answers. They're not even aware of all the resources that might be available through the senior centers or the other. There are so many disconnects in our system, I think, to me, that's the biggest barrier to accessing services and Mitel be there. I know there are hundreds of programs focused on seniors in Orange County. Probably not. Yeah."]
+[-2.4125266075134277, -1.4143762588500977, "Absolutely. You know, I've been working for the last couple of decades in behavioral health and housing. And there's a real disconnect between the kinds of resources that someone with severe and persistent mental health issues is able to access and even within what seems like comprehensive system of care through Cal Optima, and some of the new Calayan resources. One of the big disconnects is for people as they age, like the rest of the population, experiencing issues around dementia, complete disconnect in the system of care for people with a mental health diagnosis and getting support for Neuro cognitive issues as they age. Yeah, in fact, we're working on an innovation program to address that specific issue, because we expect that like the rest of the population, people with severe and persistent mental health issues will experience dementia, but we have no housing and support solutions for that population at the moment."]
+[3.8218021392822266, 7.8611016273498535, "Right, right."]
+[1.7354336977005005, 3.908489942550659, "Which which need that"]
+[0.31534990668296814, -1.343585729598999, "Well, I think it comes down to using all the technology tools that we have available, we can't rely on. We often say we're speaking to the choir. Those of us in the systems know the answers, but that's not who we're talking to. How do we address sigh Social isolation. How do we address the needs for financial resources to address housing options as couples find that they no longer qualified to have both sources of social security because one of them passed away. There are so many needs for custom information and resources. We're not doing a very good job about using most of them."]
+[3.4632718563079834, 9.11249828338623, "Yeah, yeah."]
+[-2.62556529045105, -1.6066445112228394, "So now I want to switch over to behavioral health. More specifically, I know you mentioned that earlier. But if we can expand on what you said earlier, regarding behavioral health, how and why are older adults struggling with this issue."]
+[0.9996276497840881, -2.4591455459594727, "It's different for people who have already been identified when they younger in the system. But one of the big outlier populations are the homeless, older adults. And if you look at that data around that point in time counts that we do every in Orange County, every two years, what we're seeing is a significant growth in the over 50 population. And most of those needs cannot be melt met, in our current shelter system. It's not designed around the physical needs of homeless older adults, bunk beds are not going to go climb up on the top of a bunk bed. You know, that's not a solution that's viable for most older adults. And so our whole system really needs to be customized for this population, to meet that specific need, and particularly for people, well, another population is people who are survivors, women who are survivors, typically of domestic violence. as they age, their needs are not being met met either in our system of care. So there are a lot of gaps. But there are also differences in behavioral health. A lot of people as they age, addressing issues around depression, social isolation, which are not the same issues, as our system of care is used to dealing with. They're more accustomed in behavioral health dealing with severe and persistent mental health issues. And this is not what these are. These are issues around just isolation. And as people age, often they have co occurring dementia, as we just talked about before. And so those needs are really they're not even able to be met in the behavioral health system. If you have a diagnosis of severe and persistent mental health issue, an issue, you cannot be treated for dementia in our system. It's excluded from meeting criteria for some funding."]
+[3.4229066371917725, 9.068674087524414, "Yeah, yeah."]
+[4.735959529876709, 3.445991277694702, "You're making it hard for me to use these interview questions, because you're taking it all together."]
+[1.6577333211898804, 1.6810966730117798, "I know. I just do that because I want to see integrated solutions."]
+[-4.059759140014648, -1.905745029449463, "Right, right. Right. No, that that works. That works fine. I asked earlier about different experiences for different groups of people."]
+[1.1083840131759644, 6.465427875518799, "I think"]
+[-2.1709468364715576, -1.9188028573989868, "and just talk about my experience in working with a behavioral health committee working specifically on older adult issues. So I've been on a committee on that topic for several years. Yes. So she can give you a lot of insights into that the experiences of older adults have typically been ignored. I think that's an outcome that we found in our work. They are typically grouped together with adults and not seen as having unique needs. And that's a dilemma. We put together a resource book on resources for older adults in behavioral health. We found two things they were very limited in what was available and where you could access it. And we actually thought we've done a good job by getting it to one, one and being integrated into what they were able to talk about. But we certainly found that there weren't enough resources that were focused. And another big takeaway is the master plan on Aging, oddly mentions mental health or behavioral health. Yeah, yeah. Yeah, they mentioned"]
+[-2.1283655166625977, 0.7866098880767822, "it only in context of social isolation and loneliness and things like that. But to your point, not, maybe some more severe clinical perspectives on that."]
+[1.8756853342056274, 8.61383056640625, "Very true. And what do"]
+[1.3130245208740234, 0.6174944043159485, "breaking down the silos doing a better job of communicating between agencies sharing data, being more focused on outcomes. Okay,"]
+[4.422613143920898, 7.188370704650879, "great. Now, I"]
+[-3.1124684810638428, -1.3866685628890991, "want to segue over to Alzheimer's and dementia. Anything different you'd like to say about how older adults are struggling"]
+[-1.8365468978881836, -1.1587110757827759, "I think, again, there are disconnects. in how we receive that information. There are a lot of resources. And I'm 77 years old. So I can speak as a peer in addressing these kinds of issues. And most of my colleagues and peers in my community life concerned about this. But do they know how to access resources do they know how to plan and if they have financial resources, the answers are very different than if you are living on Social Security, and have a limited income. We have I have individuals who I've been close to over the years, and one of them has developed Alzheimer's in the last few years. She lives in a very robust program, and no longer recognizes any of us that she had a house that recently sold for over $6 million. She doesn't have to worry about financial resources. Most of the people who I know particularly those with a mental health diagnosis who were living on Social Security and more limited income, any of the solutions around housing, assisted living memory care programs are just not accessible to them. So the only programs that might be accessible to them. Programs like there's a program that I'm actually working on with the state to provide more funding. It's called residential care facilities for the aging RCFVs, the acronym and the focus of that program is to make investments in those what are often referred to as Borden care homes. They might be a six bedroom house where someone shares a room with someone else. But even in that program, most people pay 1000s of dollars a month. So if your income is around 1000, for disability, that's not available to you. So the state is actually subsidizing this housing, and has a program called prevention and preservation. So they look at these facilities, they're making an investment in rental subsidies. And they're also rehabbing a lot of these houses throughout the state. And they're giving counties money. And Orange County recently got about 16 million to make this investment."]
+[2.132047176361084, 7.177248477935791, "Would"]
+[3.043445587158203, 7.160401344299316, "that go through"]
+[-0.33492720127105713, 0.5017756223678589, "social services or"]
+[-0.822087824344635, -0.16499730944633484, "But most people don't know that. Boarding care homes. They're licensed homes. And most people aren't aware of that model little"]
+[3.97078537940979, 8.123618125915527, "Wow, wow. Okay, well,"]
+[-1.7004399299621582, -2.3728911876678467, "that's very that's a that's a big step in the right direction. Absolutely. Yeah. You're tackling the unique needs of older adults as they age. It's very, very different from everyone. And then the second issue is the housing issue. We're being very active with that."]
+[0.607555091381073, -2.728074789047241, "Yeah. And we're also and I can talk about senior housing communities. From my jamboree perspective, you know, we developed a number of very good programs for seniors specifically as they age. But it's really the model is really, that model is really around affordable housing, affordable housing for seniors. But what's often needed is supportive housing for seniors. And so we're beginning to see some of those models being developed. One of our partners in Anaheim developed a senior community, which has a number of units for formerly homeless folks with a mental health diagnosis. I know jamboree has others under development in Huntington Beach, and other parts of the county, they have veterans programs, which is specifically some of the units meet the needs of the Vietnam population, veteran population, so you can customize the model within those new units. But that customization really needs to be much more available and provided in Orange County to meet the needs of this specific population."]
+[3.475567579269409, 8.428128242492676, "Yeah, yeah. So right."]
+[-4.144188404083252, -1.789926528930664, "Do you notice different experiences for different groups when it comes to"]
+[1.7586835622787476, 2.2143986225128174, "Are there more resources available to"]
+[-1.2006670236587524, -0.7400105595588684, "Yes. I mean, that's kind of a given. I live in Corona del Mar, we have a beautiful assisted living facility, I understand the memory care part of their program is 18,000 a month. Wow."]
+[0.6006596088409424, 3.108046531677246, "And that comes with an ocean view, I hope."]
+[1.640222430229187, 6.54970121383667, "Yeah. It does kind of Yes."]
+[1.946381688117981, 5.4846882820129395, "Wow, that's a lot. That's what"]
+[-1.163004755973816, -0.801819384098053, "you think about, you know, the average income of seniors, particularly if they've grown up in Orange County, maybe now, they might have some people who have an asset in their home, have choices that other parts of our community can't make, they can use that investment to buy into an assisted living community with all sorts of options. If they develop memory care issues, that's going to be there. But someone on disability income just has no access to that."]
+[-0.899726927280426, -1.107471227645874, "Absolutely. Long Term Care Insurance, certainly a segment of the population. Is this the family who's going to have to provide those resources. And in some cultural communities, certainly that is the model. You know, we don't see too many unhoused older Latinos, or Asian American community, they, the families have the culture around taking care of other generations. But if you talk about other communities, that's not part of their model. And maybe they're working themselves to provide retirement resources and they struggling, you know, we often hear about the sandwich generation trying to provide the resources for the young adults and the older adults. So it is a big dilemma and different populations are able to deal with it differently. No. You know, and like all their affordable housing options, very limited turnover in those units and availability to access them. If you need to be thinking about this, you've got to get on a list many years. in advance."]
+[3.2914371490478516, 7.958539009094238, "Yeah, yeah. Yeah. Well, you know, I"]
+[2.0287022590637207, 6.655368328094482, "feel like we've touched on"]
+[1.4156657457351685, -0.9516955614089966, "a lot on housing already."]
+[0.5408580899238586, -2.678516149520874, "Well, I think we, you know, this is a much broader issue than as it applies to older adults, that applies to all the segments of community. Affordability is a huge issue. The statistic I read last week said, in order to purchase the average priced home in Orange County, you needed an annual income of 178,000 a year. That that's not accessible for, you know, young college graduates or people who've been in, you know, air, police officers, teachers, they don't have that income. So we need to look at solutions around housing affordability throughout our community. But then we also have special requirements for older adults, in how we address their needs. Because sometimes just affordable housing on its own isn't enough of the resources. And jamboree has a really good history of providing some alternative models. They have a community in Huntington Beach that the city provided them to manage and I own and remodel and make into a nice community. But they have onsite case managers and staff who's supplement their housing model. And also in Mission Viejo, they have another community called heritage villas, which is a beautiful model to allow older adults to age in place. But those are few and far between. Yeah."]
+[3.4570133686065674, 7.4633049964904785, "Yeah. Okay. So I'm,"]
+[-3.059727907180786, -0.04180942848324776, "I'm done with this list. So I'm going to stop sharing my screen, we're going to go to a series of questions about how accessible and adequate our care system is. So the first one I would like to ask you about is geriatric care."]
+[1.028833031654358, 2.442488431930542, "Not very accessible. Yeah. Yeah."]
+[-1.3632830381393433, -2.614888906478882, "I think staffing levels are inadequate. I can speak to specific examples at the Oasis Senior Center, they have a geriatric specialist. And I think that's a resource that should be at every senior center. I'm not sure if it is. But I think people with specific expertise need to be available to the broader community. And my experience has been that staff has been excellent."]
+[1.2133265733718872, 2.1979238986968994, "Yeah, but not not as widely available as it should."]
+[0.4292069673538208, -3.1506290435791016, "And I'm not sure that people know even in Newport, that it's there. Yeah, that's part of the issue. You know, we, we smile, and we say, well, they've got a great gymnasium there, we see all those people working out. And my background, as you probably can tell, is in Australia, and so as my parents aged, I was very aware of resources that were available in that system of care. And I don't think we have anything like that here. Yeah, yeah."]
+[-1.0647022724151611, -0.6280295848846436, "Depends how much money you have. Yeah. And basically, not even with people who have financial resources, and I'm always going to share anecdotes I'm sorry to digress but I have a friend who was a teacher, her whole career in LA. Her parents both live they were divorced, but they both lived. Over 100. Wow, she found that she was supplementing their long term care. As they aged, they didn't have a lot of financial resources. So she was paying for them. Her mother, particularly I was aware of to live in Borden care in Costa Mesa. And one time she went on a trip. And she asked her friends, if we would drop in and see her mother, which we were all happy to do. And, you know, we loved her mother. And, you know, we've met her and other social occasions out of the house. But I think without exception, we were just horrified at the status of this home. And it was 24 hour care. And she was paying 1000s of dollars a month for this. But I wouldn't have put my mother there. But she didn't have any choices. So I think even if you can make those investments, what's available is not very"]
+[3.4710912704467773, 8.249153137207031, "good. Yeah. Yeah."]
+[-0.5628464221954346, -1.448622703552246, "No, we know there are huge gaps in that system of care, we do have some really good full service partner programs for older adults. And that's connected to housing solutions, where not only does that individual get a housing, affordable location, but they get what is referred to as full service partner wraparound care. And there are good programs. It's called the Oasis program. Older Adult system. I don't know what it stands for, but you get the idea. It's it's focused on on that population. But, you know, that's maybe serves a couple of 100 people. Yeah. And we know from their analysis of the system of care that there are many people who aren't knowledgeable about what that is, or maybe they don't meet the severity level, specific populations, as I mentioned, all the women with who were survivors of domestic violence, not many options available for them, unless, unless you're working and, and bringing in good salary. Most options aren't available to you. Yeah."]
+[-2.31638503074646, -1.4960556030273438, "Oh, yes. Yeah. Yeah, I mean, it's acknowledged. And that's another disconnect in our system of care. It's only been recent, that behavioral health is really acknowledged that that's part of the needed system of care. And I think they're beginning to address it. But I think as a county, we've got a long way to go in those solutions. And being able to talk to older adults about this. I mean, it's the typical model, if you've got an issue, people self medicate, they address, whatever the issue is, whether it's loneliness, grief, or other other issues, they address it with substances. I'm hearing a lot more about using CBD, which is not necessarily a bad thing. I'm always intrigued to hear I don't know if you know, Dr. Trin, is with Alzheimer's OC, I love him. He's doing a great job of, you know, normalizing the discussion around that. But I think we, you know, we were not really having those discussions. Yeah."]
+[1.2855429649353027, -2.9330027103424072, "Yeah, I wrote his name down. He's probably somebody we should talk to as well, in this in this process, about human and social services."]
+[1.0125048160552979, 1.5957748889923096, "Well, there are a lot of different programs. And, I mean, I always say it's pretty easy to one one will get you there."]
+[3.412487268447876, 9.082974433898926, "Yeah, yeah."]
+[-0.8079901337623596, -1.8470016717910767, "That's interesting. Do you think that let me let me just ask you a quick question about food for In a minute, when we're talking about social services, people, I'm sure you're aware of talking about this food cliff that we're going to experience as benefits from the pandemic go away. You know, one of the things that I think when I have honest conversations with people in the community that work in food insecurity is that they're not quite sure, they're really not quite sure what the need is. Because if you give free food, there'll be a line of folks, right, and some people will, will show up even maybe they're, you know, may not have necessarily have the need. And possibly the need increased because of a variety of different reasons. But there's a lot of people that also feel like, even if they increase food access tenfold, there'll be a tenfold increase in people accepting these services."]
+[-1.0746612548828125, -2.087803363800049, "Well, I wouldn't say it's a simple issue. I think, in fact, I just had an aha, within Allegan digress. I think delivering social programs to people can be facilitated through delivery of food. I think there's an opportunity for a Meals on Wheels program, to use strategies to engage with people, as they might be showing symptoms of dementia or other issues. But we don't we look at it as this whole separate system. And I think I've often heard people who work with faith based programs say, I'm never going to turn someone away, they might have driven up in their Mercedes or their Lexus, but I'm never going to turn them away from the food program here, because they think they need that. And we don't know their backstory. And I think that's the big takeaway. And what I heard you just describe is, the providers don't know the backstory, either. And I think it's, the big issue is, we don't do a very good job of understanding what the stories are, and why someone needs that supplementary source of income. And on a personal note, I have a 50 year old daughter, who, since COVID, began has become disabled. She and her daughter have zero income, zero, she's on a food was on a food program, she just got a denial letter. And it's probably every time she they renew this program, she gets a denial letter, you didn't fill out the form properly, you didn't give me this piece of information that I asked for in the right place on the form. We said we were gonna call you at this time. And even though my daughter says, I sat by the phone for an hour, nobody called You didn't answer the phone. So to me, that's the disconnect in the system. And I can call that woman whose name is on a piece of paper and say, you said you were going to call but you didn't call. So now we have to appeal this. So as of first of June, my daughter, and my granddaughter who is her in home support person has to qualify, again, to get a couple of $100 worth of food. I mean, the system is broken. When I describe that. Yeah, so my personal experiences, if people managed to qualify and get some healthy food and think about homeless folks who get that EBT card, until recently, they couldn't get a hot meal. Don't give me cans of food that I have no way that prepare. I mean that the whole system was just set up incorrectly. I've often had people living in our affordable supportive housing, and they pay $300 a month in rent. And their income was three times that. They ran out of food. They couldn't afford to buy good food. And often I'd be visiting our apartments in Anaheim. They just couldn't access that part of the service certainly qualified and we're deserving of that. But the system didn't support them in that so I'm always a little skeptical about the pushback that I hear from food providers. You know, there's so much food waste in our system that we can do a way better job in getting healthy food resources to people that need them and talk about families and how they need taxes. I'm digressing from older adults, but often they're part of this family. That might be the one making the dinner in that house."]
+[3.3280553817749023, 8.950377464294434, "Yeah. Anyway, yeah,"]
+[3.622805118560791, 8.201120376586914, "yeah, no, you're right. You're right."]
+[0.61815345287323, -3.3747477531433105, "Because if you don't have housing, everything else is you're probably going to die. Yeah, you're gonna die sooner. So I think for Orange County, we definitely have to address that first."]
+[3.257366418838501, 7.962780475616455, "Yeah. And what"]
+[1.2211689949035645, 0.9968658089637756, "They can do a lot in facilitating solutions. But back to our original conversation, if we don't share information, and we're not knowledgeable about what the system is and where the gaps are, we're not going to do a very good job in getting the outcome that we want. We keep doing it the way we've been doing. We're not going to get a different"]
+[3.3489513397216797, 8.907731056213379, "outcome. Yeah. Yeah."]
+[1.7046133279800415, -2.7064664363861084, "Homeless older adults. Yeah."]
+[1.2529748678207397, -0.8825817108154297, "And what would you say to somebody who says, well, there's so much money, probably unprecedented amount of money in housing right now."]
+[0.8269062042236328, -1.7959551811218262, "I think it's a huge opportunity. And we if we being thoughtful about how we're investing it, I think we can make see a major impact on that. But when we see pushback from cities on developing affordable solutions, I've been on the Senior Citizens Advisory Committee on Housing until I had to drop off because of my new job. One of the things we heard was, there was a wonderful site in Anaheim Hills, and was a church, the whole not in my backyard movement. Stop that moving ahead, it was going to be an assisted living Memory Care program. For people who were had financial resources to pay money, it got shut down. So unless we can implement those solutions for all parts of our population, the money might be there. And there is money for supportive housing for older adults, and some of these solutions and our Orange County. I think we have the smarts to make good solutions and investments. But we're not doing a very good job communicating with each other."]
+[3.259045362472534, 8.951045036315918, "Yeah, very true."]
+[-2.3692281246185303, -2.4108753204345703, "So thinking about all the issues, some of which we talked about today, but others that were on that list, all the issues facing older adults, one issue is being overlooked."]
+[2.0335593223571777, 1.1085600852966309, "I think it's the data issue."]
+[2.3993515968322754, 6.890043258666992, "If we don't"]
+[1.924213171005249, 0.956557035446167, "gather and use all the sources that we have for data, and analyze them, I don't think we can get the best outcome. And I know you believe in data."]
+[-1.0471487045288086, -1.56108558177948, "Music to my ears, Helen music. Yeah, I mean, there, there are too few of us who, you know, operate with with that mindset, but I think more and more people are starting to. So that's that's a positive sign."]
+[0.5227976441383362, 3.225900411605835, "But I liked the question around the 10 year, because I bet my mind frame it a little differently."]
+[4.230650901794434, 8.969855308532715, "No."]
+[0.24939332902431488, -2.101580858230591, "I think It would be more exchange of information breaking down silos between systems of care. You know, we have some really good leadership, I think, and different in different segments of this population. But I don't think we've really looked at the data around. They're older adults. And I, you know, most people don't know how many homeless older adults we had in the last point in time count. Let's fix that we can do that. You know, that's just one very specific piece of community. And let's not just I mean, the silver tsunami, I get that. And but there are a lot of different segments of our population. Older adults have now many more healthcare options than generations before us had, you know, where outliving previous generations. Although I know we lost a year of lifespan, I think in the last year, but, you know, I think we have lots of good health care alternatives that can help us live quality of life as we age. But, I mean, silly examples of things that we need to do even in terms of customizing our housing. For people, when we build new communities, let's make them design so that people who might have a walker can actually get into the bathroom, you know, it's like, and they can get into the shower, they don't have to, you know, evolve over a bathtub. And I just had back surgery four weeks ago. And it came really home to me, the walker they gave me as I left Hoag Irvine, didn't get through the door of the bathroom. My husband had to take the wheels off and put them on the inside, and then I could get inside. Wow. But you know, I houses aren't designed for the aging population. We should not build one unit in any community that doesn't have those design features, grab bars, all of those things that will prevent falls and injuries. And I know I didn't go to those on the list. But there are plenty of those issues that we can help address so that people have quality of life."]
+[-1.661963939666748, -0.20115156471729279, "That's more centered on around humanity, right, instead of building products and building things, we should really change the culture of caregiving."]
+[0.14905628561973572, -1.9515395164489746, "Yes, I think that's true for all our community issues. I definitely believe in that. And by the way, the legislation, and the program, the billion dollars program that I'm working on is called Community Care expansion. It's it's about this specific issue, and not all addressing the needs of older adults. But that is the focus. And it's homeless or at risk is the investment is made in that part of our community. So in your right , there's a lot of money. There's billions of dollars in California. Most people aren't aware of any of these programs, though, and what the potential is for for them all. And we have I mean, we have such wonderful academic resources in this community, but again, they tend to be siloed. So that the solutions aren't readily known and shared. Yeah, yeah."]
+[1.1220831871032715, 6.4486589431762695, "I think"]
+[0.6912475228309631, -2.9536705017089844, "the good thing in Orange County is we can actually show models that are successful and address the concerns that we often hear particularly around not in my backyard issues. Around these are safe, these providing good options for people And I'll give you one example we built with jamboree about 10 years ago in Irvine, a community was built in two phases, 60 units of affordable housing, family type housing, 10 of them was set aside for people who had come from homelessness with severe and persistent mental health issues. Yeah, by the way, but the being able to show that those models can be fully integrated and successful into the community. And most models of affordable housing that have been developed, made up of those components, where you have a lot of affordable units, and then some that allow you to fund those apartments for people with special needs, and may live very good lives and successful lives in those communities. And typically, you could never say that person who lives in Unit three B has a mental health diagnosis, you wouldn't ever know that, because of the integration into the community in the care that's provided. So being able to demonstrate the success of those models, that allows us to get to the next one, which is the real solution we need, we need a lot more affordable solutions. And you know, even around places like Laguna Woods, where we see they have certain options, they have barriers built in, people who can't give us can't live there, they can't afford to live there. And they're not allowed to live there, you have to be a certain age. So there are all these policies that prevent a solution that can be very effective. So we have to get over those barriers between different segments of the population and, and create those solutions together."]
+[-2.0492563247680664, -1.8183788061141968, "Well, I'll give you the one about aging, adults with mental health issues, and dementia, we are exploring that we're going to be applying for an innovation grant to see if we can come up with a model. That's just a very specific solution for a very specific targeted population. But I think it's a good model of how we need to look more broadly at where the gaps are, and how together we can come up with solutions. Because if we continue to say, Okay, if you're over, if you're a veteran, this age, you shouldn't live with a veteran is a different age, you know, let's come up with solutions that work for all of the populations and you know, just being more facile about how we're going to deliver on this. But again, back to you back to the what it looks like in 10 years, let's draw the picture. Let's say what it needs to be. And let's use data to document what that really needs to be. Don't tell me that you've got this wonderful master plan on aging, and you've got all these meetings going on. And but if you're not talking to the community that has the need, you're not going to get to the solution."]
+[3.425153970718384, 9.065583229064941, "Yeah, yeah."]
+[-0.5379923582077026, -2.268791675567627, "Well, we know it's we've actually built it as a way built building a pilot, and it's going to take us a few years, even if we get money. We're not just going out there and doing it. We're saying we need feedback from all of the impacted groups around what this should look like, and how we're going to pay for it. Because we can't just say we're going to put two years of investment into we're buying beds, it's XYZ place and providing this because that doesn't fix the system. Yeah. And I think it's a good prototype. for how we should be looking at the system of care, because when I read that master plan on aging, and I've been at many presentations on it, I don't I can't visualize the answer in Orange County, you're gonna be able to say, okay, Irvine has this many new communities for seniors, they can do this. Let's get us all together to come up with what the model is, and build that model, not just, you know, pull off segments of that conversation and say, well, that group has a good answer. When you're ignoring the rest of the answer and where the gaps are."]
+[-1.4582910537719727, -1.7326782941818237, "Yeah. So we started the conversation about tough, you know, most important issues and concerns facing older adults. And you said that, you know, basically, that we're very disconnected in our system of care, delivery of care. And that, because we're so disconnected, people don't know about what resources exist, if they need them, and certainly we can't fill all those needs."]
+[-0.05214054137468338, -2.2998969554901123, "It's probably not one. I think there are roles for multiple entities. One unfulfilled role, I think, has been Carol optima. Until recently. You know, when you have Michael Han say, when he does the Point in Time Count, there was an aha moment for him. He said, These people are all my clients. But knowing 900,000 People are his clients. That's the That's a big disconnect. And I know Kaleem has some wonderful, new programs. We can't we've you know, so I think this conversation and conversations like this, really, we can certainly engage with entities and should engage with entities like Kaleem and CalOptima, but different segments of our population, different cultural solutions need to be provided in our homeless arena. We have nothing customized for them. You know, I see in Newport Beach, it's obvious to me that that's a population whose needs went out meeting because they stand out just physically. But another example of, you know, we it's not one size fits all, for sure. I mean, I would want to see, county government definitely needs to be involved in leadership, equity solutions need to be had data solutions, universities, I mean, let's bring us all together. But let's paint the picture of what we want. Okay,"]
+[1.2249964475631714, 1.2925732135772705, "so do you see this effort being an effort of that kind of convening, in terms of getting everybody on the same page and being able to move forward in some sort of, you know, collaborative"]
+[0.8986046314239502, 3.982773780822754, "That's a good goal."]
+[3.5411179065704346, 6.100795269012451, "I'll take it back. I'll take it back to them and see what"]
+[4.447507381439209, 7.5829057693481445, "Okay. Well, I,"]
+[1.3491007089614868, -2.41683292388916, "you know, I think, you know, one of the gaps is we don't know what we have. Yeah. I mean, that was one of the bigger has with the Mental Health Services Act. When you look at state reports, and they tell us how we compare with other counties. I think that there's a lot of sharing that could happen that would be very helpful for us in terms As of understanding the issues, but I do know, you know, I've been working in the homeless solutions areas for more than 20 years. And I do know that the number one issue for counties is homelessness. So we better have that front and center, homelessness and how it affects older adults and how it will affect older adults."]
+[2.894860029220581, 6.329142093658447, "We better be talking about that,"]
+[-2.269312620162964, -0.4018094539642334, "but not in isolation. Because the way we provide the solution is going to be different for that person who's been diagnosed with cancer or diabetes or dementia. They're all going to need different care options. So you're worried about care, I think is the appropriate focus."]
+[5.883055686950684, 6.780467510223389, "Thank you, hello."]
+[4.634240627288818, 4.477967739105225, "I really, really enjoyed our conversation. I if you can see in my notes, it's like all over the place. I have to process everything you just said. But thank you so much. It really is very helpful and meaningful"]
+[4.800124168395996, 4.084240913391113, "to I never stay in a box, Katie, on that out of the box."]
+[1.269589900970459, 7.735617637634277, "Well, thank goodness"]
+[4.908545970916748, 4.734499931335449, "for that. And thank you for especially during the time that you are experiencing right now with your family for making time for this I really, really"]
+[1.6467175483703613, 1.4013419151306152, "well, I am passionate about these solutions. So when I can help I want to be involved."]
+[3.683145761489868, 4.686129570007324, "Okay. Well, if I may, I might come back to you and take you up on that. And there will be some recommendations that we will have to put together at the end of this journey. would really appreciate some time with you to think recommendations."]
+[4.725457668304443, 6.394712924957275, "Okay. Of course. Okay, thanks. Thanks for your work. Okay."]
+[4.141247272491455, 7.6711835861206055, "All right."]
+[3.9736366271972656, 7.0504231452941895, "Oh, I don't think so. Okay, wonderful. Okay."]
+[-2.520406723022461, -3.4774701595306396, "So the primary goal today is to identify what needs you think are most important to the older adult populations, particularly the ones that you serve. And in this interview, older adults is identified as those who are 60 years and older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. So I'm going to now share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through this list. And then we will begin the interview"]
+[3.573427438735962, 7.659794330596924, "Uh, huh. Okay."]
+[3.3783748149871826, 4.134399890899658, "Quite a list. Let me look through this about halfway through here. No problem."]
+[3.5752692222595215, 7.102859020233154, "Yes. Okay,"]
+[3.6650378704071045, 4.7389960289001465, "the list will stay on the screen, so you don't have to memorize anything."]
+[-0.8212464451789856, -3.348052740097046, "Sure. So I'm the CEO and President of the Council on Aging in Southern California. And through our programs, we engage with about 100,000 older adults in our service area annually in a five county service area, Orange, Riverside San Bernardino counties in Inyo and mono counties, but we're headquartered here in Orange County, and where we've been serving the community for over 50 years. Great."]
+[0.15998919308185577, -4.060893535614014, "And thinking about Orange County and looking at this list of common issues and concerns. planning,"]
+[-2.5157599449157715, -2.515538454055786, "planning for aging is not listed on here. And I And to me, as we think about what we've heard from the community, and how people contact us, they typically have not planned well for aging, they have not planned for these things to happen to them."]
+[-2.520089864730835, -2.576667547225952, "Okay, I'm gonna add that to the list here, if you can just imagine it being added. So including planning for aging, and all of these other things listed on this list."]
+[-1.8579257726669312, 1.3553355932235718, "Just I guess one question I have for you first Katie is as we look at emotional well being is that really to encompass mental health in general, or,"]
+[-2.0210437774658203, 1.3325703144073486, "yeah, you can interpret it however you'd like Lisa, and you can say mental health if that's a term and"]
+[-2.047032594680786, 1.1679388284683228, "that to me, I mean, I mean, they're they're elements of mental health, I think that are included in emotional well being. But I don't think that that's necessarily all encompassing. So if I think about what might also be missing here is, you know, mental, mental health support meant just mental health in general, I guess."]
+[-1.98142671585083, 1.3825862407684326, "Yeah. Sure. If you look at the second line item is is behavioral health and mental health. Oh, I'm sorry, I missed it up there. Oh, that's okay. And then mental. Sorry. Yeah. And then these examples next to it, but if there's something else that's not there,"]
+[4.121071815490723, 7.015460014343262, "that's, that's better. That's okay. I missed that. I missed Okay. Okay. So now you want"]
+[-1.574213981628418, 1.288313865661621, "Okay. Top three. Okay, I would say behavioral and mental health is number one. Housing number two."]
+[-2.467283248901367, -2.602355480194092, "Transportation number three, and planning for aging. Okay, I think about I think about planning for aging is that having a plan for aging sort of encompasses all of this, but it's one of the last things that people do. We've talked about that when we met the other day."]
+[-1.9415483474731445, 1.3876186609268188, "Yeah, yeah. And you can call that out specifically, that's fine, too. I think that is a very specific thing that we need to incorporate. So I'm going to ask you the following questions in relations in relation to that the four that you mentioned, and I want you to think about them. Think about these questions for each of them. So we're going to go one at a time. So the first one you mentioned was behavioral mental health."]
+[-1.8344879150390625, -1.5598548650741577, "Well, I think part of it is just, you know, there, there oftentimes are cognitive changes as as individuals age, and we're dealing with a demographic that typically hasn't acknowledged mental health is something that, that they need to request support on, they sort of from a generation that they oftentimes feel they have to tough it out, or they don't know where to turn. Alternatively, they don't know where to turn for resources. And that, in turn, can lead to many of the things that are listed here. It is example stress, worry, drug, alcohol, addiction, and so forth. So, but it also ties into the topic of emotional well being just this isolation and loneliness, which often happens in as people age, I think it's a it's an incredibly important area that needs focus. Yeah, and what barriers"]
+[-0.7392615079879761, 2.398629903793335, "exist to seeing improvements in this area,"]
+[-1.270236849784851, -1.170672059059143, "lack of awareness of our resources, and that, and then an acknowledgement that it's okay to ask for help. And it's important to know that people aren't asking for like a handout, but they're asking for a helping hand."]
+[3.828594446182251, 7.8858184814453125, "Right. Right. Right."]
+[-2.1322696208953857, 0.644586980342865, "Oh, definitely. I when I think about some of our immigrant population, they have endured some significant struggles in their efforts to come to America. And also they have cultures where you don't talk about mental health, you know, as well. So I think they're definitely different experiences, you have veterans that take a different approach to mental health and others might. Yeah, definitely. There's differences."]
+[-2.1359174251556396, -1.5471572875976562, "Well, that's a that's a loaded question. I mean, that's, that's a, that's a major undertaking, we're making some great strides with support from the health care agency. I think it's also worthwhile to mention that coming out of COVID, you know, we've got a whole level of isolation that we hadn't seen before. And, and then just, we've lost so many people, you know, as a result of COVID. So there's just much more that needs to be done to be able to support to support older adults, and to help them know, and it has to be more of a larger, pervasive sort of a plan than what we're doing today, we're making good strides, but there's much more to be done, particularly as the population ages. Yeah. And that's going to involve multiple entities here in the in the community, local health care providers, individuals, physicians, nonprofit organizations, the county, it just needs to be more aware that it's okay to ask for and receive help. And that talking about mental health is is, is is good for for folks, there should be an opportunity that you don't feel embarrassed to talk about mental health. I mean, just like you're talking about any other kind of knee replacements or whatever is going on, we need to be talking about mental health in the same way."]
+[1.0352938175201416, -1.236116886138916, "So now I'm going to talk about housing, which is your second choice. How and Why are older adults struggling"]
+[0.15351589024066925, -1.2352524995803833, "I just saw a statistic you yesterday that less than 50% of older adults have sufficient savings you know for retirement or have any actually any savings at all for retirement."]
+[3.7339234352111816, 15.498732566833496, "Yeah."]
+[-1.7250289916992188, -0.5334538817405701, "I think the other barrier that exists with long term care. So long term care is not covered by Medicare. And many people don't realize that till they're in a crisis situation. Yeah. And we will not have enough we know, we will not have enough beds and long term care to be able to support the need here in the county. Yeah."]
+[-0.49910759925842285, -1.4955158233642578, "I think so I think you have situations where older adults may anticipate that they're going to move in with their children. There, we also have issues with we see this in our long term, our work in the Ombudsman Program, where you see pockets of care facilities that maybe are Korean speaking, or Vietnamese speaking. But there's not enough of those to support the needs of the community, if people have linguistic issues that, you know, would not enable them to live in a English speaking long term care facility, let's say for example,"]
+[7.082519054412842, 6.117957592010498, "yeah, yeah. And then once again, what do you suggest is the best way to address this"]
+[0.9846867322921753, -1.7600934505462646, "Well, we need to identify ways that we can provide more affordable housing here in the county. And I know, of course, is the master plan for aging. You know, that's part of one of the things has been that's one of the issues that's being discussed. I think is the big is the big challenge. And"]
+[0.28411999344825745, -2.4006431102752686, "then lastly, you said transportation, but if you want to also comment on planning for aging this, how and why are older adults struggling with this issue."]
+[1.2830216884613037, -1.2418239116668701, "We noticed as we think about as we think about housing, as we think about mental health, as we think about transportation, and not being able to drive anymore. These are all topics that people don't really want to talk about. And so there is no plan, families typically are not planning and then. And so consequently, the I mean, like, for example, the idea of taking away the keys from mom or dad or them giving up the keys, you know, it's not a conversation that anybody wants to have, particularly here in Orange County where everybody's got their own car and driving around by and large. So that becomes that becomes a real challenge. And, and it's just like a taboo topic. Yeah."]
+[-0.7022462487220764, 2.3304860591888428, "And in addition to the, to the barriers you just expressed, are there other barriers you'd like to mention with regards to seeing improvements in transportation or planning,"]
+[0.44335299730300903, -3.116279363632202, "but one of the things that we've started to see in a lot of communities that that they are providing free transportation, not certainly not all across Orange County, but communities, communities are providing free transportation within their city limits, you know, to go to a doctor's appointment, or to go to the grocery store, or whatever. But these are just small, short term efforts, but we are seeing that these programs are successful."]
+[0.3221307694911957, -2.6491618156433105, "Oh, I'm, I'm sure there are you have language barriers, that would be it would be different. One of the things that I think is going to be interesting as our population ages, you know, as we think about the freeway system, that is utilized by so many when we start having older adult, you know, 25% of our population is you know, 65 and over what's going to happen on our freeways, I mean, the average speed on the freeways got to be 7075. Can you have Can you envision having this much this many older adults on the freeway driving at that high rate of speed, or does it mean that we're gonna have to reduce the speed limits or what's going to happen will people just not do drive on the freeway. I haven't heard anything from the state of California about their plans to manage that element."]
+[3.8317112922668457, 15.422722816467285, "Yeah."]
+[2.711577892303467, 5.998969078063965, "I don't have the answer for that one."]
+[-1.2541420459747314, -3.9893553256988525, "Yeah, that's a hard one. Yeah, exactly. Alright. So now we're going to move on for from these top three things. We're going to ask you some general questions. And then then specifically, in your role at the Council on Aging, I'll ask some follow up questions, as well. So generally speaking, I would love for you to describe how accessible and adequate the following care services are in Orange County. So we're going to start with geriatric care and geriatric care, we are defining as a branch of health care that focuses on the unique needs of older adults or the aging process. So just as pediatricians care for our young, we are referring to geriatric care is care for"]
+[-1.4590884447097778, -3.810227632522583, "older adults. Yeah, whatever you'd like, very difficult to access. There's a I don't know what the actual number of that that would be an interesting statistic for you to find out how many geriatricians are actually here in Orange County. But it's very limited number, there's some that are affiliated through UCI, I don't know one or two at Hoag, maybe. But very, very few. And this is a big and it's a problem nationwide. It's not just here in Orange County. But we have geriatricians really are very familiar with the needs of older adults and the impact that medications can have on them and so forth. So this limited number is deaf and you have a lot of the older adult population that never considered that they needed to see a geriatrician as opposed to maybe the internist that they've been seeing for years. So there's just a there's there's a lack of them. And then there's also a lack of awareness. We give presentations here at the council that describes what is a internist versus a geriatrician versus a gerontologist, versus a Geriatric Care Manager. And people were always paying attention to those slides. They, they don't know the differences."]
+[5.095017910003662, 7.1909027099609375, "It's interesting."]
+[-1.8324394226074219, -0.5395223498344421, "Well, it's accessible for those that can afford it, you know, so. So Medicare will pay for a limited number of days, you know, following a hospital, stay, for example, I think it's up to 30 days. But beyond that Medicare does not cover that expense."]
+[-1.320143222808838, -3.644434928894043, "I mean, that's across the board, being able to actually get a mental health appointment, whether you're a child or an older adult here in Orange County is very difficult. Yep."]
+[-1.318007469177246, -3.689629316329956, "Do you know of any services or programs in Orange County that provide mental behavioral health care to older"]
+[-1.9284766912460327, -2.30754017829895, "Yes, here at the Council on Aging, we have our reconnect program. Nami also provides programs I mean, there's a myriad of different programs, but many of them are not widely known in the older adult community."]
+[-0.9332830905914307, 0.4095296859741211, "It would be rental assistance, food access, it would be, you know, just other social services that are not healthcare related."]
+[-1.5870311260223389, -2.1077001094818115, "Yeah, yes, I think it's difficult oftentimes for older adults to know how to access them. Many might call the office on Aging, for example, for resources or perhaps 211, if they know that those organizations exist. We also utilize the answers resource guide that we've published, I've shared one with you. So that folks know about that, that gets a distribution of about to about 50,000 readers at least every year. But there's just a general lack of awareness of where to turn. And once again, because of a lack of planning, when folks do call here, they're often in a crisis mode. They're there it's not a pre planning, you know, situation."]
+[-1.3462402820587158, -1.3270379304885864, "Just one single thing, you can name more than one, I could give you a laundry list. This think I, I sort of come back to this, this topic of planning because I was fact, I was just talking with Todd Hansen about this today. There's a real need for a plan, we plan for so many other things in our lives that we do not plan for aging, we do not plan for transportation, housing, you know, all of these things. And unless we're starting to have these conversations, and let families know that this is something that impacts us all, we're just going to continue to have problems, you know, that. And it's and the, the other thing that happens is it drives families apart, you know, when you you, you've been through it with your own within your own family, right. So you, it can cause just problems among siblings, because there's, there hasn't been a discussion with mom or dad or grandparents about what this how to handle this. It can cause I mean, it cause really fractures in relationships forever. And so the importance of talking about aging and planning for aging, when the older adults can be part of the conversation is really critical. And that in itself would start to alleviate some of the problems, I think that we face around all of the different topics that you have identified. And there's no one that's really leading the charge on this in the county. And so it's one of the things that we're talking about that at the council that we could be doing a better job is initiating, helping the community understand that we need to initiate these conversations. And maybe if that's something that we can do through your work, Katie, I think that would be really interesting. Because if we start to engage the community to think about this, versus when they're in a crisis, it could make a big difference. A big difference, you know, but there's, yeah, we are talking about it."]
+[-2.530177116394043, -2.573777675628662, "Well, we are going to focus group, recently retired folks. And one of the things I think I'm gonna ask them is, if they've ever thought about planning for aging, so be curious to know how many people have done so."]
+[-1.2385365962982178, -1.231278657913208, "And it has to be beyond making an estate plan and getting your wills and trust in place. It's the difficult conversations that oftentimes, families don't have."]
+[3.4298858642578125, 9.073783874511719, "Yeah, yeah."]
+[-0.3863273859024048, -3.069707155227661, "I think the government can play a very important role in terms of helping to build awareness around what are the available resources, the importance of planning, and that we need to make Orange County a safe and good place to age and particularly and so we need to take proactive steps now to be able to help make this a better place to age when, in fact, we're going to have to catch up because we're not doing enough quickly enough."]
+[0.0647403821349144, -4.935256481170654, "So now thinking about all the older adult residents in Orange County, who is getting the least amount of attention."]
+[0.5493324995040894, -0.28585314750671387, "Oh, there are minority populations, for sure. The underserved."]
+[2.3170065879821777, 2.737945079803467, "And then thinking about all the issues, including some of the ones we talked about today."]
+[-2.4933905601501465, -2.5795695781707764, "Planning. Okay, planning for aging."]
+[-0.30821889638900757, -4.035214424133301, "And then alternatively, what programs or services or maybe, you know, barriers to them not working in Orange County."]
+[-1.1928552389144897, -2.0051488876342773, "Okay, so, why they're working, they're working far better now that we're back out in the community again, when we were limited and not being able to be face to face with residents and long term care facilities or in their homes, or at senior centers. That was so limiting. And now that we're back out in the community making those connections, that's really that's how we that's how we make a difference in and being one on one, serving individuals or or in other cases, we, in order to reach more, let's say, through our high cap, our Medicare counseling program, we do a lot of work through our call center. So that can reach those that aren't able to, you know, come in for a face to face meeting at a senior center or whatever. So being out in the community has an incredible impact. And through that work in the community, then we find that stories about how we've helped individuals that are shared with friends and family, and that helps to spread the the the word. So I think that's certainly one one of the ways that we can really make an impact. And I mean, if I think about our ombudsman program, for example, when our ombudsman weren't able to go into facilities, how do you check on residents, you know, if you can't go in and walk down the hallways and see what's happening in facilities, you know, you you, you can't so same thing with our reconnect program, we're able to go out to older adults homes now and be with them. So. And I think the one of the things that is inhibiting our ability to reach out and serve more is just the lack of funding. So that's, so we so for example, the grants that we receive are typically for a three year period. And as our population is growing, the funding is not keeping pace with the growth of the population. And so oftentimes, the funding is flat year to year, we've started to see some more funding coming out of the health care agency for our reconnect program. But it's definitely not keeping pace with the growth of older adults. Yeah, yep."]
+[-0.1345984786748886, -1.9600635766983032, "Well, it's funding as if funding is important. And it's important thing, and helping. And this whole topic about planning, I think, is another to I'm really sort of zeroing in on this a lot lately, because I just think that there's something here, there's something that, that we need to do a much better, a much better job as a community. And just in the presentations that I've given. So far in the community, it's clear that there's just been a discussion with so many people, there's just, it's clear that there's a lack of planning, and there's so much more that we could be doing in this in this area, and getting people to have those conversations. So that's one thing. Funding is a big factor I'm gonna use when you think about what's going to make a difference in the community, whether it's, you know, it's mental health support, whether it's transportation, whether it's housing is funding is going to play a massive role in our ability to solve these problems. And who,"]
+[2.716498851776123, 1.7565497159957886, "or what entity is best suited to address that issue."]
+[-1.0851619243621826, -2.656944990158081, "It's not just one entity, it's going to have to be it's going to have to be a group of organizations, it's going to be the health care agency, the Board of Supervisors, the office on Aging, the California Department on Aging, and the federal government, it's got to be a if this is not it, I mean, this is not a simple problem to solve. If it was, we would have solved it by now. So this is a very complex problem to solve. There's not a, you know, a single answer."]
+[0.2972945272922516, 0.9338230490684509, "And what about, you know, corporations and,"]
+[-1.4006537199020386, -1.209676742553711, "well, less than 3% of philanthropic funding supports older adults in the United States today. So and we talked about this also, yet, when we look at who the philanthropists are, many of them are older adults themselves. So we have to, we have to do a better job of planning, but also talking about the needs of older adults. And so maybe this discussion on planning will start to build more awareness because this does impact every family about the need to support older adults and family caregivers. Because that's, you know, and as we think about and I want to make sure that we don't overlook family caregivers, because as you think about I haven't really talked about this much, because if you think about the top three issues that I discussed, they impact family caregivers equally with the older adults themselves, right, whether it's housing, transportation, mental health, because the family caregiver is going to be actively involved in hopefully, in dealing with those topics. But you have, you have family caregivers, oftentimes that are family members that aren't involved. We just had a visit out to a gentleman that last Friday that he received one of our smile makers, holiday gifts that we do, and the gifts that he wanted and received was three white t shirts. That's all this this gentleman wanted. And of course we for that we put in socks and other shampoos and other kinds of things that the person might need. But he wrote us a note and he said, You know, I'm so thankful for this gift that you have sent me It's so unexpected and I'm so appreciative of it because of my age, I just feel isolated and, and useless. I have no value. So we went and met with we went to see and we went to wanted to meet this gentleman went to meet him. He's a Korean immigrant. He says that he he's a physician. He's a general surgeon, believe it or not. And he said that he spent most of the last 10 years in his room at a long term care facility by himself reading. And there are people around him, but he's just very isolated. He has a son that lives in Las Vegas, and he has two children that live in South County, and they don't have two sons. And they don't really visit him. He said, they're busy with their own lives. And he's, this man was brilliant. He had he was 94, sharp as a tack. And yet, here he is, he couldn't believe that we came to visit him. He goes, this is such a treat, when we thought we would initially go and visit for like about a half an hour, we stayed for an hour and a half. But this is just one example of someone that is just, you know, feels that they're completely worthless. And yet he was so sharp and so delightful, and just a pleasure devils are gonna go back and visit him again. But it's an ombudsman in and out now is actively involved. The Ombudsman, and this gentleman both went to the same engineering school in Korea."]
+[3.623241424560547, 8.722982406616211, "Wow. Yeah."]
+[-0.8271299600601196, -1.2582510709762573, "So I'm basing my world I know, I know. So anyway, it was, but it was just it was just like a snapshot of this is why our work is important. And this is yet why you see an older adult with family members in an Asian family, which usually Asian families, oftentimes are very focused on their older adult family members, but he's just alone. And it was just really, he's got so much to say and offer about all of his experiences on how he came here survived the Korean War. He actually went to did interpretation and translation for the South Korean army, and then the US Air Force. And then, you know, immigrated here with $25 in his pocket. I mean, the guy was amazing. And we had no idea from this little handwritten note that was just so precious to have received from him. But I said, Well, if somebody feels that they're just, you know, useless, we need to go meet them. And so this, this is just one snapshot of what's happening in our community."]
+[-1.6255106925964355, -1.669323444366455, "Oh, yeah. It's, it's a real, it's a huge, huge problem. So here's what's so when you think about that whole topic of mental health and, and yet, and so what are we going to do about that yet, he's, here's this gentleman that's living in a care facility that must have 75 residents, but he just, he just chooses to stay in his room, you know, and yet he has so much to offer and so sharp and so Oh, engaging and funny. And he's just he escaped out of the out of one area of Korea where the war was going on, on the top of our rail, commercial rail car with a bunch of free as if they was like a curves, like a curved real car. And he said to stay on it, they had to sort of like form this big human chain to just hang on, as the at once the train started moving. And they they went through tunnels, and if some people were standing up at the time, it got knocked off the train, and oh, my gosh, this guy's stories were just incredibly well, interesting to talk to. Yeah, yeah. So Lisa, in your work, what,"]
+[1.858778715133667, 0.8281130790710449, "what kind of data metrics do you look at, either to assess your success or to assess the need."]
+[1.7296819686889648, 0.6733036637306213, "So we have in all of our programs, the Ombudsman Program, the high cap program, the reconnect program, we are required through our contracts to provide data on information about the number of clients that we serve their ethnicity, if they're veterans, the type of we owned the savings in the terms of the high cap program that we provide, the number of complaints that we address to the Ombudsman Program, the number of pre and post surveys and our reconnect programs. So there's a lot of data that we have to track for the contracts that we manage."]
+[1.7878782749176025, 0.7743546366691589, "Well, we look at the things we look for data from a variety of different situations. Of course, we've got, you know, Orange County, data that we rely on here. But then I also look at national trends, you know, whether that's data coming through the Kaiser Health Foundation, a RP, US Census you know, articles that you see in you know, a variety of New York Times, Washington Post those kinds of things. We get data from a variety of sources"]
+[1.3132039308547974, 1.159155011177063, "You mean other organizations that you think we should talk to that you should talk to"]
+[5.852156639099121, 6.733506202697754, "That we thank you,"]
+[2.159223794937134, 5.466699600219727, "I would think you'd probably you've probably got some of them. I can't think of any off the top of my head that I,"]
+[4.723799705505371, 3.50132155418396, "okay. If one does show up, then let us know, we'll be happy to include them in the process. So unless you have any final thoughts or comments you'd like to add, this concludes our interview. You"]
+[0.21446500718593597, -2.654341220855713, "know, I would like to say, I'm so glad that you're doing this and of this undertaking, you know, this is this is this is sort of like, oh, I don't know, peeling back a lot of different layers of an onion and trying to figure out and there's no, there's no magic answer. You know, it's it's, it's very complicated. But, you know, I was just reading the earlier this morning, that the Orange County strategic plan for aging and the you know, that they have a data report that they're putting out, but one of the things that's highlighted in the data report is just the shortcomings of the data report and the difficulty of getting the data. So I think that approach that you're taking is particularly important as we think about having really measurable, meaningful data that we're going to be able to share with the community. And that's what's also going to get their get their attention and, and hopefully start to drive people more towards thinking about the challenges, how to how to support this, both from a government perspective, but also, if we could drive more dollars and philanthropy towards supporting older adults, this is a very wealthy community. And there's an opportunity definitely to support the needs of older adults, because it impacts aging impacts us all. That's one thing that's so critical, and yet it's often so overlooked. So, absolutely. Hats off to you and your team for doing."]
+[-1.6535589694976807, -0.23329928517341614, "Well, we're going to try our best as you saw. But we do think it, you know, however this ends, I think it will be a game changer in many ways, because we are starting this conversation, this this deep planning that's associated with it. You know, I just came from meeting with them yesterday, and we talked about doing a broader campaign about caregiving. And to your point I'll conversation about people don't think of themselves as caregivers. And so I would love to, like float some of those pieces with you and see if it resonates."]
+[-1.599233865737915, -3.0052411556243896, "Oh, yeah, I think that's very, I think that's very important. By the way, you know, I said that I would introduce you to Erica Dan seckford, that was used to let head the office on aging. Yes, I thought I had her email address at Cal optima. With me, but I don't. So I reached out to my contact at the office on aging, and she's on vacation this week. So I haven't heard back from her. But I get that someone I definitely want you to, with, okay, because she has, she headed up the office on aging during the most difficult times of the pandemic. And so she saw, and because she was over all of the major, older adult contracts. And so she'll have a different perspective than Nadia Bhatia, who's just starting because Oh, my gosh, she saw us through some really challenging times. And, you know, like a seven or eight fold increase in the needs for Meals on Wheels. It was it was incredible how that just jumped up so dramatically. So she's a really important person for you, too."]
+[4.287604331970215, 4.052022457122803, "I would love that. I can even try to source it to source her connection as well and see if I can find it. But if you can help with that. I think an introduction"]
+[-0.019150013104081154, -4.854989528656006, "would be Yeah, yeah. Very busy in our new role at Cal optimize. So but let me get that. And I'd actually like to talk with her. Also, she was just such a supporter from the county to provide some funding for the answers guide for the current issue of the answers guide when we were never able to get funding. And by the way, there was a one thing you might look at it was a few years ago, probably maybe, maybe five now. There was a grand jury report on the office on aging. I don't know if you ever saw that or not. Okay, so that grand jury report, maybe it's been more than five years. But there was a grand jury report and in that it said that the answers guide should be provided to every Orange County older adult resident because they they like they need to have something so they know where to turn and so that never happened. But that would be something I would be interested in and working Because I just older adults just don't know where to turn. You know, it's, it's if they're not accessing the internet, you know, that's another another problem. So"]
+[4.718352794647217, 4.395370006561279, "yeah, yeah. Well thank you. Thank you so much. Thanks available. I will definitely be in touch with you Lisa with things. Okay. This thing will go on until the end of the year. So it's a long process."]
+[4.715949058532715, 4.6954240798950195, "Yes. Good luck, and if there's anything that we can do to be helpful or whatever, just just let me know. Happy to be out."]
+[4.877256870269775, 5.157375335693359, "I will. Okay, thank you. See you later here. Bye."]
+[4.081913948059082, 7.178276538848877, "Okay, great. No, no, I'm good. Okay, wonderful."]
+[-2.7241063117980957, -2.9409706592559814, "Okay, in a moment, I'm going to show you share my screen and show you a list of common issues and concerns impacting older adults."]
+[-0.8210689425468445, -3.309814691543579, "Yeah, so my name is Jordan, I am the Interim Director of Housing Services for illumination foundation, I work with older adults is specifically with older adults experiencing homelessness or who have recently transitioned to independent living and housing from homelessness. Traditionally, we primarily interact with older adults, and our recuperative care services and at our senior micro communities that are designated for seniors aged 55 Plus, but we do serve older adults across all of our services."]
+[3.9526731967926025, 4.521996021270752, "Great, thank you. Okay, so I'm going to show you share my screen right now, show you a list. Please take your time to read over the list, take as much time as you need. It's a lot on there. And then when you're done reading it through just let me know."]
+[3.5348775386810303, 4.888268947601318, "Okay, I've read through them all."]
+[-0.4800536334514618, -3.7770588397979736, "Okay, great. So the primary goal today is to identify what you think are the most are most important needs facing older adults that you serve. And so for older adults, we are considering them to be 60 years or older. And we want you to think about them as broadly as possible, taking into consideration the older adults themselves, their families, their caregivers, and the community. Okay. So I'm thinking about Orange County, and looking at the list that you see in front of you here. Mm hmm."]
+[3.1752984523773193, 4.249475002288818, "I think this is actually pretty comprehensive."]
+[-1.2450056076049805, 0.8619649410247803, "Okay, great. So of all the lists, that of all the needs that are listed on this list, Please rank the top three that you feel are most important. Do you want any context, so why I think they're important here are to do that later. We can do that later. Okay. So I would say housing, disability. And emotional well being. Okay, gotcha. All right. So for each of these three categories, I'm going to ask you the same set of questions, right, and we're just gonna repeat them three times. So for the first item that you selected, which is housing, right. power wire, older adults struggling with"]
+[0.3280802369117737, -1.4088172912597656, "this issue. Yeah. So you know, most of the older adults we work with are no longer in the workforce are no longer able to be in the workforce. So they're very dependent on fixed income. A lot of them may not have had the economic well being to be able to plan for retirement effectively when they were younger. So a lot of the times they're entirely dependent on Social Security income, potentially supplemented by SSI or SSDI. Or you know, whether widows survivors benefits, but because they're on fixed income, a lot of the times they're not able to afford housing. In the current housing market, particularly with the low vacancy rates and consistently increasing rents we have, we also find that our older adults oftentimes don't have the kind of informal network that could support their housing. So you know, family or friends that people who are younger, may be able to rely on, we find that our older adults aren't as able to rely on those informal networks for housing."]
+[3.386652708053589, 9.038276672363281, "Yeah, yeah."]
+[0.9527577757835388, -1.2634416818618774, "So I mean, I think that the overall housing crisis is the main contributor. There's just not enough housing unit. It's out there, which drives down vacancy rates and continuously drives up rents. I do think that that results in some particular difficulties with people who are older, a lot of the times they had mobility issues, they require downstairs units, which oftentimes are priced higher than upstairs units. Sometimes they'll need ADA accessible units, which they have difficulty finding, if they are able to find or if they aren't able to find it, then they have to request reasonable modifications and are often in a situation where they have to pay for those Reasonable MODIFICATIONS themselves, which make it harder to access housing, they also have increased need for different social support. So you know, being able to access medical care nearby, being able to access something like a senior center nearby, or some kind of social support. And they oftentimes have mobility issues, being able to reach our transportation issues being able to reach those support, so they have to live nearby those supports, which further limits the housing stock that they could look at."]
+[3.6638846397399902, 15.541152000427246, "Yeah."]
+[0.105010487139225, -1.3860894441604614, "Um, yeah, I mean, that the data I've seen this couple years ago is that that elderly women are the fastest growing homeless population, a lot of the times they weren't in the formal labor market when they were younger. I've had lots of clients who are taking care of family members, for example, right. So they, they didn't have the, you know, opportunity to build up retirement or build up the kind of resume that they could utilize to find a job that can sustain them when they're older. So I think that, you know, older women face some particular barriers. Because of that. I think that disability is the other big one that we run into, like I mentioned, people will need reasonable modifications, or ADA accessible units, because of disabilities related to their age, and they have a harder time accessing units that meet those needs."]
+[0.42623263597488403, -3.7442734241485596, "Thank you. And what do you suggest is the best way to address the housing needs in Orange County for older adults."]
+[0.7614536285400391, -1.487899661064148, "I mean, ideally, like reducing barriers to building more housing and increasing the density of housing so that we increase the housing stock across the market to help try to drive up vacancy rates and drive down costs. You know, when vacancy rates are higher, landlords tend to be more lenient with the residents selection criteria, which makes it easier for seniors who may have more barriers to entry to be able to access some of those units. You know, for example, some of the seniors might have trouble looking up their credit, they may not fully understand how to develop their credit, they may not understand how to fill out online applications. So in a very tight rental market, all of those barriers they have are just amplified make it much harder. Sorry, I had something else with that too. Oh, just increasing the stock of housing that is suited to their particular needs related to their disabilities. So you know, increasing access to programs that could pay for reasonable modifications, having, you know, greater expectations across society, that units will be more accessible for people with disabilities would be helpful, I think as well."]
+[0.9056494832038879, -1.696152687072754, "Yeah, and then I think really trying to develop programs that work with our pop with the older population that's often on fixed income. So you know, a lot of rental subsidies right now are either like permanent rental subsidies, or they're like Rapid Rehousing where they're paying a significant portion of rent for either a limited period of time or forever, but having something like a flexible subsidy pool so that, you know, we could pay for $200 of rent $300 of rent for a variable amount of time, could really help push seniors on fixed income across the finish line and allow them to afford something like a room. Room rental or room and board. Yeah, yeah. Okay,"]
+[-1.8101718425750732, 0.7433608770370483, "so now we're gonna move on to your number two ranked item, which is disability. And I'm going to ask you the same questions with regards to disability."]
+[-1.7433912754058838, -0.9281796216964722, "Yeah, so I mean, as as people age, of course, they need greater access to health care services, to be able to address any disabilities they have. So have, you know, I think that a lot of people with disabilities may have trouble because of their disabilities adequately accessing the health care they need that would, in turn allow them to be able to access things like subsidies to pay for reasonable modifications, some of the durable medical equipment that would help them live independently. So I think that, you know, access to health care with their disabilities plays a component. I also think that, you know, what Colleen is helping with this a bit, you know, access to some of the kinds of intensive care needs, they have to live independently in the community aren't really fully built out. And to the degree they are built out, there's there seems to be consistent, like staffing issues, you know, with finding qualified caregivers. So a lot of people we have who may be struggling to experience cognitive decline, or may have like advanced mobility issues have trouble continuing to live independently in housing, because they have trouble accessing that kind of consistent care that they need. And then there's accessibility issues, I think, with housing subsidies in general. So, you know, while housing subsidies for people experiencing homelessness will take into account disability, a lot of the times to access the kind of permanent ongoing subsidies many of these people need, because of their fixed income and their disability status, they have to be what's considered chronically homeless to that who have been homeless for longer than a year for periods in the past three years to qualify for these subsidies. So we're putting these older adults in a situation where they have to experience something that is a traumatic and be, you know, further jeopardizes their health, to be able to access the subsidy they need to stay stably housed. So, you know, that presents an issue. I also think that a lot of the services we do, there's a kind of a cultural competency issue, right, where this is a particular population with particular needs, and particular cultural norms. And the workers who are dealing with them tend to be younger than they are right, people are still in the workforce, of course, right. So they may not fully understand the perspective that our older adults are coming from and how to suit some of their particular needs. Just because of the age gap there. Yeah,"]
+[0.7296557426452637, -1.7041255235671997, "You know, the there's one kind of particular thing that comes to mind to me, which is a lot of the housing choice vouchers, right, that are targeted towards people experiencing homelessness, who are disproportionately older adults, of course, are, you know, non non elderly, disabled vouchers, particularly the mainstream voucher program with HUD, and that has an age limitation where participants can't be over the age of 62 when they lease up. So it seems like one of these, one of the key resources in the community that really allows people to have a choice of where they're going to live with this subsidy, excludes people who are elderly. You know, that may offend to try to prevent cherry picking and targeting these subsidies only to older adults. But I have worked with a lot of clients who are missing out on subsidies that would be able to resolve their their housing instability, specifically because of their age."]
+[5.3751020431518555, 6.323294639587402, "Wow, I didn't know that. So that's crazy."]
+[-0.5911981463432312, -1.7547249794006348, "Um, yeah, I mean, gender and race come to mind for me that you there's of course, an intersection there. And those vulnerabilities tend to compound each other. Right. So, you know, having that lack of cultural competency for the older population, that just adds on to not having the cultural competency for for, you know, gender affirming care or for care that is affirming if somebody's you know, racial or ethnic identity. So, I think that the older adults who also fall into some of these more marginalized groups are just even more vulnerable. goal."]
+[-0.7504398226737976, -2.0809133052825928, "Yeah. So, you know, I think that nonprofits and other providers integrating health care services into what they do is a key component, right. So instead of just offering housing, offering resources that could connect to health care, and just having institutional knowledge on how to navigate the healthcare system, can help ensure that there's equitable access for older adults with disabilities in really any of the programs that are designed to suit their needs, and I think that there is a lot of integration missing there, particularly with with homeless services. So yeah, healthcare access. I think that kind of in alignment with the cultural competency component, there's not really like peer mentors that are specifically geared towards the older population. And there's not really trainings on how to address some of the particular needs of this population. You know, for example, our work at a nonprofit, maybe we would like an advisory group made up of older adults, but looking at ways to kind of increase the cultural competency and understand some of their self stated needs."]
+[3.0226199626922607, 5.146544456481934, "Yep, yep. Okay, so I'm gonna go now to your third item, which is emotional well being."]
+[0.17263644933700562, -1.7286566495895386, "Yeah, so, you know, I think the older adults we work with, you know, they're at a different phase in their life and, and the social supports, they need differ than a lot of the social supports, we tend to think of as as normal or tend to offer in society, right. So we'll actually have, I've had a surprising number of people come to us or recuperative Karason shelters, and they get very comfortable with the social element that's there, right getting to know all the other people kind of having people who are continuously checking in on them and seeing how they're doing. And when they make that transition to housing, it can be difficult from them, because they're losing a lot of that support that they previously had. And they have trouble knowing where to go to find replacements for that. So I think that social isolation is huge, we do try to address that with the senior micro communities where we're leasing out individual rooms, and we try to create a community out of that single family residential house that each person rented a room is tapped, so that the people there try to rely on each other a bit more for some of that, that social interaction and for some of that understanding, by living with people who are going through, you know, are in a similar situation or from a similar background. So I think the loneliness is huge. And I think that that is just really highlighted by the recent Surgeon General Report on loneliness, if you saw that, some of the negative health outcomes that come from that, you know, and that then, like I said, I think that transportation and technology understanding play key roles in that to where, you know, when our seniors move into housing, they a may not be able to get the different resources that they want to access or be, may not understand how to go about finding those resources for themselves. So they're really dependent on having somebody help them navigate the kind of the social safety net and find things like senior centers for that or volunteer opportunities. Okay."]
+[-1.3483784198760986, -2.23751163482666, "Yeah, so I brought up you know, technology, literacy, transportation is key issues there. I think the cultural competency plays into this as well where you know, we have case managers and the case managers have particular services, they tend to zero in on right, and those may not be suited to the older adults specific needs, you know, they're going to kind of jump to the general populations needs. So, you know, they may not understand specifically that are seniors have a greater need for for services that could help with emotional well being than some of our other clients. So they're less likely to identify that and care plans or to notice that when they're doing assessments with clients, and to try to direct the client towards resources that can help with that. I do think that the seniors tend to be more isolated from some of the social networks that we tend to take for granted. So like friends, family, co workers, have tend to have less access to those than people who are younger. So they, you know, are that they don't have the usual supports to to rely on. So they're, they're much more dependent on what the the community can offer in a more structured way through things like senior centers, that kind of stuff."]
+[-0.33739376068115234, -0.7730770111083984, "Yes, I think there's once again, a cultural competency thing where people are part of multiple, you know, disadvantaged groups that, you know, it makes it even harder for them to connect with people who have a similar understanding and similar background to them. So I do think those tend to compound each other. You know, I think that people who are economically disadvantaged or have transportation issues have greater trouble accessing these resources. So that kind of subgroup as well. Okay."]
+[-1.3717663288116455, -2.163154363632202, "Yeah, so, you know, I think that a lot of assessment tools that we tend to use don't do a great job of identifying how lonely somebody feels, or the level of social isolation they're subjected to. So I think changing how we assess client needs as a system can help to better include that emotional well being. I also think that we could do a better job of connecting people to some of those social networks that they may have, may be disconnected to so things like family and friends, we I don't think we do a great job of reconnecting people to that and trying to nurture those relationships. Because I do think that the older adults face greater barriers and maintaining those relationships as well. So they need additional support and help with nurturing those relationships. And then I think that our communities are really structured in Orange County, for allowing that kind of organic social interaction. So it's very, you know, you're very dependent on getting in your car driving to somewhere to go to go do something. But it's, it's much harder to be able to take the bus when the buses aren't coming super often, you have to take five different connections. Sometimes it can be hard for people to qualify for OSI access to get a bus that will come pick them up. So I think kind of how spread out things are creates difficulties as well. And then I think that with this population, that outreach to them for these resources needs to be done differently than it is with the general population because of some of the issues with technological literacy. So there needs to be a lot more direct person to person outreach with older adults, I think to let them know about the different resources that are available to them. And I think ideally, there needs to be kind of a peer mentor element to that as well. You know, talking to people who have come from a similar background, and are have experience accessing those services that deal with emotional well being helped convince them that those are, you know, safe places for them to go that will help them fill that need for emotional well being. Yeah, yeah."]
+[-1.2193118333816528, -4.077849388122559, "Okay, so we're gonna move away from this list. I'm going to stop sharing that. And I'll just ask you some general questions about care and access to care. And then we'll go into your specific area of expertise. And talk about that. And then we'll shortly after that, and the interview. So I'll start by asking you if you can, please describe how accessible and adequate the falling care services are in Orange County, so geriatric care"]
+[0.7299119234085083, 3.615201950073242, "not nearly as six So I suppose it's very difficult."]
+[3.811415910720825, 15.421038627624512, "Yeah."]
+[-1.189411997795105, -0.8763625621795654, "Yeah, because, you know, most of the geriatric care needs that we deal with are people who have substantive enough cognitive denied to look to claim that they really need like memory care assisted living. And being able to access assisted livings that are specifically suited to their needs are, we find this difficult because it, it tends to be pretty expensive. So for somebody on Medicaid or Medicare to be able to, to afford that, and also on fixed income is, is quite difficult. I find that like I HSS. And caregiving can be difficult, in particular with our population, because they're transitioning from homelessness into housing and for HSS. Part of it is a social worker assessment that's done in the home. So we need to get the person in housing, right. But to be able to maintain that housing, they need the HSS. But to get the HSS, they need to be in the housing and have the assessment done. So there's like a gap in care there. That has been addressed a bit with Colleen recently, there's a service called homemakers, which is supposed to be like an interim service. With while people are getting set up with IHSS. But we don't have a ton of experience connecting people to that to that yet. And when we talk to the providers, they have difficulty staffing up and being able to hire enough people to provide the service. So yeah, so institutional settings are difficult to access the homecare can there are some barriers there as people are starting to get access to that. I do think there is a bit of a quality control issue with IHSS as well. So the older adult chooses their IHSS worker, which is great, they should have that choice, right. But if the worker they choose isn't providing services that are adequate to their needs, I think it's kind of difficult for them to identify that. And, you know, report it and get the assistance they need and finding somebody who will help them to the degree that they need. So I think there's a little bit of a quality issue there. As far as other geriatric care, we're pretty lucky as far as health care goes, because we have nursing students that come through our senior micro community so that we find that we don't have too much difficulty being able to identify a client's health needs and get them connected to the appropriate health care services for them. That seems to be going pretty well for us right now. Trying to think other geriatric services. Yeah, well,"]
+[-3.2030134201049805, -0.45012912154197693, "I think, you know, for most, most people who are not dealing with the population you're dealing with specifically, you know, geriatric care seems to be almost a luxury, because most people just have a doctor or an internist. So it feels like it's one of those. It's a luxury to have, if you if you can find a geriatric geriatrician to take care of you or your"]
+[-0.9002346396446228, -1.644304633140564, "loved one. Yeah, yeah. And that was, yeah, any kind of specialist Charisse is, can be, you know, we find that we, you know, we can get the referrals done, but the getting the appointment set up, it can take months, you know, so that's definitely a barrier that we noticed, we are, we did end up having to create our own medical group, the illumination foundation Medical Group for primary care that's kind of more suited to our client's specific needs. So it's more geared towards the people experiencing homelessness. But you know, by extension, some of the specific needs of older adults, for example, they've started doing some in home visits with our senior micro communities so that the seniors aren't having to leave their home to access the medical care. So we're trying to bring it to them more and more to suit that need. But we've definitely had to build out infrastructure to try to fill some of those gaps of bringing the health care directly to them."]
+[-2.757803440093994, 0.21227869391441345, "Yeah, Yeah, there's something else called Long Term Care. Are you familiar with long term care, it's just the care that somebody receives throughout their lifetime as their aging and includes a combination of both medical and non medical care services. So it's usually case management where they follow the older adult, you know, through a variety of different challenges, not just health related."]
+[-0.8414018750190735, -1.9090169668197632, "Um, yeah, I mean, I think it would be great for programs to be funded. So that case managers have lower case loads. So we find a lot of the times the frontline staff that are interacting with our client consistently, like, at least once a week are case managers. So they're their best position to know the client understand what their needs are, and to address those in a timely basis. And the case labs tend to be a little high to kind of really provide some of the personalized care that they need, I think, and also, just from, from our perspective of our agency, we're a homeless services agency. So as we approach the services we're providing we're primarily approaching it from, you know, homeless services perspective, as opposed to, and like Aging in Place perspective, you know, or, or kind of understanding the specific needs of the older adult population. So there is that kind of cultural competency issue where we just were looking for the issues that people experiencing homelessness space, as opposed to the issues that older adults face."]
+[-2.216754198074341, 0.9749241471290588, "Understood, understood. What about mental and behavioral health and substance use treatment is, are those services accessible and adequate in your opinion."]
+[-2.033071994781494, -1.5118882656097412, "So that's another one that we tend to offer in house, our Medical Group has therapy and psychiatry, and then we hire substance use counselors across our various programs in house so that we're able to provide, you know, at least from a, you know, I'd say it's not like super intensive outpatient, but for kind of a lighter touch outpatient, we provide that for substance use to for our services, they tend to be pretty accessible, I will say on the behavioral health side that hiring therapists and other clinicians has been incredibly difficult. The pay that we can offer just isn't super competitive in the marketplace right now. And then also, it's working with this population, it's a lot of hands on interaction with people out in the field, and a lot of the therapists that we've tried to recruit seem to be more interested in telehealth just from their career goals right now, which doesn't quite suit the needs of the older adult population in some circumstances, I think. So I do think that behavioral health has been a little bit difficult. You know, I think that's kind of compounded to, you know, I'm not a clinician, but I think that, you know, being able to provide adequate clinical services to differentiate between what might be cognitive decline, and what might be an actual mental illness is a little bit difficult. And then I think with substance use, it's just overwhelmingly the perception is that the population of people with substance use disorder tend to be younger. So a lot of the population working, or a lot of the workers working with that population tend to be younger. A lot of the services tend to be geared towards people who are younger. So I don't think that there is a lot of focus on older adults, in particular with substance use, but I don't think that I've run into any, like particular barriers for somebody who is an older adult acting, accessing substance use beyond, you know, the the issues of technological literacy and transportation that we're talking about. Yes, yeah. And then"]
+[-0.3295857906341553, 0.5474874377250671, "lastly, human and social services."]
+[-0.8625921607017517, -2.1215975284576416, "not adequate, not as adequate as they could be. I think so. You know, with food access. Once again, I think CalAim has helped a little bit with that where there is medically tailored meals now so they can get referred through their insurance to have a nutritionist, consult with them, see what their dietary needs are, and then give them meals at least for 12 weeks potentially longer, that are specifically suited to their dietary needs. Beyond that, though, I think a lot of food assistance as far as accessing things like Food Banks, you know, more traditional food assistance isn't very well geared towards the older population, because it doesn't take into account some of their specific dietary needs. And also doesn't take into account some of the difficulties they may experience with food preparation. So I do see that a bit. As far as some of those other human or social services, I think there's a gap for kind of life skills to where, you know, some of those skills that would really help people be able to function independently, and the community without the level of assistance that they may initially need aren't available. Like we're not, we're not teaching people what they need to do to live independently in the community for as long as possible. So a lot of the times people just get referred when they're in crisis and those services directly provided for them. Housing, I think, is very difficult to a lot of so you know, a lot of low income housing is funded through low income housing tax credits, right. So it's divided into extremely low income, very low income and low income, which is pegged to the area median income. But when the area median income is $90,000, and your senior is making, you know, $12,000 a year, the affordable housing that's designed for somebody who's extremely low income at 30% of that $90,000 Ami, that it's still designed for somebody who's making $30,000 a year, not somebody who's making $12,000 a year, you know, so a lot of like low income housing, I don't think is suited to this particular particular populations needs. And then there's just, you know, so much so many gaps in affordable housing in general right now that it's, it's difficult for them to access it."]
+[3.430402994155884, 9.07768440246582, "Yeah, yeah."]
+[0.3442283868789673, -0.9857169985771179, "I think it has to do with the economic well being and housing where, you know, the vulnerability of Social Security, and its failure to keep up with rising cost of living is just going to mean that their incomes lag further and further behind. Yeah, exactly. So, you know, I think that I primarily worry about the income that they need to survive just kind of lagging further and further behind what's needed to really survive in society, particularly in Southern California, where everything's just so expensive."]
+[-1.3336485624313354, -2.1097192764282227, "I think probably seniors who need some kind of ongoing institutional care but have difficulty accessing yet because, you know, by definition, they're, they have difficulty handling some of their activities of daily living. And that makes it so difficult to be able to try to navigate those resources by yourself, particularly when there's a shortage of those resources, or they're priced out of a lot of those resources. So I think that population of people who really need institutional care and have trouble accessing it, they're kind of stuck in a situation where they're waiting until they end up in the hospital or there's APS report. And even we find if there's an APS report, a lot of the times there's not much APS is really able to do."]
+[-2.2108302116394043, -2.3815793991088867, "Yep, yeah. So now thinking about all the issues facing older adults, not just the population user, what issue is being overlooked,"]
+[2.247246742248535, 2.883899450302124, "overlooked the most."]
+[-1.347801923751831, -1.6912349462509155, "I really think that the social isolation of those independent living skills, those things that really empower people to live fulfilling lives in the community, as you know, normal non No, non older people would get out. Or missing. So, you know, a lot of the resources are crisis resources, right. So we're waiting until peep somebody's in a crisis to help them and that that kind of early intervention that allow people to function as they want to, I think could be difficult to access, but I could be a little bit biased there because I'm specifically dealing with people who are in crisis."]
+[3.711761951446533, 15.52142333984375, "Yeah."]
+[-0.1779693067073822, -1.9318257570266724, "I think that the I mean, I have a pretty expansive view of it, but just kind of personal. But, you know, I think that government should be there to ensure a certain level of social wellbeing, right social and economic well being. That there, there's a standard that everybody kind of has in their head may expect for, you know, if they do everything, right, and society, this is, this is the deal, this is what I'm going to get right. And I don't think that our society really adequately provides that for a lot of people. And that, you know, government should step into ensure that that that social and economic standard is maintained for everybody."]
+[2.683347463607788, 4.600149154663086, "Okay, so now drilling into your specific area of work and expertise."]
+[-0.6614214181900024, -2.1211764812469482, "You know, for for the particular nonprofit, I work out, I think there's a great integration healthcare services into the housing, which helps address some of the older adults needs in a way that didn't really exist five or 10 years ago, you know. So I think that that is, is working well. And I think that a lot of the expansions at the state level, are going to have disproportionate benefits for people who are older adults, like just, you know, the Medicaid expansions, the all the expansions of the lieu of services with medical services are, I think, disproportionately benefit people who are older adults, which is good. So I think that is working well."]
+[1.2767146825790405, -1.3543111085891724, "You know, I think if somebody gets connected to a housing resource right now, particularly if it's a permanent housing subsidy, right, then it could suit their needs. Well, as also, I just don't think we're doing a good job at offering that at the scale that's needed. But like, if you access a housing subsidy through your your public housing authority, I do find it tends to be adequate for their needs, which is good."]
+[-1.1229900121688843, -0.8501073718070984, "I higher level of care is the thing that always comes to mind. So they, you know, are the only thing they're going to be able to access to some form of fixed income and being able to access you know, social security, SSI SSDI, we find could be a time consuming multi month process. And then they're going to need an assisted living waiver on top of that, which is another six month process while they're working on their own. And then once they have their assisted living waiver and their income, if it's social security, or SSI, SSDI, they need to get the amount increased oftentimes to be able to pay for the rent, because the assisted living waiver, it's only playing paying for the clinical services, wherever they end up that. So we find that getting people to that higher level of care can be an almost year long process sometimes. Meanwhile, by definition, these people can't handle their activities of daily living. And then also, we find that the number of assisted livings that will take assisted living waivers is pretty limited. And then, you know, it's some of them aren't places I would want to send my Grandma, I'll say like, they're, they're having to provide a lot of services for very little cost because they don't have much money coming again. But I'm very sensitive to but you know, I do think the older adults deserve more. So I think higher level of care is, is has been a huge barrier."]
+[5.19688606262207, 6.1599884033203125, "Yeah. Well, that's great. Thank you so much for your time today."]
+[1.4038132429122925, 1.2813358306884766, "Yeah, they're gonna do a focus group for us as well. So, um, you know, it's that's a great suggestion."]
+[1.7846444845199585, 8.112104415893555, "So,"]
+[4.604097366333008, 3.1701467037200928, "I just did, Lisa today, so Okay, yeah, yeah, yeah, that's great. Well, if you can think of anyone else, even after our call, just, you know, ping me and we'll, we'll figure that out. And we'll add them to the list. This is a year long assessment. So there's so many different components to this, starting with the stakeholder interviews, and then we're going to do a bunch of surveys and such. So if anytime you have another thought, or you know, you want to re engage for some reason, please feel free to reach out. Okay. Well, thank you. So this concludes our interview officially, thank you so much for your time. You know, it's been super helpful to look at this issue through your lens specifically. So once again, thank you."]
+[4.318746566772461, 4.198031425476074, "Yes, thank you so much for taking the time to talk to me and for your interest in what we have to contribute to this."]
+[1.306078314781189, 1.419063925743103, "Yeah. And thank you for your work for the community. It's really just an incredible service you guys offer and so needed and I'm sure everyday you walk it through the doors and see a longer line of people in need. Yeah, it takes a it takes a big heart to keep, you know, showing up."]
+[5.412899017333984, 6.914880752563477, "Well, thank you. I appreciate that. Yeah, yeah."]
+[4.62738037109375, 5.676059246063232, "Okay. Take care."]
+[4.8542609214782715, 4.861266613006592, "You too. Have a good day."]
+[10.671324729919434, 8.351469039916992, "Thank you so."]
+[-2.678921937942505, -3.1603944301605225, "So the primary goal today is to identify what the needs, what do you think are most important to the older adults population that you serve, which are those like all over almost 60 years and older. So we want you to think as broadly as possible,"]
+[-2.6831517219543457, -2.906771659851074, "thinking into thinking into consideration. Older adults, caregivers, also families and communities. So I'm going to share my screen so you can see some common issues and concerns, like older adults. And let me share my screen real quick. Just"]
+[3.818235397338867, 6.94450569152832, "Oh, there we go."]
+[3.725351333618164, 4.637871265411377, "Yes. So take a few minutes, go over the list. And let me know when you are done. So the questions that will follow will be based on this table."]
+[4.514097690582275, 7.867415904998779, "Okay, so you want me to tell you which"]
+[-2.8341126441955566, -2.742607831954956, "adults will be subjected to. Not right now, like right now just go over the list. And let me know if there's anything that is missing from the list, okay."]
+[2.2638823986053467, 4.817249774932861, "So a major thing that I don't really see here is"]
+[2.0268261432647705, -1.9104318618774414, "extreme heat. And being that we're a climate nonprofit, is something we think about a lot, one of the major impacts is going to be felt in Orange County."]
+[2.1015090942382812, -1.6611171960830688, "last summer or the summer before in, like Seattle, and the Pacific Northwest where the extreme, they experienced, like unprecedented heat."]
+[0.09872788190841675, -4.791476249694824, "who are sometimes the elderly. And actually, a UC Davis study in 2021, that used satellite data found that metro areas have a greater temperature disparity between their poorest and wealthiest neighborhoods than any other state in the United States, in California, and so, you know, many of the low income communities and disadvantaged communities in Orange County"]
+[1.5954797267913818, -1.2601871490478516, "poor and there are a lot of folks who don't have access to air conditioning. That's what it is. And then also what we know is that"]
+[2.0159730911254883, -1.5164374113082886, "and 14%. So we're going to see really exacerbated heat impacts in those areas. And that'll be something that'll really impact older folks at home without access to air conditioning."]
+[5.3355231285095215, 6.418673038482666, "Thank you. Okay. So and then I could add,"]
+[1.964835524559021, -1.5997803211212158, "I Okay, here we have, okay, you do have respiratory conditions on here. But I would add that something else we work on is gas exposure and indoor air pollution. And we know that three quarters of the emissions from a gas stove occurs while the stove is off. And for children, a child in a home with a gas stove has a 42% higher chance of having asthma than a child in a home with an electric stove. And so you could sort of extrapolate, you know, for respiratory health and asthma conditions for the elderly. You know, they're subject to those same pollutants, benzene and formaldehyde, and NOx emissions, which are really harmful to respiratory health, that are in that, that are produced Nox, when when gases burned indoors, and we know that in low income homes,"]
+[2.0311460494995117, -1.5547266006469727, "there's often inadequate ventilation when people are using these appliances in their most used living spaces. And so and then, in these also, in these vulnerable communities and vulnerable families and individuals living in these conditions, they're already living in environmental justice communities with more pollution, and more heat, and then they're having this indoor exposure at a time when they're going to be needing to stay indoors. Right. So, so yeah, the air conditioning thing, and then the fact that, like, first, some people talk about the solution for heat being like cooling centers, but it's just not sustainable to expect people for weeks at a time to like leave their homes, or months, we're going to have like the heat event that we had last summer here in Orange County that lasted like maybe a week or two where it was incredibly hot, and like you couldn't go outside temperatures of above 100. What the scientists say is we're going to have those events are going to last for months,"]
+[1.9761327505111694, -1.5007030963897705, "in the coming years, so we need people to have access to air conditioning at home. And there are there are other policy issues in place that prevent that, unfortunately, especially in affordable housing, which is something that we're working on. But that is a major concern."]
+[5.445377826690674, 6.354250907897949, "Thank you so much. Yeah, so I am."]
+[-0.6420067548751831, -3.104684829711914, "My title is actually director of policy for Orange County for climate action campaign. We are a nonprofit climate policy watchdog. And we build we advocate and organize, to win policies that meet the scale of the climate crisis. And in terms of how we engage with the elderly, we don't necessarily engage directly with the elderly as like end users. We more we focus on policy change, and building sufficient political will to facilitate that change. A lot of times the folks that we volunteers that we work with happen to be older. But I think that's just because they're retired and have time to work on these issues. But we don't usually talk about the, you know, their particular health issues. We are not like a service provider in that way. We provide policy advocacy and like developing an understanding of these issues so that folks can advocate and use their, their latent sort of political and, you know, advocacy powers to to win policy change."]
+[0.11853588372468948, -3.9848697185516357, "Great, thank you so much. So thinking about the Orange County and looking at the list of common issues, like at the table, and including the one that you are in,"]
+[3.514350175857544, 8.899698257446289, "Yes, yeah."]
+[1.9223377704620361, -1.8748506307601929, "Older adults, I would say number one would be access to cooling, access to air conditioning. And then I would say, I didn't even talk about transportation and mobility maybe second would be respiratory conditions by way of our indoor air pollution, infrastructure. And then maybe third would be Oh, we also have of course, you have on here environmental concerns drought, wildfires emergency preparedness. Yeah, you're gonna have, like emergency preparedness, we're gonna have an evacuation problem with elderly adults needing to get out of their homes that ties in with the transportation and mobility problem. We have cities continuing to build sprawl, housing, in fire, you know, wildfire, extreme wildfire risk zones, certainly in Orange County, and as you look, north, Yorba Linda Brea all those areas. Like, what is the plan there cities also don't have climate action plans. Not a single Orange County city has a climate action plan that protects its residents from climate impacts. And none of them meet California climate goals. And none of them has a adaptation policy that provides for things like evacuation. So we're gonna have these incredibly, you know, hot, fast moving wildfires with people living in housing and wildfire zones and No, no evacuation measures. And yeah, we're not going to have transportation folks will have to be able to use cars. They'll have to be able to drive their car, they have to hope that they have access on the road. So So yeah, I don't know."]
+[-1.495760440826416, 1.3109380006790161, "um, yes, the number one was access to Cooling. Ah, and the third one is environmental concerns. Yeah, I guess. So."]
+[1.5109277963638306, 8.797333717346191, "And sort of that"]
+[0.5750214457511902, 1.1807889938354492, "or I probably say, transportation."]
+[0.5632564425468445, 1.240470051765442, "mobility."]
+[-2.7161993980407715, -2.8015167713165283, "So, I will ask you for the next questions. I will ask for each of the concern the issues that you mentioned the top three. So I will ask you for those following questions. So how and why are older adults are struggling with access to cooling."]
+[3.6468327045440674, 10.99329662322998, "Um,"]
+[1.9411884546279907, -1.6611610651016235, "because many Orange County neighborhoods like low climate impacts are increasing. So it didn't used to get as hot as it does. Now. Basically, it's getting hotter. And so their homes are built without air conditioning. And the addition of an air conditioning unit represents a rather large one time expense, and that can be hard to manage and plan for and pay for. So folks ended up not having it and then in terms of affordable housing. Actually, there's an issue with the public housing authorities in the county that do not. Let's see, they public housing authorities have these policies called utility allowances, which are a rather obscure, but they basically set the amount of utility like the assumption the assumed amount that a family is going to pay for utilities in their in this is unregulated affordable housing. And that amount is, is added to the net rent to equal the gross rent or sort of subtracted from the gross rent equal the amount that the tenant pays to the landlord. And currently, those policies to not incentivize building owners to install energy efficient heat pumps, which are much more efficient than air conditioning units, and so operate at a much lower cost. And so that means that a family or an elderly person living in an affordable housing units, for one thing may not be able to afford to run their air conditioning unit because we know electricity prices are increasing, SCE plans to increase rates another 45% Between now and 2030. And electricity prices are already not affordable for many families. And so you'll have them not wanting to use their air conditioning because of the cost of it. And then with this utility allowance issue, there's no pathway for them to"]
+[1.8380824327468872, -1.0915793180465698, "there is there's no way for the building owner, the building owner is disincentivized from improving the situation, so the situation doesn't change. So that adds to the problem. That answer your question. I guess the"]
+[2.829470634460449, 6.11160135269165, "you might have answered this."]
+[2.0331871509552, -1.660461664199829, "Yeah, so it would be, yeah, it would be cost and then like that our climate used to be, it didn't used to get as hot. That's all. And so we have a lot of housing most of the housing in Orange County, which was built, like before the 70s, I believe. And so in a time when we didn't need as much cooling. So that's and then adding cooling is expensive. And then we have this"]
+[0.9236683249473572, 0.6048101186752319, "cost issue."]
+[3.7303390502929688, 15.036609649658203, "Definitely."]
+[0.8629897832870483, -0.29015541076660156, "So where communities who have experienced historically and continue to experience oppression,"]
+[10.656365394592285, 8.44135570526123, "Thank you."]
+[1.0845558643341064, 5.592623710632324, "Well, for"]
+[1.9088165760040283, -1.8044756650924683, "one thing, City's public housing authorities in Orange County could adopt energy efficient utility allowances, which is something that many other housing authorities in the state have done. And that basically incentivizes the building owners to install"]
+[1.7475258111953735, -1.2398487329483032, "heat pumps. And so they operate at lower costs for the tenants. And they allow the building owner to keep the housing affordable. And this would also support the supply of affordable housing. This is something we mentioned the Board of Supervisors just this week, we've been advocating around this, and we had some advocates ask for it. We have not gotten support for that from the Board of Supervisors. It would be amazing if if advance OC could help with that."]
+[1.2634010314941406, -1.9894074201583862, "to cities, and actually cities can join."]
+[1.991754174232483, -1.8080567121505737, "There's the Orange County Power Authority, Community Choice energy programs provide a pathway for cities to provide funding for these for these sorts of programs like local distributed energy resources. And so that's why we worked for five years to, to bring the first Community Choice energy program to Orange County. And so it's it's had a lot of issues and its initial years, but we've seen some important reforms there recently. And so when we can grow that agency, it will enable, it will, it will provide additional resources, basically, for cities to be able to afford these local resilient energy resources like batteries and local solar and local wind power and other things to make sure that folks can keep keep the lights on keep their refrigerators on importantly, like you think about the elderly and medications that need to be stored. So yeah, that would be, that'd be another one."]
+[-2.7172863483428955, -1.7320231199264526, "Thank you so much for your answer. Now, I'm gonna go ahead and ask you the same questions for the second issue that you mentioned. So how and why older adults is struggling with respiratory conditions."]
+[3.723886489868164, 7.871298789978027, "Right, so"]
+[1.8364007472991943, -1.869484782218933, "let's see, exposure to indoor gas pollution is the highest for our most affordable, most vulnerable families in Orange County, who, like I said, are already disproportionately burdened with pollution from other sources. And they're also living in communities in smaller homes with less ventilation."]
+[2.0051708221435547, -1.6412614583969116, "And so we know that exposure to this gas appliance pollution is connected to a wide variety of acute and chronic negative health, negative health outcomes, and those include respiratory disease, and cardiovascular disease, et cetera. And we know that a leading source of indoor air pollution is gas stoves and new research from Stanford University last year found that gas stoves leak methane and other pollution into our most used living spaces around the clock because of leaky gas fittings, and stove connections and inland in house gas lines. And actually, in some cases, families experience more pollution from their stoves than the than the highways that they live next to. And the pollution levels caused by these gas stoves would in many cases be illegal if they occurred outside the home. But EPA rules don't apply to indoor air quality. And so it's perfectly legal for that pollution to occur inside the home. So the solution for that is to facilitate this switch to modern electric equipment, which is electric cooktops, especially induction cooktops, which are amazing."]
+[2.019571304321289, -1.6053506135940552, "But they, they do not create waste heat in the home. So no, no, heat escaped from them when you're cooking, are radically less than with a gas stove. And they eliminate that leading source of indoor air pollution. And they bring tremendous other climate and health benefits, particularly to those who need those benefits the most."]
+[-0.7624306082725525, 2.334233283996582, "Thank you so much. So what barriers is see some see any improvements"]
+[2.307359457015991, 9.506376266479492, "Yes,"]
+[3.298499584197998, 6.501333236694336, "let's say that when again,"]
+[2.0096306800842285, -1.7950177192687988, "Oh, my goodness, well, one of the biggest obstacles is the fact that in Orange County were served by the largest for profit gas only utility in the United States, which is called SoCal Gas. And they have a whole army of lobbyists on the ground that are working constantly to keep Orange County addicted to gas, basically. And so we battle with them. At every turn, they're always engaged with local electeds trying to sell them, you know, on continuing use of gas even though we know that it's not consistent with climate goals and not consistent with health goals. So that is perhaps one of maybe the biggest. And then but barring that, really it would be much easier. And we do have, like the inflation Reduction Act federal bill that was adopted by Congress and the President last year that is going to incentivize people to make these changes but but yeah, SoCal Gas is always pushing back in the other direction on that."]
+[2.155961513519287, -1.6224493980407715, "Which I should say also adds to all the heat impacts right and"]
+[2.0321969985961914, -1.7195154428482056, "Because IPCC says that eliminating methane, which is 95% of what comes out of a gas stove is critical to staying within this band of warming that we've always humans have enjoyed since the dawn of humanity, and that we are in the final years for, for avoiding the worst climate impacts. So the actions that we take now are extremely important. And yeah, so the IPCC has said we need to reduce methane pollution 30% below 2019 levels by 2030. So, which is like that goal gets further and further out of reach all the time, it feels like and it's always SoCal gas that is pushing back"]
+[3.0422701835632324, 8.441333770751953, "Yeah, definitely. Because"]
+[1.4042237997055054, -1.1827870607376099, "And they're likely to have more people in the home and live in a smaller home where their exposure will be greater."]
+[1.7373969554901123, -0.560011088848114, "Yeah, thank you so much. Well, city should adopt"]
+[1.808150053024292, -1.619844675064087, "reach codes that require that buildings have all electric stoves and other appliances. And this has been done by more than 100 jurisdictions in the US more than 75 here in California. SoCal Gas recently had a win at the in the Ninth Circuit Court of Appeals, where they got two Trump appointed judges to find that the city of Berkeley's ban on gas appliances could not be enforced. But we don't think that's on very strong shaky ground on strong legal ground. And we know that reach codes are still very much within are feasible for cities. So cities can still implement a building reach code, that's that applies to buildings within the city and requiring requiring developers in the city to to build all electric and then requiring retrofits of existing buildings with a focus on putting resources into retrofitting affordable housing or say, senior housing to protect folks who live in those homes. But it requires a whole, like, cities need to adopt plans to do this."]
+[6.990890026092529, 6.232063293457031, "It doesn't happen by itself. Thank you so much. Now I'm going to move on to the next issue they mentioned. I would"]
+[2.0333569049835205, -1.7054028511047363, "say it's because wildfires are more frequent and bigger and hotter. Is that was the question."]
+[1.5076076984405518, -1.8131585121154785, "Okay. Yeah, well, if they live alone, then they it might be extra challenging for them to, to evacuate, maybe they're, they require certain medical equipment that they have to be able to transport with them that might be difficult, they might have limited mobility and difficulty, you know, packing up their personal belongings and getting out quickly. If there is a fire coming. They may not be familiar with technologies, like you know, cell phones and certain apps that might alert some people. But, you know, older folks might be left without that information. When it comes time to evacuate, and then because of their you know, others ties into the respiratory health issues. But a fire, you know, will exacerbate their, you know, any respiratory issues and breathing and so might make it more difficult for them to function in those circumstances. When it comes time"]
+[-0.7834272384643555, 2.350379228591919, "Thank you and what barriers to seeing improvement in this area. Environmental concerns, barriers to improvement."]
+[3.634855031967163, 10.958253860473633, "Mm"]
+[1.208845853805542, -1.599963903427124, "hmm. Well, we have the fact that cities are not planning for the circumstances in large part, and cities continue to build in wildfire zones, build housing. I'm not sure how much of it is senior housing in particular. But surely there are elderly people who probably live in those areas."]
+[-1.530181884765625, 1.3726832866668701, "So yeah, I would say both of those things contribute"]
+[-3.4246325492858887, -1.7272520065307617, "your and other different services for different groups of older adults for different backgrounds."]
+[2.2098634243011475, -1.5673285722732544, "concerning this, about regarding this environmental concerns."]
+[0.3898487985134125, 0.13259997963905334, "Yes, because people again, with greater wealth will have more resources to to cope with the problem when it comes and they'll have more, they'll have better help around, they will have maybe less isolated. And they will have better access to technology."]
+[-0.6507188081741333, 0.67723548412323, "And, yeah, that would be all those things would contribute."]
+[1.904069185256958, -1.7752302885055542, "Well cities should make plans for how they're going to"]
+[2.125087261199951, -1.838712215423584, "And that should be part of a comprehensive plan that that plans for all impacts in a city, which would be a Climate Action Plan."]
+[2.1236672401428223, -1.8702013492584229, "And that should have, you know, evacuation routes and other emergency preparedness measures. Access to water, to ensure that, you know, like firefighters have the water resources they need and the time comes. species selection, actually of trees will be important. So to reduce flammable material around homes, we know that some trees are much more flammable than others. And that can be something that is part of a Climate Action Plan. Again, something that Orange County cities, the vast majority do not have right now at least well, there are six cities in Orange County that have climate action plans. And they're, of course, 34. Cities include the county and we have 35 jurisdictions. So a very small percentage that has a Climate Action Plan, and most of them don't, don't plan for those impacts."]
+[5.616006851196289, 5.969184875488281, "Thank you so much."]
+[3.8349461555480957, 4.514992713928223, "That's all for the questions regarding this table. So I'm going to stop sharing my screen."]
+[-3.0670788288116455, -0.08575458824634552, "Thank you so much for sharing. So now move on to the next question. So the first one is geriatric care how accessible and how often would you think that services"]
+[0.9698762893676758, 2.477973222732544, "accessible and"]
+[2.657618522644043, 5.586806297302246, "I'm sorry, I don't really have an answer on that. It's not my area of expertise."]
+[1.0036848783493042, 2.498487710952759, "How accessible and adequate are"]
+[-0.2972358167171478, -0.23905117809772491, "I am just very little bit that I know of friends who have tried to identify these resources seems like not very accessible. It has a cost. And that folks are I know people who keep have to keep parents out of state basically, because they can't afford to keep them"]
+[0.744870662689209, 0.9964497089385986, "locally or have to move."]
+[7.1752400398254395, 4.64732027053833, "Thank you for sharing."]
+[1.7317112684249878, 8.087019920349121, "So"]
+[1.1964986324310303, 2.936262845993042, "to say that probably, and probably inadequate."]
+[1.0450880527496338, 1.9309817552566528, "I don't know. How accessible and adequate using those services are"]
+[1.3416935205459595, 3.1864469051361084, "I think they're pretty inadequate."]
+[-0.6853783130645752, -3.9296061992645264, "Because I don't I know in Orange County that are there's not been a focus on using county resources to provide those services. I would say in the city of Irvine. I have heard good things like about you know, there's the Meals on Wheels  program and senior services, but I'm not sure if that's the case countywide."]
+[0.6591991186141968, 1.1384323835372925, "Moving."]
+[2.1219258308410645, -1.658549189567566, "extreme heat"]
+[2.292410135269165, 9.504293441772461, "Why yes,"]
+[2.0373456478118896, -1.5484284162521362, "oh, yes. As it is going to be extremely hot, and people are not going to have air conditioning, and it's going to be too expensive to buy it and the cost of energy is going to dramatically increase. And people are not prepared for it, they're not aware of it local electeds are not aware of or planning for it. And we're going to be even more energy dependent than we are now. And so it will present even more risks than it does currently. And the heat events are gonna get worse."]
+[-0.5241770148277283, -3.093198299407959, "So in your opinion, what do you think the government's role should be in meeting the needs of older adults in Orange County,"]
+[2.079049825668335, -1.8518348932266235, "the government should act to create all local governments to create strong climate action plans that enable Orange County to benefit from historic funding that is now available from the state and federal government. Governor Newsom has made available $54 billion in climate funding in particular, and because Orange County cities don't have climate action plans, they're very much at risk for missing out on that funding. And that funding will be able to provide things like, like cooling for for vulnerable communities at home and in cooling centers, provide for job training to to for folks to install, you know, H vac people so that we'll have an adequate supply of people to do that work to provide for those distributed energy resources, like batteries and, and other other similar facilities that enable us to not be so dependent on the grid, which is subject to outages due to increasing wildfires in large part, which are only going to become more frequent."]
+[1.4630639553070068, 8.850518226623535, "And"]
+[2.108647346496582, -1.876255750656128, "so yeah, so that is definitely a comprehensive climate action plans that protect communities and prioritize vulnerable communities. That is what we need in Orange County."]
+[0.11700404435396194, -4.482851505279541, "Thank you so much. So thinking about older adults, residents and Orange County, who is getting the least amount of attention."]
+[0.27335184812545776, -0.6100454926490784, "That would be the folks who have always been sacrificed for you know, in our fossil fuel economy. That would be low income people communities of concern bipoc People"]
+[2.279376745223999, 1.8847692012786865, "who have who have not benefited from the creation of the problem, but but suffer the greatest impacts from it. So"]
+[-3.077418327331543, -2.2489686012268066, "yeah, so that includes older folks. younger folks."]
+[3.41684627532959, 9.074892044067383, "And yeah, yeah, people bipoc"]
+[0.1536714881658554, -4.119025230407715, "thank you. and thinking about all the issues facing older adults in Orange County."]
+[1.6620699167251587, -1.1481568813323975, "Well, if I could nominate again, those same, I would say extremely is definitely being overlooked. They're not planning for it. There. It's it's really distressing, how little attention there is being given to it with our the lack of air conditioning at home with, you know, around 30% of homes not having access to air conditioning."]
+[-2.204103708267212, 0.7305848002433777, "And, yeah, respiratory health."]
+[2.055925130844116, -1.8205997943878174, "And building electrification policies being ignored by most cities, cities, not taking advantage of those possibilities cities missing out constantly on this on climate funding."]
+[2.2776577472686768, 4.265244960784912, "would nominate all"]
+[3.09196400642395, 4.6624956130981445, "Thank you so much. So in addition to what we already have talked about, now, we're going to talk a little bit more in your area of expertise."]
+[1.7520755529403687, 8.087160110473633, "So"]
+[0.8556427955627441, -1.8130254745483398, "I would say it is not working for anyone, it is not benefiting anyone. Other impacts we're going to have are flooding, which we saw a bit of this year, and we can we know will get worse."]
+[0.5312938094139099, 2.957693099975586, "maybe even worse, because there, there'll be little warning of them, also there's going to be a tremendous amount of erosion when we think about beach communities. And sea level rise maps show show"]
+[1.5942012071609497, -1.9678468704223633, "substantial erosion at the coasts that cities are not planning for, they're going to have to retreat from the coast. And so yeah, they are not planning for that. And how is it how is it working, I would say is, I would say, 100%, in the category of not working, except for the people who are making money from creating the problem, like the people who work for, you know, the companies that create the problem. So the fossil fuel companies or real estate developers, it's all working fine for them, because they're still making money from it. But let's see what other sort of climate impacts that they are not, that are not working for them like currently today. Yeah, and then I would add, just the indoor air quality and outdoor air pollution, we also have the fact that transit wise, people are still, like electric vehicles are not accessible to everyone, they're less accessible to lower income folks, driving Orange County is very car dependent and car centric, and that is not that's very harmful to seniors, because that means in most areas, they're like, when they come when the time comes, when they can't drive, then they're, if they're not in a senior community, that means they're going to be isolated, they can't leave their home."]
+[0.3131248652935028, -2.5192596912384033, "And that leads to significant mental health issues. And so if we could have, you know, transit systems that are accessible to everyone, where folks can take the bus or bike, you know, in the Netherlands, folks are able to bike and elderly people don't experience the same isolation that they do here, in large part because biking is always safe. And they, you know, biking infrastructure is amazing in"]
+[0.6815406084060669, -2.9124419689178467, "that in the Netherlands, in particular, and other European countries as well. But in Orange County, we have transportation systems that are like exclusive streets that are engineered exclusively around cars, and all other users of the street are incidental, and very much just subject to the harms that may be inflicted by cars. And we have there, they've been designed this way to create clear zones in case a motorist makes a mistake and you know, rolls up onto a sidewalk, they've cleared all of the trees, adding to the heat impacts, they've cleared the tree so as not to threaten the cars, when the car rolls off the road, without any thought of what is gonna happen to the person who's walking on the sidewalk who can't afford a car or the insurance that goes along with it, or, you know, or maybe it can't use a car at all. Not, you know, regardless of the costs, if they're senior, for example. So this is literally built into our streets. And so what is possible and what is done in other parts of the US also in the world is that we have spaces for everyone. And our streets like we have there, there's a sidewalk for walking, and then there's a protected bike lane, very importantly, where we have physical separation from cars where people can feel safe to bike. And data shows that when that folks feel safe biking, then they are more likely to bike. And so that would that would protect people"]
+[2.9095606803894043, 0.030712688341736794, "from those impacts as well. There's so much right answers to what new or revised policies are needed. This"]
+[0.6580755114555359, -3.0365655422210693, "so there's a policy that's very much available. It's called a complete streets plan. And that is where a street is planned or redesigned with everyone in mind where lanes are narrowed, which causes cars to drive slower, which which causes makes accidents less likely makes harms less likely and then also adds value to spaces. It makes it more likely that folks will actually stay where they are instead of commuting all over the place and so So complete streets and we need policies that promote urban density and mixed use of spaces. So where we can have, you know, walkable bikable neighborhoods where you can get to everything you need to use in your life, you know, then everything you you know where you're going to shop and where you're going to play and where you're going to go. And you can get there. Using your feet or using a bike it's also healthier for people lends itself less to obesity, and other health harms. So this is the way to more accessible Orange County and then also with less"]
+[2.001469850540161, -1.9201643466949463, "and more trees and honest in planting trees again over streets instead of clearing them in order to create these clear zones for cars so they don't crash into them. We put in we add trees, and that provides shade and it makes it incentivizes people to walk and bike and brings down the temperature of a city"]
+[2.1463420391082764, -1.7846105098724365, "Climate change mission."]
+[0.6240999102592468, -3.1896114349365234, "Complete Streets policies are available to every city council in Orange County and to the county itself for the areas that it's in charge of. And if the county did it, the county could adopt more policies that would also benefit."]
+[0.37943902611732483, -2.790546178817749, "county wide and agencies like Octa, there are measures that Octa could take to support those policies, such as increasing the frequency of a bus transit and things like that."]
+[-0.005763628054410219, -3.42849063873291, "So yeah, every jurisdiction well, every city and the county how's it, it's available to them."]
+[1.4745805263519287, 8.839925765991211, "And"]
+[1.9582282304763794, 1.1406605243682861, "thank you so much. So what sources of data we can find relevant to the work."]
+[3.6548073291778564, 10.995949745178223, "Um,"]
+[2.090769052505493, -1.8827120065689087, "let's see, oh, my goodness, what sources of data I have a lot of peer reviewed research and best practices established by other cities, there's been a lot of good work that's been done. In San Diego County, there's almost every city in San Diego County has a Climate Action Plan, and is planning for these impacts. And that's in large part because of the work of climate action campaign, my organization and our team, we started in San Diego, we've been working there for much longer than we have in Orange County, but we're trying to bring that kind of change to Orange County. Yeah, so we can look around and see examples or, let's see, I'm a fan of strong towns in terms of transportation. And this is, you know, an organization that champions, complete street policies and things like that. And then in terms"]
+[1.8477896451950073, -1.7698551416397095, "its sadly, it's hard to come by, in some ways. on the energy front, well Cal CCA in terms of community choice, energy. That's the Industry Association of Community Choice energy programs, that establishes best practices, and really focuses Community Choice energy programs on on creating these kinds of benefits for the community. So they are a good resource."]
+[2.0576043128967285, -1.9047409296035767, "and without staff to ever even notice that this funding is available, like cities don't most Orange County cities do not have sustainability departments. They don't have grant writers, and certainly not climate glant grant writers with expertise"]
+[2.021056652069092, -1.6979007720947266, "who are looking at these kinds of issues. And so yeah, so they won't even know that they're there. If they do know that they're there. When they go to make their application. They're gonna you know, the application is going to ask them for their related plans and their climate"]
+[2.8874001502990723, 0.08854349702596664, "action plans that are not going to have any to point to."]
+[7.125244617462158, 4.651927471160889, "For the most part, thank you so much for sharing."]
+[-1.9682897329330444, -2.7226834297180176, "Let's see for impacts on seniors."]
+[4.342496395111084, 4.25362491607666, "I believe she is. Okay."]
+[1.4596861600875854, 8.855025291442871, "And"]
+[4.70963191986084, 3.1608686447143555, "He you talked to ocj"]
+[1.603284478187561, 6.556136131286621, "I'll check that."]
+[2.275409698486328, -1.7542195320129395, "EJ. Environmental Justice."]
+[4.782980918884277, 8.034239768981934, "Okay"]
+[1.5764321088790894, 5.304553508758545, "Have you talk to I assume you're talking to like religious groups,"]
+[2.0308897495269775, 7.766174793243408, "like,"]
+[1.510971188545227, 5.301382064819336, "just groups like,"]
+[0.8271229863166809, 0.8884254097938538, "I think of like the Jewish Community Center in Irvine."]
+[0.5566250681877136, 1.795235514640808, "You should think that those be good places for you to get."]
+[2.386880874633789, 6.251056671142578, "I don't know, at least good feedback."]
+[4.723620891571045, 3.518324851989746, "Thank you so much. Yes, please. That'd be great. Thank you so much. And yeah, this was the interview. Thank you so much for your time. And everything our was like, very helpful. So."]
+[5.31901216506958, 3.601998805999756, "So thanks. Good. Oh, yeah, let me stop recording. Now."]
+[-2.7647275924682617, -3.208950996398926, "Okay, so the primary goal today is to identify what what needs you think are most important to the older adult population that you serve. Those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. And I'd like you to take a few minutes to read through this list. And let me know when you are ready to begin and take your time. And do let me know when you show up. You'll see what I mean. It's a it's a little small, try to fit everything on one page, but let me know if I need to enlarge or square down in question."]
+[4.665467739105225, 7.936466217041016, "Okay, okay,"]
+[-1.1136752367019653, -3.113856315612793, "Okay, well, right now I am a supervising deputy Public Guardian, with the public guardians office, my experience with the older adult population, you know, I was just transferred to a unit new unit, I went now what's called I'm in the supervisor for the LPS unit, which is deals more with the mentally ill, I was transferred here to this unit, probably about three months ago. Before that, I was in the probate unit for 15 years, six, probably, almost seven years as a supervisor for the probate unit. And that's when I dealt most, mostly with the older adult population. And with the public guardians office in general, I've been here for 15 years. And previously coming to Orange County Public Guardian, I was with LA County Adult Protective Services for seven years. So I have at least 21 22 years experience dealing with the older adult population. And I have seen the changes, you know, starting from when I started dealing with the older adult population till now just how everything how a lot of things have evolved. That's why one of the things that I'm looking at on this list is this digital divide, I would say more tech, technology confusion, as you know, with older adults, even after past age 40, it's hard to keep up with the ever changing technology. And then, you know, I myself, I still haven't gotten gotten used to a smartphone, I still fumble around with it. I'm asking him how to do certain things on a smartphone."]
+[3.466700315475464, 4.078343868255615, "Let's get to that list yet. Well, you know, there we go with my next question."]
+[-1.3942534923553467, -1.7262130975723267, "It's pretty it's pretty good. I would say if anything, accessibility to resources. I mean, I think a lot of older adults don't know that there are so many resources out there and I think either a they're intimidated by reaching out or just don't know how, you know, for example, something that I'm, I'm pretty sure Tammy, you probably got a lot of are those robot robot robot calls or whatever those automated calls and they're saying we're calling, it could be a message in another language. So I get all these phone calls that are in Chinese, sometimes their messages saying that they're the IRS and you can be arrested if you don't call us back or stuff like that. And there are older adults who really are intimidated by those phone calls. And they will and you know, these are scam these are scams. And I think instead of, you know reaching out maybe to some resource to find out, hey, Is this legit, these people will actually fall for the call, they will call back. And we know these scammers they they fall for these scammers hook line and sinker, these scammers know how to talk, they know how to woo or intimidate the older adults and eventually will get what they want."]
+[2.555211305618286, 3.7897233963012695, "Okay, now of the needs on this list, and including the ones that you just suggested, please read the top three that you feel are the most important."]
+[4.053646087646484, 8.458148002624512, "Wow. Okay."]
+[4.106854438781738, 5.619525909423828, "Take your time."]
+[2.4619152545928955, 3.9445581436157227, " Yeah, cuz a lot of them are really top three."]
+[5.385472774505615, 8.65263557434082, "I understand."]
+[-0.32364025712013245, 1.2491199970245361, "For sure, economic security."]
+[-0.9198045134544373, 1.4283820390701294, "Wow. There's a lot of ties. Yeah, I'd have to say that the digital divide. But it goes a lot deeper than just what it says the lack of access or familiarity with technology. I mean, there's, that's why I hate to really call it the digital divide. I would rather just call it the technological divide."]
+[3.3734819889068604, 4.07553768157959, "I mean, we can't possibly list everything. That's why you know, we are going to doubt. Okay, you know, take a little bit of deep dive into each."]
+[3.6472487449645996, 5.751826286315918, "This might go over an hour, then."]
+[3.1012120246887207, 4.575413227081299, "Let me ask you my next question. So I'm gonna ask a set of questions based on the top three that you just identified. Okay."]
+[-0.45047417283058167, -1.0274906158447266, "Well, a lot of older adults, they are on a fixed income, you know, and especially if they were in a dual income household where they're married, and then their spouse passes away. They, the surviving spouse, especially if children aren't around, or they're estranged, it really becomes difficult for them to maintain, you know, and in this society that we live in, I hate to say this, but it's really the rich, and the poor, that have the services that they need. It's really in the middle, which is the majority of the populace, especially the older adult population, where, you know, they don't have enough to afford certain things. And then they're too low income to get certain benefits. So that's where the real struggle is, and especially with, you know, just how much inflation there has been, and it seems everywhere you go is, you're really, I mean, to use a quote, you're looking at a menu, looking at the from right to left, you look at a price of something now as opposed to what the service is. And even caregiving services, they're just, they're not affordable. So that's why there's a lot of older adults now going out into placement, they're looking for facilities to move to because they just can't afford to live on their own granted, their property might be paid off. They might be living in a decent apartment, and they can afford their rent. But that cost of caregiving services at one time, caregiving services up even up to about 10 years ago was about $15 An hour $15 An hour is a minimum wage now and caregivers make more than minimum wage so and caregiving is out of pocket is an out of pocket expense. So it's not like insurance covers that you know, and it's just it's too much to bear and then it causes a chain reaction. So you have a an older adult who was already stressed out about A living alone, B wanting to live in their own home not wanting to be placed, but now they have to worry about okay, I in order to live home alone, I have to pay for a caregiver. Then they see how much it's gonna cost and It's just, it's just not feasible. So now there's that added stress. And then it's like I said, it's a chain reaction. Now it's like, okay, now I have to consider being placed in a facility somewhere where I don't want to go, you know, this older adult was so used to living independently for so many years. And it could be an individual who is not does not work well, living in a larger community, with others coming. It's like moving into a place with a whole bunch of strangers, you know, some people just aren't meant for that. And that is, has become a reality for them, that they that they will have to move into a place where there will be strangers walking around."]
+[-1.630884051322937, -1.9449137449264526, "Well, of course, it all comes down to the costs, the cost of everything. And, depending on the older adult, I'm just generalizing here, but the barriers to accessing and knowing knowing what's out there, like I said, there's, the individual who has been living alone, independently for so many years, now has to make other decisions, decisions that they once did not have to do or dependent on a loved one to do for them. Now they have to make these decisions. And again, it's just adding to the stress that's already upon them. So now it's like, oh, I have to call these people and, or, you know, going on to the internet, and the older adults, some of them aren't as savvy, surfing the internet, knowing know what to look for, you know how to click around. And, again, that can cause stress to like when, for example, calling a certain agency and you get, you know, 20 something year old receptionist, that's on the other line telling the older adult say, Oh, just go to our website and, and look at the services that we have, you know, and a lot of times these older adults, they're gonna be like, either a, I don't have access to the internet, or I don't know how to do that, you know, back in the days, people would take trips, they were like, let's just say if the older adult wanted to check out the checkout facility, sometimes the facility would come pick them up, drive them, or somehow there would be transportation to get on there. Now facilities, they just go to our website, you can take a virtual tour, and you can see all the amenities on in the gallery. And, you know, it's just too difficult for certain older adults who, like I said, who either a don't have access to the internet or just don't know how to navigate the Internet."]
+[5.558496475219727, 8.801396369934082, "Okay."]
+[-1.5409574508666992, -1.8284677267074585, "Absolutely, yes, of course, older adults that have a greater support system, whether it be family, friends, they they have more, I guess more, they have a greater ability to do the research to have a knowledge of what is out there. You know, of course, then, and, you know, as far as far as economic status, I mean, there are some that are isolated, they, they do, they're well off, that are that are isolated, because that's just what they they're used to. And again, they still have their barriers to because they can't, you know, they just don't have the knowledge and expertise that maybe again, their spouse did for them. Sure. But of course, there are some that just like the ones that are well off the low income that they are so isolated, that they don't know what's out there. I mean, again, I think phone contact is direct. Yeah, phone contact has just gotten so difficult, you know, whereas before, that was the norm now it's like, send us an email, go to the website, go to our Facebook site, or Instagram, what have you, or come in, but coming in is might not be feasible for certain individuals, whether it be they don't know how to get there, they can't afford a ride or, you know, facilities just don't have the resources to provide the transportation. You know, it's really, it's really more of this. Do it on your own, you have to find a way, you know, this services just seems so limited. And, you know, I can't pinpoint exactly why things have changed why it's whether it be due to, again, either lack of funding or because everything is so high tech now. You know,"]
+[3.7854275703430176, 15.447046279907227, "yeah."]
+[-1.0081349611282349, -1.8075183629989624, "Well, I hate to say it comes down to funding again, I think there should be more funding to the the resources that provide assistance to the older adult population, they, they need to have more of a way to be able to, you know, one thing that's really hard to set up for older adults, and there is a waiting list is what's called a friendly Visitor Program. I know in Orange County, through the Orange County Council on Aging, they have they have that, but there's such a long waiting list for that. And all it is is just someone to come out and check on on these individuals. They don't provide any type of case management services, it's really just a friendly visitor to check up on them and see what kind of needs they have. And it helps though, it helps a lot. Because number one, it prevents the isolation of these clients. And then even though this friendly, the visitor they might not be, you know, an MSW or anything like that. They know if something they can tell if something, something else is going on in that house where they sit, they can go back and say, You know what, I think there's something more, and we need to do, you know, further outreach to this individual, but of course, time and money, it all that stuff costs time and money, you know, and then when you bring that up to these older adults, especially when you say, Oh, yes, there is a cost, I think because they're just they've just been so used to saying, No, thanks. No, thank you. They kind of see it as its solicitation. You know, there's that. And that's something that's been going on, you know, that's why you always see those signs on the doors. He knows no solicit solicitors not allowed, you know. But that's the funny thing, too. They'll put signs on the doors that says no solicit no solicitation, but then they'll get a call from a scammer, and they'll fall for the scam. So yeah, I think there should just be more, more and more invested into providing. And again, it doesn't have to be case management services, but one on one, to be able to go out and check on these especially isolated, older adults."]
+[-1.441888689994812, -1.4428966045379639, "Yes, and I just have to identify the ones again, the ones that are kind of isolated that they don't have to be on their own. That could be a couple, I mean, this it's a very common situation where you get a couple that because they're starting to do to decompensate that simple tasks, your simple activities of daily living are just becoming so difficult cooking, you know, cooking, which was once such an easy, easy thing to do, and even enjoyable, has become a very difficult task. I had one case years ago, where it was an elderly couple, and they resorted to buying frozen chicken nuggets. And the way they warmed it up was they would just drop it into a pot of boiling water. You know, and especially And that was number one, it was a dangerous situation number one, because they both had dementia. And the water would basically sometimes not turn off the stove. So continue to have the water boil until it would evaporate, and they would just have a heating pot. Granted, they took out the, the chicken nuggets from it, but that was their their normal thing. And, you know, again, the just the lack of caring for bathing, right, you at a certain point, you become sort of frail, you're scared, you're scared to get in the shower. But as we know, hygiene is very important. And then they get scared Oh, well, what if I fall then we go to call 911. You know, it really it's, it's just again, this whole chain reaction of what if it could, it could lead to something I don't want, I want to die in my own home, I don't want to go anywhere. But because of that, they start to really it's kind of it's becomes counterproductive, because then they really neglect their care. And they in a sense, start to deteriorate in their own home. Like I said, the hygiene, the cooking, and what else even like paying bills, you know, at one point, yeah, at one time paying bills was simply writing a check, maybe they can't write a check no more, maybe the, the merchant doesn't accept checks anymore has to be an online payment, it has to be through Venmo, or PayPal, or Zell. And of course, a lot of these older adults, they don't even know what that is, or even how to access that or set it up. You know, there's so many, you know, even myself, I know every time like, I hear a new app, and you got to set it up. And then you have to go through a process. Oh my gosh, you know, even setting up like a family link. So I can monitor what my kids are doing on their tablets. I'm like, Oh my gosh, it's so it's so complicated. You know, and so I can only imagine these older adults, how they're just, they're just set, they're set in a way and it's a have to make a change to you know, keep up with technology and society is just become so difficult and and it could have an effect on their personal care. I mean, you know, what it says there as being able to take care of oneself that, I mean, that's such a broad statement. But it really is, it's, it's not just, you know, combing your hair and brushing your teeth, but it could fall into that too. I mean, there's so many houses that I've been to where you they opened, the client opens the door, and it looks like they they've been wearing the same clothes for years, you know, some have still been in a hospital gown that they that they used at the hospital, you know, so it's, it is an issue because, you know, no, especially if they're isolated, they're not, you know, they're not getting any attention. You know, I mean, it's, it's really, you know, the cases that we get, we get when we get a referral, especially when we're an adult, when I was in Adult Protective Services. They're just a small percentage of what's really out there, you know, thank God, this client had a, a nosy neighbor, I'll call them a concerned neighbor. And they, you know, and they would call, they would make a referral, and we would go check on them. But again, but again, even that, it's a small percentage, there are so many out there that we're not aware of."]
+[-0.7732863426208496, 2.2583534717559814, "Well, you almost ask answer the next question, which is what barriers exist to see improvement in this area."]
+[-1.336746335029602, -1.911972999572754, "And here's another thing, another thing too, because of and I'm not trying to put down, you know, there's new generation, the millennials and Gen Zers or anything like that, but they seem to be less concerned about it. You know, when I when I talked about nosy neighbors, I meant that in an actually a good way, because there was a time when, you know, you know, there's a saying that a lot of people neighbors became less social when the electric garage opener was invented. Because back then you'd have to actually come out of your car and manually manually open your garage and when you see your neighbor, you say hi and engage in small talk. Now everything is just so unengaging, you know, and you people just Have a lack of concern for other people, you know, we're just so focused and getting to do what we need to do, as opposed to, how are my neighbors like, even where I live, my neighbor, I've lived where I live for about almost three years. And I said hi to my neighbors, probably about twice, never engaged entirely, because everyone just seems so focused on themselves. So, you know, and you can't really expect older adults to do that as well. Because like I said, they become so set in their ways. And they're like, I'm not gonna go out. I'm, you know, and who knows what conditions they might have. They might be paranoid, too. They don't, I forgot what the condition is. But people that are scared, really scared of getting out of the house, but that is a real condition. And a lot of older adults might have had that or have some, something similar to that where they, they don't trust, they don't trust what's out there. It's always disaster tragedy, you know, and they're just like, oh, my gosh, all this going on, I'm not going to go out there. You know, and it becomes difficult when people aren't, because number one, they're either estranged for the family, or family is far away, or there's no concern, whatever. Then you got neighbors who aren't really concerned either. It's, it's unfortunate, sometimes it's it's not until it when it's too late, you know, the neighbor will smell something funny coming from that residence, or they might call the police say, you know, what, I haven't seen my neighbor in a month, you know, and I tried knocking on the door thing, you know, and then again, by that time, it's, it's just too late. So, yeah, because like I said, that the referrals that come in to us Public Guardian, and back at Adult Protective Service, it's just a small percentage."]
+[-3.9445061683654785, -2.088332176208496, "You and are there different experiences for different groups of older adults, different backgrounds,"]
+[2.3514175415039062, 5.264217853546143, "backgrounds, as far as like,"]
+[0.06573588401079178, 0.07460684329271317, "like, you know, for example, where they live, their disability status, income, education level, etc."]
+[-0.8568126559257507, -1.0192627906799316, "You know, Tammy, it's, it's all the, they're all the same, like I said, in, you know, more affluent communities you can get the same problems, as you would, you know, on a low income community its just on a different level. You know, because, like I said, an isolated individual is an isolated individual, no matter what background, you come from, where you live, you know, its just, of course, those that are that have more income, I mean, there have, they have more ability, they have more, I mean, they have more flexibility as far as what they can utilize to, you know, for, for assistance with their care, but that, and that's great. But if you if the individual, him or herself, does not want to reach out, or for some reason, you know, they still believe that they don't, they can't afford it. I've had clients where they had millions, and we'll talk about caregiving servers, they're like, I can't afford it. That's too expensive. You know, so there's something going on their mindset, where they were, they feel, I mean, whether it's a bad experience, or they it's just something that they were so used to maybe it was a spouse that kept telling them, we can't afford it. We can't afford it. They just got so used to that mindset, you know, and, again, when they're when they're isolated, they become stuck in those ways. You know, you know, because I also have seen these functional households, the elderly couple, they keep, they keep up, you know, they support each other, they keep up with the times and, and they're great. But then, of course you have, you know, individuals who like I said, certain way it was always had to be this way had to be it was so strict to a certain lifestyle. It's so hard to change their mindset from that, you know, and they might become so stubborn that they don't want help. You know, they're very prideful. A lot of people are very prideful. No, I don't need any help. I don't want any help. You're just, you know, interfering with my life. Because I'll tell you to him and I have seen hoarded homes, again, in affluent communities, and low income communities. But again, a hoarded home is a hoarded home. And it became that way, because of the mindset of the people of the individual living in that household. You know, and I hear the same excuses, hey, we can get you some help to clean this out. No, no, I don't I want it. You know, it's like, if you start touching their stuff, like, start cleaning up, I mean, we know that it's in their best interest, because it's number one, it's a health hazard to be living in hoarder conditions. But they see it as I need that I might need that later on. Oh, I've, you know, it's, it messes with their ya know with their way of living, because they got so used to it. And because I have seen clients lose it, when they're stuck when their home started to be clean. They got so it gave them such anxiety, because they were so used to how it was, you know, and even if it could have just been like, a National Geographic magazine from the 80s. And they're like, because they were so used to seeing that in that one spot and to take that away, it just threw a wrench into their life. If that makes sense. Yes."]
+[3.672267436981201, 15.546096801757812, "Yeah."]
+[-0.6510501503944397, -2.165130615234375, "Well, I think it's I think, being able to educate, educate these individuals, but that's but that's, that is a good question. But then that's the thing they have, but then how do you reach these people who are so but you know, I say this too. I'm so busy. I, I can't really get to know my neighbors. I don't know. Well, that's great, but I just don't have the time. I'm so busy. This is just fantasy. Okay. I will say there should be you know, for each city, they should have designated, you know, community representatives, whether, and you know that and I think a great way would be to even have volunteers. So, the ombudsman, if you know, the ombudsman program, they have their volunteers, these ombudsman that go to a facility that are assigned to facilities. I think there should be community ombudsman, too. There should be some type of I mean, that's the whole purpose of doing what's called the census, you know, use you determine where people of certain age are, you know, and they identify, you can do it and out, like an analysis says, Okay, this community has, you know, 20% of this community has an older adult population, let's assign a community ombudsman to check up on them, you know, or, you know, and let them be aware that there are services available, should should you need any, you know, older people are the older adult population, I think, are less inclined to reach out for help, again, for so many different reasons. But I think it'll help if they're like I said somebody reaches out to them, and at least makes them aware that hey, there is there are services for you, in case you ever need them. Okay. Like, yeah, of course, something like that. Again, that would need some type of funding to organize. Yeah, you know, I like that community ombudsman, you know, they have facility ombudsman, I think there should be community ombudsman. So."]
+[-2.2437212467193604, -1.9282671213150024, "Moving on to the third topic that you identify, which is digital divide. So How or why are older adults struggling with this issue."]
+[-2.111117362976074, -1.2666689157485962, "And I don't mean to sound like sound like a broken record, but a lot of these answers that I'm providing, they're probably what I've already said. But older adults, again, their mindset, where they're too proud to get assistance, or they feel like they don't want to have their life interfered with, like I said, they're, they're so used to living a certain way. And any kind of disruption of that could cause them anxiety. You know, and especially with, you know, any other existing medical medical conditions they have, adding an extra stress could be a stressor on any other existing medical condition, like I see, there's, you know, on this list, heart disease and stroke. Next thing, you know, I mean, they already have that condition. Next thing, you may have somebody coming to their house and say, Hey, hi, I'm here, we're here to I'm here to help. You know, because it's so"]
+[3.285781145095825, 5.738139629364014, "yeah, right. So the next question, you know, you're always ahead of me."]
+[-1.6110872030258179, -2.152982234954834, "Yeah, and this is something that I learned in grad school, this is what's called, we call  it the wicked problem, no matter what you do, it's not going to be resolved, you know, sort of, like, for example, there's a river, you can always build a bridge over a river, you can resolve that problem, but certain problems in society are never going to be resolved. Crime, politics, the differences of, you know, all the religions coming together and in harmony, you're not going to fix it, you can try. And that's one thing with servicing the older adult population, it's never going to be 100% resolved. So all we can do is really try there's, there's got to be I say this again again. But there has to be more funding to put in place into what can be done, how can we effectively reach the older adult population, because you know what, time's gonna continue technology there's going to be so there's going to be more, that's gonna make the aging population become more and more confused, and more and more separated from the outside world with what's going on, you know, the only again, the only connection isn't be what they see on TV. At one point. years ago, that was the norm, you know, and, and you were cool. If you also had a cable box to attach to it. Remember, at one time, it was just a TV, and you press the buttons, channels, two through 13 and 28. Then eventually came the cable box, then eventually came flat screen TVs and then even to the point where they said, after one point, there's not going to be antennas are going to be completely useless. Everything's going to go digital. So the old these older adults, you know, everything's just changing and it's, it makes life so confusing. And again, the chain reaction, it's going to cause stress, it's going to cause these this population to just start to deteriorate because they don't know what to do. They're, again, either they're, they have too much pride. They don't want any interference in their life, or whatever. I'm sorry, barriers."]
+[-0.13730250298976898, 2.3620026111602783, "The barriers exist."]
+[-1.3671478033065796, -1.9452005624771118, "Yeah, so there's got to be a way to You know, whether it be through the local senior centers, city programs, or what have you to find a way to give the older adult population comfort, comfort, and trust that, you know that they are not just going to be tossed aside, there's always someone that can help. I know, I know, a lot of senior centers, they do have classes they do have classes on, this is how you surf the internet. This is how you how you send an email. That, you know, that are like that, that have that mentality of I don't want it and I don't need it, you know, but in reality is it, you have to just keep up with the times ever changing times. And that's the only way you really be able to fulfill that, you know, fulfill that potential of what you what you can get, you know, like, like, it's like a veteran who was not reaching out to veterans services, you know, they're there. But maybe the veteran is just doesn't know, how does a want to who knows, but that veterans not getting all that they can not maximizing the potential of what they can get to benefit themselves. You know, same thing with these overalls they, they're just, for some reason, whether it be, again, whatever mental state they're in, they aren't maximizing their potential for living a higher quality of life."]
+[-3.957742691040039, -1.7629419565200806, "Yeah, are they again, are there different experiences for different groups of older adults from different backgrounds, right, like, where they live that disability status. And"]
+[-1.2091929912567139, 0.4362449645996094, "I think that's the only difference is just the status because like I said, I've seen both ends of the spectrum, experiencing the same issues. You know, I'm gonna say this, again, an isolated individual is an isolated individual, no matter what social status you're in."]
+[7.17938756942749, 6.159667491912842, "What do you suggest is the best way to address this issue or to see"]
+[-0.6547051668167114, -1.4542759656906128, "I'm gonna say it again, community ombudsman, I love I want to patent that or something. But yeah, just the getting, just getting it out there that there are resources available. You know, because, again, both ends of both ends of the spectrums, you know, low low income area, where you have if you have people involved in your life, you know, the, the friendly neighbors, social system there, you're good. Same thing with the on, on the affluent one, you know, if you have a good support system, whether it be your neighbors, and friends, the community, then you're good, because you have people looking at after you. So that's why I say I mean, and again, they go through the same problems, too. They both get the same calls from the IRS, and the same scam calls. You know, it's just that the ones in the affluent community, there's a higher, higher chance of losing more because they have more, but again, even the low income they're targeted to. Yeah, I mean, scammers are indiscriminate."]
+[3.170487403869629, 4.486282825469971, "Hey, okay, so that that's okay, so we're done with that those set of questions. Now moving on to the next one. I'm going to read out four subjects and you can we can go back to you you know, each one individually or you can just answer them in the aggregate."]
+[2.826976776123047, 5.356995105743408, "Okay, let's start with the first one. The first one was"]
+[-3.2807133197784424, -0.2445705085992813, "geriatric care"]
+[-1.7346055507659912, -1.0725488662719727, "geriatric care. I think access the accessibility has greatly improved. The I mean, they Geriatric Care is out there. I mean, there's a there are a lot of there are a lot of organizations throughout the county throughout different you know, Different cities, they have different programs. You know, there's always that resource of calling 211 211 from a phone, you know, to find out what resources are available, because, yeah, geriatric care. I mean, I, when you talk about that to elderly, older adult population, that they start to have misconceptions of it, though. And like, No, not necessarily. But it probably be best for you, because you'll actually go somewhere where they specialize in providing, you know, day to day care for the older adult population. But I mean, geriatric care is that's that's such a broad term too. But I really don't see an issue in accessing it. And that might be the same answer to all four. So if I repeat myself,"]
+[-1.0723037719726562, -4.2079901695251465, "if you could describe how accessible and adequate Long Term Care is in Orange County,"]
+[-2.0088140964508057, -0.060651615262031555, "Long Term Care, I'd say is probably a little more difficult, because you know, there are a lot of them are full. A lot of facilities are they have a waitlist, and especially long term facilities that"]
+[-1.948669672012329, -0.5966594219207764, "are, you know, either funded by med by medical, or they are they accept Social Security. When you have, when you have the funds, if you have the funds, it's a lot easier. I mean, you can go to"]
+[-1.1401691436767578, -0.821465790271759, "a Silverado, Silverado care, that's $10,000 a month. And if you can afford that, they're always they usually have openings, because not many can afford that type of care. So I'll say what that is an area that is pretty difficult to access, because, like I said, not I mean, the majority of the adult older adult population are on a fixed income, and that they need that long term care. Like I said, there's that middle section, the middle class, where it's like, okay, I'm not rich enough to afford a nice facility. And I don't, I'm not low income enough that I can just be on long term care, medical and be placed in a, in a facility. You know, and, and besides, there's, it's not often that you get an older adult who says, Yes, I want to be placed in a long term care nursing home, you know, if anything, there might be willing to go to a lower level of care assisted living, or a residential care residential care facility for the elderly, or some type of boarding care, where they can still have some independence, but those are privately funded, you have to pay out your own pocket. And, you know, to get a lower rate, you'd have to get a shared bedroom, a lot of older adults don't want to share a bedroom, they don't want a roommate, you know, and then, and even with that, they're still pretty pricey. Again, these private pay facilities, it's hard, it's hard, almost impossible to find any facilities that will just that except Social Security, Social Security can be I mean, or SSI, could be anywhere between, you know, 1100 to, let's say, $1,900 a month, and which is kind of common for the overall population for their as far as their income. And that's, it's practically impossible to find a long term private pay facility to set that much. You'd have to start going, especially going out of Orange County to do that. That's one of our difficulties, because that's a lot of our, our target population that's about their average income. Now, we have to start looking facilities that are, you know, in questionable neighborhoods, in, you know, in Los Angeles area, North LA or even in the valley, we have some facilities in Sylmar and that's pretty far. I mean, considering that we have, you know, our client lives is an Orange County resident. Now we gotta go outside of Orange County to find a facility that they can afford, you know, San Bernardino, Riverside, it's not uncommon to have to, you know, place an Orange County resident out of county."]
+[-2.2199230194091797, 1.032279133796692, "What about mental or behavioral health, substance substance use treatment, how adequate or accessible, accessible, those services are"]
+[-1.8728199005126953, -1.4663419723510742, "definitely accessible. The only thing is with that tart with that target population, a lot of them, they don't know that they have a mental illness, or they refuse to believe that they have a mental illness, sometimes, and especially for our department for the Public Guardian, if they come to us, because they, you know, something happened, they were placed on an involuntary psychiatric hold, you know, and then eventually comes to us, because during that hold, they were not able to recover, or the facility felt that they were not safe to go to return home or go back to wherever they came from. And in a lot of the interviews that we do, that's how that's even those, those individuals that are on an involuntary hold, they say, nothing's wrong with me, you know, and again, these are the ones that have come to us, which is, again, the small, just a small percentage of what's really out there, you know, when you, especially when you walk around certain areas, you'll you'll see, people, you know, whether they be transient or not, it doesn't matter, because, you know, there are affluent affluent individuals, older adults who have a mental illness. And, you know, you'll see them talking to this to themselves doing bizarre things. And unless someone comes to them to do an assessment, or they reach out for help, they're just going to go continue on their merry way with no any no assistance, no type of treatment, but it's out there, there's, I think that's one area that has improved that access for mental health services. And I think it's because of some things that have happened, you know, within the past seven to 10 years of, you know, especially law enforcement not being quite educated of how to deal with the mentally ill. And sometimes, unfortunately, that those have resulted in tragedy, you know, not knowing that, you know, thinking that a mentally ill person was dangerous. Well, they weren't dangerous, they were just going through a manic episode. You know, so there's, you know, the services have improved, definitely, access is there. But once again, it falls to, if no one is reaching, yeah, reaching out to that type that population, then it comes down to that population reaching out for assistance. And again, a lot of times they don't, they don't, they don't do it, either. Because they don't feel they have a problem. They don't want anyone interfering with their lives, or what have you. So, yes, but it is there. And like I said, it's if the services aren't accessed, it could result in you know, something a little more extreme. Again, that's how we get our cases here."]
+[-1.6977887153625488, -1.6085530519485474, "Oh, absolutely. I mean, we have, there's the Orange County Mental Health, I mean, that's part of our agency, the health care agency, there are so many. But again, if you want to, if you want to actually say you'd have to go online, to go to a healthcare you see website and see what resources out there. Otherwise, I mean, I don't know how it works as far as just walking in to any type of facility, but again, that target population, there, maybe a small percentage of them, but most of them will not go out and say, Hey, I need some help. What can you you know, what can you do for me, you know, and especially if they are all on their own, you know, it's, it's easier, yes. When we have our younger clients who are still living with their parents, and the parents are aware of the mental illness, and they noticed that the, it's getting worse, so the parents will reach out, you know, they'll go, they can research what, you know, resources are available, but again, those individuals, the, the transients, the ones that are independent, are isolated, you know, that's those are the difficult ones, because will they reach out, you know, and it's, and it is a more difficult moment, the, the mentally ill population, it's, they do go out, you know, as opposed to, you know, the older adults who kind of isolate themselves at home, the mentally ill, I think they they go out more so it's I think it's good and it's bad. It's good in the sense that they are getting out there being exposed are they are able to, you know, walk into a facility if they have to. But it's bad too, because if they have a, you know, a manic episode out there on the street somewhere it could, you know, it could be dangerous to themselves or, or, you know, dangerous to others. And, again, if you get a first responder who doesn't really understand mental illness, then you know, they could it could get ugly."]
+[-0.29647311568260193, 0.5376408696174622, "Right. Okay. And lastly, human social services."]
+[0.9991462230682373, 2.536079168319702, "You must have adequate or accessible"]
+[-1.3936315774917603, -1.6874772310256958, "Oh, sorry, I'm sorry. And you know, that that one's gonna be the same answer for this last one about mental health services there. Again, social service, there are so many out there. Again, it's a matter of just reaching out. The problem I see, though, with social services is that depending on what is needed, again, if you need, like, if it comes down to personal personal care management, or personal personal care and management, there might be a cost to it. People get scared of cost, because everything is just so expensive these days. And then now to add a service of personal care management, its people will just shy away from it. But yeah, services are there. I mean, at least I know how to Google, you know, everything. If I typed up, you know, social services, a lot of stuff would come up, and I can I can navigate from there. You know, people have different abilities as far as doing that. But I think they are out there. Very accessible again, I'm starting to see more billboards or advertisements about calling 211, to see what services are available. But again, well people do that. Yeah."]
+[-1.8826019763946533, -2.041860342025757, "Oh, the ever changing technology. To go back to that one it's like, and I think the changes could result in increased paranoia. But here's the thing with the, with the, with the baby boomers, it's going to be rough, if they live long enough to see just technology continue to improve it, and they're, they're just going to fall behind continue to fall behind. And then I'm going to, I'm sorry, I'm gonna say this, Tammy, I think they're, it's kind of to a point where they're just gonna wait around, wait around to just die, you know, because they just can't keep up. And again, I'm not generation bashing or anything. But you know, these younger generations, they're not too concerned about the elderly population, the older adults, you know, they're more focused on Yeah, they want to improve social media, they want to, they're, they're completely on board with all the new technology, and everything. But the older adults no, because they remember what remember what they grew up to, you know, what, it's what they were used to, it's what's familiar, and what's its what's comfortable. And then now it's taken away, it's become obsolete, you know, and and I think it, it causes them to fall into a depression, it causes anxiety. And again, then it just results in them and results in they're just deteriorating. And then without any community,  ombudsman type to come out and check on them and say, Hey, don't worry, we're, we're here. You know, we understand that it's difficult to keep up, but don't let that cause you to, you know, neglect your care. You know, you have people that are here to help you there are resources, you know, so that would be ideal, but again, to get that type of service comes down to funding for that. You know, I mean, even even with the public gardens office, we have one social worker we used to have four social workers now we only have one and I mean she herself is is an older adult so she can have she has a good she can relate to these older adults and we would love to have a whole but her name is Lynn we would love to have a whole bunch of Lynns to service our Clients, you know, but unfortunately, reality is we can, we can only have one. And again, she's only providing the service to our conserved clients, our Public Guardian clients. Because I mean, we love her, I would say, Lynn, you need to go out there and just, continue to make contact with these older adults. I mean, that would be ideal. I mean, we can have a lot of Lynns to be able to go out there and be able to relate to the adult older adult population. And at the same time, you know, give them comfort, because she is so comforting. And she's so you know, she helps our clients with their anxiety, you know, a lot of clients, they, they're experiencing anxiety, and she she soothes them, you know, and I think, you know, to be to use to use that term bluntly, yeah, we just need some type of service to sooth that older adult population who are having a such a difficult time keeping up with the times"]
+[5.319671630859375, 3.5879507064819336, "Yeah, well, I mean, we're trying, I mean, we, you know, every county, okay, this is recording still, okay. And"]
+[5.284573078155518, 3.545067071914673, "every cameras are anonymous right now."]
+[4.207051753997803, 7.193755626678467, "Okay. Very good. Okay,"]
+[3.4292140007019043, 5.977842807769775, "speak your mind."]
+[-1.2052654027938843, -1.9651447534561157, "Okay, then I'm gonna say this, every county, they all want to say we're doing this, we're doing that we're, we're providing all these services, you know, but sure, they're there. But that's all, that's all that's happening is, it's just there. So think of it as you have a you're, you're at a wedding, and there's a buffet table, okay, the food is all there, you can have different variety of food. But unless, you know, and then of course, there are some, you know, in the crowd there are, you know, well, and able bodied people to go up and get it and I don't know if you've ever been to a wedding where they, they have to call by table numbers, or else, you know, it becomes this rush. And of course, the ABLE well, and able bodied people are able to get there first and serve themselves. So, then you have the elderly who are slow, they might be in a walker wheelchair, they need help, they need help to get to the buffet table, you know, and unless somebody comes to get them, they're stuck, or it's unless somebody gets their food for them, you know, but again, if they're just all the services, all the food's there, okay, not all the services are there. But unless somebody brings that service to them or helps that that older person to the services, then it's pointless. If that makes sense, I don't know if my if my analogy just threw things off. But yeah, every every county, I mean, they all no matter where you go, no matter where you go, they're always say, Yes, we have the services available. We care. And and I'm not knocking, that's great. Orange County, I think Orange County does have resources available. You know, and that's again, that's where it comes to, like every community should have a community ombudsman. Yeah. Yeah, so we should make something of that, instead of just getting instead of just getting statistics. Okay, we got the stats, let's do something about it now."]
+[0.059975530952215195, -4.89069938659668, "Now, thinking about all the older adults, residents in Orange County, who is getting the least amount of attention"]
+[-1.2295864820480347, -1.7757962942123413, "I think those that I just talked about the ones that people aren't aware of, you know, we get, we get a lot of referrals from adult protective services, and Adult Protective Services found out about these individuals because people were there were concerned individuals, or they got a referral from a hospital. I mean, That's the only that's that's the only way that we found out about these individuals because there were concerned people. And I'm sorry, Tammy, I sound like a broken record. But that's how we do. We were sent out something in the mail to fill it out."]
+[-0.5177846550941467, -2.130289077758789, "You know, again, if my experience is in my community, that everyone is like, my neighbors where, we're kind of just all to ourselves, and don't even bother to check up on each other or anything that might be throughout the entire community, you know, and there might be that one isolated, older adult who's just in there, and nobody really cares, or knows what condition they're living in, you know, so, yeah, to have really like a, like, a community ambassador or something like that, where they really know they like, you know, they like how police officers, they have their own, they patrol their their own reporting district. So they know, they know, the area, they know, the problem spots, you know, maybe we can have something like that where, you know. Yeah, but of course, that requires funding to have that, you know, because you an individual can only be assigned to so many communities to know, you know, I mean, you can have, yeah, you you fund for one person throughout the whole city. But they're not going to really, they're not going to be able to really be detailed with a certain area. You know, it's just too much for one person. Yeah. So maybe like little blocks of communities throughout the city. Yeah, but yeah, that would be there would be no need for that."]
+[3.964597463607788, 5.133861541748047, "Well, once again, I just want to check I know initially, I sent an invitation for about for an hour or 30 minutes. I have a few more questions to go."]
+[3.3012776374816895, 5.017326831817627, "So as long as we finish 1035 Yeah, we should be okay. All right."]
+[-0.0029858516063541174, -3.951889991760254, "Let's try to do that. Let's try to get this done then. Okay. Again, just a few more questions. So thinking about what your topic which is protection from abuse, neglect, and exploitation what are some ways It is working or not working for older adults in in Orange County, this topic protection from abuse, neglect and exploitation."]
+[2.8301613330841064, 8.345025062561035, "Or oh,"]
+[-0.9000807404518127, -2.1468422412872314, "yeah, ways that are working. Okay. So, look at programs like US Public Guardian, Adult Protective Services, I mean, that, I think has improved over time. And I think because the, you know, abusers, whether it be scammers, or, you know, family members who are taking advantage of the elderly, because they're starting to become more sophisticated. So I think we're just trying, we're trying to keep up with that as well, so that we can properly serve our target population. So in that sense, I think we're improving, there are a lot of programs. I mean, we're between you know, government agencies, and nonprofit and just any type of community community agencies, I think we're doing a really good job, Collab. Networking and collaborating. So, I'm part of the, it's called the well our, a lot of staff in our office are part of what's called the fast which is the financial abuse specialist team. And we meet every month, and it's, it's organized through the Council on Aging. And it's a opportunity to discuss difficult cases, we have guest speakers. And when we have this, these guest speakers, then it's sometimes like, oh, wow, I didn't know that this program existed. And now we have another available resource. So we have just this network of like minded professionals, and we will reach out to each other to say, Hey, I had this difficult situation, and some of these members of the fast, you know, they could be like, they could be realtors, you know, because a lot of times we deal with real property issues. So we'll reach out and say, Hey, I have this older adult who is going through this issue with their property, they might have signed a quitclaim deed, whatever, and we help each other. So I think that has improved greatly just the collaboration of different agencies to, you know, combat, the, whatever type of abuse is going on out there. Yeah, and I think as we we, you know, we gain knowledge from the meetings that we have. So when we go out and do our work our cases, we we can share it with our, with our clients, too. And we know, like, you know, if the client did go through something, they went through some type of, they're going through some type of a scam or whatever. We're knowledgeable about it. Yeah."]
+[2.985569477081299, 0.08858489990234375, "So again, if this is related to your area of expertise, so what new or revised policies are needed."]
+[2.939321279525757, 0.031977321952581406, "Policies. I mean, that can come in different ways. I mean, you're talking about as far as like, from a, like a, like a human resources perspective for our staff, or just, you want me to answer however, I feel fit."]
+[2.145901918411255, 8.425615310668945, "However, yeah,"]
+[2.633981704711914, 1.6188644170761108, "gotcha. Okay. Well, I think that everyone that deals with our target population, really should have a good knowledge of how of, you know, knowing the types of abuses that are going on out there. And also how to access services to deal with those types of issues. I mean, that's ideally, you know, that's ideally who we want on board with us people that know how to that have had experience dealing with that and know how to, you know, direct our clients to the appropriate resource as the Office our Office as a whole"]
+[-0.5782239437103271, -2.2746567726135254, "how to access more funding. For, again, more social workers. You know, we like I said, we only have one social worker for all of our clients, you know, and you can only do so much with limited time and resources. Our social worker also she's considered extra help, because she's a retired nurse. And she's only here part time. And with her position, we only fund it for one fiscal year at a time. You know, then we get into a quandary, do we give that position give up her position, to save that to be able to hire another deputy. You know, cuz that's, that's a tough one, you know, if you can only fund for one of those positions, whether it be a full time deputy, or a part time social worker, that's like, that's, that's a that's a difficult challenge. So if anything, I think just the prop, you know, this is this is way above my paygrade here, but proper budgeting for, you know, to be able to have sufficient staff to do the deputy work. And also the social the social work aspect to it too. Because it is kind of sad how, you know, the deputy, we do the work, we investigate, and then we petition for conservatorship were granted conservator. And then that's it. We're like, Okay, that's it, there's no more connection to the client anymore. I mean, it's, it's really hard. I mean, ideally, we visit the client every six months, maybe a year. But our social worker, she's, she's really the face of the public guardian, because she's the one that will go out regularly, regularly. And as needed, she'll go to the facilities visit the clients in, in the nursing homes, the morning cares, and they've become familiar with her. Sure. You know, they know that she's the go to person for that, you know, and it, it's difficult to, you know, she's only here part time, you know,"]
+[-1.0863627195358276, 0.07194487750530243, "I mean, I guess I would have, I would have to talk to Jenny saw, it would be really our department, going to health care agency, which is our parent agency and saying, Hey, this is what we need. Because if we're going to properly serve our clients, and not just see them as a conserved individual and tossed into a facility, and we want to really be involved and connected to them. And yeah, we're gonna have to ask for a little more funding. So yeah, that would be Jenny's job."]
+[3.4430644512176514, 5.8143310546875, "Okay, just to two more questions."]
+[-0.7187974452972412, -2.007394313812256, "Yeah, so I mean, we, all the referrals that come in to us, I mean, we do. That's our data, to see how many cases come in how many cases we petition on and are appointed as conservator. That's always the big one. Because, you know, the deputies can only handle so much of a caseload. We are at an extremely high caseload right now. And as far as staffing we're a little low on staff as well, because we had to factor in, you know, turnover to people retire, people will, you know, just move on in life. And it's the most difficult thing, when you you can't prepare for that. I mean, you can only prepare so much. But, you know, we're forces beyond our control, when the Human Resources says, well, we can't really do recruitment until the persons actually gone when they are physically gone. And then going, going through the recruitment process itself takes, you know, four to seven months. You know, that's four to seven months of like, Rush services. Now now, we're because, you know, deputies have to take on the extra caseload from the Department Deputy. And, you know, the only way to be able to properly manage because, you know, we are on time constraints is what we do have to report to the court. So because of that our attention for clients is not there, you know, I mean, we're just rush, rush rush, it becomes more of it's like our clients are on a conveyor belt and we're just like okay, done done done done, as opposed to let me give you more attention. Let's really talk about your plan. Let's see how what we're going to do for the conservatorship, you know, this is going to You know, and that's, and that's why, again, why the social worker is so important as well, because she helps they help us with that, to do the stuff that we normally won't have time to do, because we have to write reports, we have to submit petitions, we have to do declarations, we also have to pay their bills, all the invoices that come in, we have to apply for the help apply for their benefits. There's so many aspects of the conservative we basically become, you know, I mean, yeah, we're like, it's like taking care of a child, we're, we're a guardian, again, except just for an adult, you know. So, you know, all those administrative matters, it takes away from the whole social aspect, and that personal connection, and to have one social worker do it for all of our clients. Again, it's just really difficult, you know, and, you know, it's sad that, you know, sometimes the facilities, because the court, they also have their own court investigators to check up on how the conservator is doing. And I'll read the reports and say. We haven't seen the Public Guardian in like seven months. And it's like, it's not like we're doing it on purpose is that we don't have time, you know, so"]
+[4.181140899658203, 4.503377437591553, "Well, is there anyone else you think that we should talk to"]
+[-0.6941955089569092, -2.246641159057617, "the board, whoever can help us, whoever can help us with funding for, you know, just, even again, our certain social worker, again, she's, she's a part time, you know, even if we were to have one full time social worker, which yeah, like I said, when I, when I first came into the Public Guardian, we had four, four full time social workers. And those were, and even they were busy as it was, then they all got taken away, and the deputies had to do the social work. And that was probably one of the most difficult times, then we got, ended up getting one full time social worker. And that was a big improvement. But she moved on. And then again, we had no social worker again. And until we had now Lynn, come on our our extra help social worker, so yes, it's an improvement. But there just needs a lot more or else we're we are just as the department, not the deputies as a department We're just going to be so disconnected with our clients and the facilities that they're at."]
+[3.6931309700012207, 15.109028816223145, "Yes."]
+[4.669710159301758, 3.1698930263519287, "Great. Now also, this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research. If you find that you've done what you share, please feel free to reach out to us. Our contact information is available on our website, www dot advanced oct.com. And you can leave an anonymous voicemail on our telephone line at any time. And then of course, I always tell people you can always reach out to me if you think of anything else you'd like to add."]
+[4.177368640899658, 4.149453639984131, "Okay, perfect. And likewise, if you have any follow up, you can shoot me an email Call me whatever."]
+[5.514237403869629, 6.045823574066162, "Oh, wow. Thank you very much. You just stopped doing"]
+[4.696280479431152, 4.140020370483398, "I think Katie went over most of my questions. Okay."]
+[3.421759605407715, 5.293592929840088, "Great, then I will just get started the primary."]
+[1.636679768562317, 1.2329527139663696, "So the finding of the needs of the community will, we'll be gathered together in aggregate at the very end of our research project. That will end approximately in February, and I believe you will be able to have access to that."]
+[3.6937973499298096, 7.122596263885498, "Yes. Okay. Please. Yeah. Yeah."]
+[4.085779190063477, 7.045736789703369, "Okay. Okay, let me I just made a note of that, so I can remember it afterwards. Okay. Okay. Okay."]
+[2.2190752029418945, 5.849823951721191, "Not that I can think of offhand. Okay."]
+[-2.656461477279663, -3.2463297843933105, "Feel free to interrupt me at any time. So the primary goal today is to identify what needs you think are most important to the older adult population that you serve, that is identified as those who are 60 and older, we want you to think as broadly as possible taking into consideration the older adults, caregivers, families and their communities. So I'm going to share my screen so you can see a list of common issues impacting older adults. Please take a"]
+[-1.3994485139846802, -0.2668668329715729, "minute mentioned caregivers, mentioned caregivers family as well as the adult any other areas"]
+[3.8067498207092285, 4.2165703773498535, "and their communities. Communities, okay. Yeah, okay, go ahead. Okay, thank you. So I will share this list"]
+[3.600198268890381, 7.176042556762695, "Yes. Okay."]
+[3.9187631607055664, 4.990251541137695, "Great. So please take a few minutes to read through the list and let me know when you are ready to begin."]
+[3.405179738998413, 4.063267707824707, "big list Yeah."]
+[3.5979034900665283, 4.737634181976318, "I will have a few questions on it. But I just wanted to give you time to read through it beforehand."]
+[3.5929386615753174, 5.027663230895996, "Okay, I've read through it."]
+[-3.432793617248535, -3.000560998916626, "Okay. Thank you. So, first question is for our records. Can you please tell us your role and how you interact or engage with older adults."]
+[-1.2745227813720703, -2.7632899284362793, "I produce the programs at the Jewish Community Center for seniors. And so we have about 1500 seniors who are members of the community as well as public people who come to the JCC for programs and I provide programming for them to address some of the issues in here and for recreation and immunity, contact and lifelong learning and clubs and groups."]
+[0.11791415512561798, -4.1814069747924805, "Thank you. And thinking about Orange County and looking at the list of common issues and concerns impacting older adults."]
+[2.1958580017089844, 6.461809158325195, "Um Gee, I I don't know, I'd have to give that a lot of thought"]
+[3.1814372539520264, 4.128563404083252, "you covered a lot of areas. So I'd have to give that more thought I can't really answer that. Now that I mean, this is a pretty extensive list"]
+[0.06850291043519974, -2.6709420680999756, "I would say something I can think of is legal assistance with estates wills. Any kind of legal assistance that somebody would need. Lawyers are very expensive. I don't believe that was on there with it. I don't think it was. No, thank you. So that that would be important. Legal Aid, it's very hard to get something like that. And and it's all kinds of situations that have come across people being put in living situations that they don't agree to, and their children decide that for them. medical situations that were not done properly. And at what point is someone not appropriate to drive anymore, that's a very big issue that needs to be explored. I know, I think if you're over 70, they give you another driving test. And then if you cannot drive, I do see, there's transportation. There's limitations on the transportation available and very difficult to get. As far as our JCC, we've had many problems because we're off the route of the Orange County Transportation. And so the buses won't even come here. So for years, we've tried to work with them on this and we have not been successful. So we we have a great deal of difficulty with transportation. And also in addition to transportation, perhaps providing some kind of funding for buses that a senior center could use themselves to pick up people in the area who need transportation. So that's another aspect of people losing their license, not being on the route of the transportation line route, and then providing funding for that. So"]
+[2.5424227714538574, 3.8956353664398193, "yeah, sure. So of needs on the list, including the ones that you just suggested, Please rank the top three that you feel are most important."]
+[0.5094224810600281, 1.1451575756072998, "I'm just reading to transportation."]
+[1.2038261890411377, -1.7068521976470947, "Okay. There was one more, I think it's on there, though, housing affordable housing. The I've noticed that the housing, the affordable housing is very limited. And it's very difficult to get into there's long waiting lists. And even though the Irvine company says you can apply for affordable housing, if you can't afford to live in their very expensive apartments, it's most of those apartments say, oh, there's no spots left or we don't do that anymore. And their discounts are minuscule. So I actually think affordable housing is something that should be looked at increasing affordable housing."]
+[5.449130535125732, 6.421843528747559, "Thank you. Okay."]
+[2.455601930618286, 3.9563443660736084, "Yes, top three."]
+[-1.269646167755127, 0.11687648296356201, "Oh, caregiving is is is very important. Caregiver is very expensive if you have somebody coming in, I don't know how many people can afford that kind of fees every day for caregiving, but that seems to be a big financial problem and burden for people who want to remain in their homes. And in addition to that, were the people who are caregivers. While you probably know caregiver support, let me see, I would say transportation is a top one, caregiving. I'm going through the list now."]
+[-1.8641446828842163, -0.8491045236587524, "Disability is big. living with a disability vision and hearing loss, cognitive decline, that's a big problem. Reading through this along with health care, that kind of fits with transportation, people need transportation to to get their health care. I say housing, I'm taking notes myself. I'm almost at the bottom of the list. Um, you know, I think I think that's it. And then along with unintentional injuries, I had a situation where the husband all of a sudden got very ill, he had some brain disorder that just emerged, and then his wife was taking care of him. And then she fell and had to be hospitalized for a hip replacement. And it was nobody take care of him. And that goes back to the whole caregiver thing. Having access, especially in an emergency to caregivers, who are not exorbitantly expensive, and they the caregivers don't get paid a lot. But when you're talking about 12 hours a day, or 24 hours a day, it mounts up and it becomes very costly. So I think that, so I've kind of given you the top things that I've noticed."]
+[-1.2489149570465088, 0.6006708741188049, "Thank you. And correct me if I'm wrong, I noted the top three as caregiving, transportation and disability. I know you also mentioned housing."]
+[-1.2706879377365112, 0.47793325781822205, "Yes. Well, caregiving and disability kind of go together. Okay, I would put that together as people come disabled, then they need a caregiver, so So I would say transportation, housing, and disability, caregiving, and number four would be legal assistance, possibly, that you only want three. Okay, thank you. Okay, got it."]
+[3.109227418899536, 4.4213056564331055, "So the next set of questions, we will be going through each of these three needs that you have identified. I know you've discussed a little bit about it already, but I will just go through the questions."]
+[0.5250172019004822, -1.4543311595916748, "Well, the people who have paid off their homes will want to stay in place and that's, that's okay. But the people who have not, don't have that situation, struggled to find apartments that they can afford on a low, you know, a retired income, or especially if it's a low income, I mean, people can't even live on Social Security. And and then if they need help, they have to go to a senior living facility. And those are exorbitantly expensive. You know, I've done some research on this. And, you know, they're 1000s 5000 a month for the worst places, and the nicest places go from 10 to 15,000 a month. So it's unaffordable, to go to these places and have the care you need. So there's nothing that's less expensive that I'm aware of, maybe there is and I'm just not aware of it. For people who either just need independent living or or need assisted living So I think that the housing is a dilemma unless people have a lot of money, but most people don't. So"]
+[0.9547957181930542, -1.6114089488983154, "I think it's a lack of funding and focus on developing these kinds of living situations. The real estate market is just into building and making money off of it. And there's very little left, I know that there's contracts with developers, if you're allowed to develop a certain area, then you have to have one low cost affordable housing senior facility in the area. But it's, it's so little and so limited. That That seems to be a barrier. I mean, I've seen beautiful new senior living facilities come up. But they're very, they're very expensive. So I think it's a lack of seeing a need for lower, more lower cost affordable housing."]
+[10.72628402709961, 8.369482040405273, "Thank you."]
+[1.2309505939483643, 7.725005149841309, "Well,"]
+[-0.22730828821659088, -0.6859684586524963, "I really think I think it has. If you have enough money, you can figure it out. But if you don't, so I think it's people who are less wealthy. And then the problem they encounter is there's long long waits, there's years of waits to get a spot. And that's, you know, the need is more urgent than that. So, and some of the places that they end up with it, which have somewhat expensive, are not very pleasant."]
+[10.590020179748535, 8.487899780273438, "Thank you."]
+[1.0971887111663818, -1.562064290046692, "Think the developer companies that are making so much money on squeezing housing and apartments in should be putting more of their profits into more humanitarian care of seniors because the senior population is growing tremendously. And I think that need is growing as well. And, and some of their profits should be going instead of to other things to making a for developing more affordable housing. Nice, affordable housing in the"]
+[1.053463339805603, 1.2907235622406006, "area. Thank you. Yes. Okay. Thank you. So now moving on, I"]
+[3.93924880027771, 6.384067535400391, "feel like I'm saying the same thing over and over. Go ahead."]
+[0.5257437229156494, 1.1826097965240479, "Moving on to transportation. So I'll go through the same questions for transportation."]
+[0.18252818286418915, -2.4421370029449463, "Because if they get more elderly and frail, and they lose their license they what I see happening is they have to get on a list, and there's a long waiting list. And then when they need the transportation, there's long waits for the transportation to come. And they only have limited places they go. Like I said, they they refuse to come to our JCC because was off the route and so people couldn't get rides here. So yeah, so that's a big problem."]
+[-0.4423375725746155, -2.4732091426849365, "increasing the availability, improving the routes, and providing buses, possibly for agencies, I know the the community centers, the senior centers that are funded by the cities and state have their own buses. But agency like ours doesn't have that kind of resource. So, you know, thinking about nonprofit agencies like ours, who could use some assistance in either funding buses, or specifying assigning certain buses to work with us, and picking up seniors. You know, I just want to say, what ended up happening here at our JCC is that we have two groups of seniors, we have the younger seniors who are like 60, to about 80, maybe 85, mostly 80. And then there's the older seniors 85, to 100. And the 85 to 100 are more frail and limited, and those are the ones that need the busing the and have a terrible time trying to get here. And they have to have people pick them up, they they, you know, if they're lucky, or they just give up, and then they are alone at home isolated. And although there was during COVID, there, there was some ability to get computers, so they come on Zoom, but that's a computer contact, it's not personal contact, the younger people can drive here and engage. So it's really more for the older seniors, there's, you know, as I said, there's a divide now it's younger seniors and older seniors. And, and it really makes a difference as people get more elderly and frail."]
+[-4.077381134033203, -2.066736936569214, "Thank you for sharing. Yeah. And are there different experiences for different groups of older adults from different backgrounds,"]
+[-4.044305801391602, -1.8766719102859497, "Um, pretty much I think backgrounds don't make much of a difference, except if a older senior has a family nearby, it does help. If they don't, it's, they rely on people in the community to help them. And so that's, you know, that the more older seniors are, who are who don't have family nearby, or are more at risk, and isolated."]
+[10.612404823303223, 8.437403678894043, "Thank you."]
+[2.3146979808807373, 5.304900169372559, "Oh, wait, this is what I was thinking. This is the difference in backgrounds. Yep."]
+[0.5749111175537109, 1.1860435009002686, "Yep, specifically for transportation."]
+[2.781541347503662, 5.580451011657715, "But I don't know, I came into that. I think I've said everything about this. Okay."]
+[-1.4417015314102173, -0.04194404184818268, "Thank you. So now moving on to caregiving."]
+[-1.331508755683899, -0.6532807946205139, "Because there's two parts to it. If a family member takes care of them, the family member can live their own life and they are burdened and they become maybe unhappy or depressed themselves. And, you know, you hear all this bad caregiver support. So that's one aspect of it. It's hard being a family member, caregiver. And number two, if you have somebody come in, it costs a lot of money. And so that's a big problem. It's very expensive, and I don't know what the solution is, but"]
+[2.401355266571045, 2.678403377532959, "it's a problem."]
+[-1.8332844972610474, -0.6579468846321106, "I don't know. I mean, the only thing is You know, assigning some kind of funding, or there's a certain amount people can get certain amount of care people can get through Medicare, but it's not like 24 hour help. You know, maybe it's somebody coming to see them for a few hours here and there, or somebody coming in dropping off a meal, you know, if Meals on Wheels. But, you know, in general, I think the cost is a big barrier, and maybe there needs to be some kind of, even if they came up with some kind of qualifying situation, I'm sure the list would be, you know, we're waiting six months or a year, there's no quick that the whole system is very slow, and large and complicated. And it's hard to get immediate care for somebody who might need it."]
+[10.689947128295898, 8.393695831298828, "Thank you."]
+[-4.209478855133057, -1.8602865934371948, "Well, we talked about the backgrounds already. So they Yeah, there are different kinds of experiences. I think the biggest issue is if you have family or very close friends nearby."]
+[10.67271614074707, 8.457097053527832, "Thank you."]
+[-0.5936663746833801, -2.3967714309692383, "Um, maybe hiring, maybe the county, to I know there's agencies that charge money for a visitor to come and be with you, or drive you. But again, it costs money. But I guess, you know, getting funding for home visits, home visitors, home drivers, you know, pay actually paying seniors out of a government funding to go visit people and spend a little time with them, maybe bring them a meal, take them to a doctor's appointment or something like that. So assigning some funds for seniors, because what I'm concerned about is the senior population is growing. And people are living longer. And so we're getting more and more frail, elderly people who do need help. They need people in their lives. They need support, they need transportation. And I'm not sure I know there's funding going out for so many things. But our the situation for seniors is just going to get worse and worse. Because people are living easily to 100 these days. And they're probably pretty frail from 90 on."]
+[-1.150008201599121, -4.068881511688232, "Thank you. So there are a few more questions left but I will stop screen sharing. So the next question is can you please describe how accessible and adequate the following care or services are in Orange County starting with geriatric care"]
+[-2.749143600463867, -0.7933814525604248, "it's very, very difficult to get doctor's appointments. I know many people have to wait weeks when something comes up unless it's an emergency and they go to emergency room. And that's what the doctor's office says because you might not be able to get an appointment for several weeks or even a month when something comes up. So the that kind of doctor care is growing more and more difficult. More and more doctors are becoming concierge doctors. And the doctors that are not are booked to the hilt with appointments. It would be great if there was more geriatricians I've looked around for geriatricians in the area. There's not as many as I would hope. Who specialists specialize in care for elderly. the medication problem is one size fits all. Oh, you're depressed pop a pill. Oh, you're, you know, whatever it is. There's a pop a pill. The people are being over medicated. And half the time the doctors they see a list of medications and then they say oh well you have this pen. We'll just add one on so many people are taking so many medications, but it's affecting their brains their balance. I think there needs to be more of a specialty With older people I know some doctors have said, Oh no, I would never give that dosage to an older person, a younger person can handle it, but an older person needs half the dosage. So I think there needs to be more focus on, on training doctors to work specifically with this very old population, even the young seniors, but really, with the old seniors even more so that that, and then the hospitals are just factories, I just don't see great quality of care of medical care. And it's not to say the doctors, I just think the doctors also are just overworked and overburdened, too. So that's part of the problem, then. And that's such a much bigger problem than I could even imagine trying to handle."]
+[5.647305965423584, 6.3532257080078125, "But that's a problem. Thank you."]
+[-1.117630958557129, -0.7139314413070679, "Well, it gets back to assisted living, the, the not only the assisted living, where people who can function but the assisted living memory care places. They're just very expensive. The long term care, and the quality of life in the ones that are less expensive, are poor, in my opinion, the quality of food, the quality care, the environment, the activities, are poor. You know, if you have big money, and you go to these fancy places, you get more. But still, there's pieces missing, unless you have a personal caregiver. So long term care, is not very appealing for most people."]
+[10.595455169677734, 8.49363899230957, "Thank you."]
+[-1.860843300819397, -1.6068096160888672, "Well, there's two things, I know Medicare does provide psychotherapy, visits with a therapist, if somebody's able to get there. Because if they're, if they don't drive, and they're isolated, um, they're not going to be able to do that, and they probably wouldn't be able to get on Zoom to do online kind of session, it's still very lonely. So I just think mental health is really a problem because of isolation and loneliness, and lack of purpose, lack of social. So I don't know, I'm trying to think of what what can be done, except that, you know, in certain places, like, where I am, and some of the senior centers people meet, and they have group meetings and discussions, and that seems to be helpful. You know, for like my group, it's a younger group of seniors who meets and we have a kind of a support group. But for the older seniors, now, they can't even get here. So that's a big problem. So I don't know. I'm just trying to think more about I don't know about the solution for that, but it's definitely problem. I don't know. Maybe some other people can figure it out. Thank you. I don't know. Whatever. Okay."]
+[-0.38648107647895813, 0.19239245355129242, "Well, human and social services to me is the same thing. It's, it's mental health. Having enough food. I think that's it because we already talked about the housing thing. It's really having food because especially if people are alone, they're not even cooking for themselves. They're eating frozen dinners, if they can get those delivered or go to the market or, and. And like I said, in isolation, they're just that's part of human services, food and company, and the biggest I think"]
+[0.1548892855644226, 3.459561824798584, "and what do you think will be the biggest challenge older adults So faced in the next 10 years,"]
+[-2.107865571975708, -2.0986697673797607, "we're having a boom in the amount of seniors. And as the seniors in their 60s and maybe 70s, age and keep on living a long life. It there's, I see the future is holding a lot of questions about the aging population, which is just increasing all the time."]
+[10.717808723449707, 8.37639331817627, "Thank you."]
+[0.954439103603363, -2.3448543548583984, "I think they have to reevaluate funding. And recognize that this population is growing and becoming more and more needy, and find donors especially there's so many huge, wealthy companies of all kinds I, that I just got a newspaper from Irvine, and it was four pages of these tech companies and social media companies and all these major major companies, and they're making so much money, I think these companies ought to donate or be taxed to contribute to addressing the needs of the older seniors. And I think that I think the companies that are really doing well, I don't want to tax the people anymore. But certainly, you know, the Irvine company is making a huge amount of money, I think they should be helping with this supporting more housing, all these developers, Lamar, and all these developers that are coming in, should be supporting the housing, the companies that are doing really well here and growing. There's lots of entrepreneurs coming in starting companies in Irvine, it's the appealing place, there should be some kind of tax or charge. And these funds should be directed, not to the program director of you know, in the government, but to the, to the people and to creating programs that will improve the quality of life in all the areas that I mentioned, and that are on your list to older seniors."]
+[0.09856224060058594, -4.987473487854004, "And thinking about all the older adult residents in Orange County, who is getting the least amount of attention"]
+[-0.2825468182563782, -0.7608917951583862, "I think that people who don't have transportation, who have some kind of disability, who are living alone, who have limited funds. That's it."]
+[3.468186616897583, 4.085583209991455, "Oh, boy, that's a hard question. There's I don't know. I mean, I mentioned one here that I didn't see on your list, which was legal assistance because we mentioned all the others"]
+[1.3947123289108276, -1.147886037826538, "I think the big thing that is being overlooked is affordable housing. I think that's a big thing. Legal Assistance is there but it's not the biggest I think affordable housing is and maybe food scarcity. I just think of people who you know, just aren't able to cook aren't able to shop. So yeah, that's it. Thank you, boy. upsetting, actually, yeah."]
+[4.8148417472839355, 3.4896860122680664, "That concludes our interview. So thank you so much for your time."]
+[2.8616645336151123, 4.82759952545166, "Oh, good. Yeah, so I would like to get the results of what they come up with. So"]
+[5.582116603851318, 6.345514297485352, "Okay Thank you"]
+[-2.678955316543579, -3.2654714584350586, "No. Okay, so the primary goal today is to and identify the needs that you think are most important to the older adult population you serve. Those who are 60 and older. And we would like you to think as broadly as possible taken into consideration of older adults, caregiver, family and their community. I'm going to share my screen so you can see a list of common issue and concern impacting older adults. Please take a few minutes to read through this lesson. Let me know when you are ready to begin. And whenever you want me to scroll up and down, let me know."]
+[4.30770206451416, 5.365072727203369, "You can scroll down"]
+[3.8344027996063232, 7.87293815612793, "right there."]
+[-3.3447837829589844, -2.966371774673462, "Okay, I think we just have one more on the list. Okay. Well, I'll record can you please tell us your role and how you interact with older adults."]
+[-0.9727758169174194, -3.363020896911621, "Sure, I am the manager of the emergency services at Saddleback Medical Center. I interact with our patient population, every day that I'm in office, I help facilitate education for our nurses, any policies or procedures that go into place that would impact our our older community. And then I'm on the floor in the ER every day interacting with with patients as they come in, be seen and treated and then discharged as well."]
+[0.155187726020813, -4.081669330596924, "So thinking about Orange County and looking at the list of all common issue that impacting older adults is anything missing from the list"]
+[2.8074188232421875, 3.9085474014282227, "now that's a pretty comprehensive list, I think it hits all the highlights that I I had in mind already."]
+[2.522793769836426, 3.9030954837799072, "So up there next on the list, Please rank the top three that you feel are the most important I"]
+[-1.398043155670166, -0.9734039902687073, "think, for us, honestly, transportation, mobility is a huge one, we're having a lot of difficulty arranging transport for our older population, especially after hours at nighttime. So that would be currently number one on my list. And then after that is thinking the top there was one about caregivers finding appropriate caregivers so the patients can stay at home and still be well cared for in a safe manner. And then with behavioral and mental health do we are seeing a lot more patients with dementia come in that are quite challenging for family to care for. But then they're also not necessarily meeting criteria for long term placements. So they're kind of in this limbo state of where they can get the best cared for. We prefer them to go back to their home setting with with caregivers at home is ideal. That's right, that's one of our big challenges, too, is patient placement population."]
+[0.5627751350402832, 1.098154902458191, "So for the next set of questions, it will be a little bit repetitive as we dig deeper into the three topics that you selected. It's gonna let you know. So when you think about transportation, how or why older those struggling with this issue."]
+[-1.419762372970581, -0.9442927241325378, "I think a lot of times they have another loved one is also elderly and either has difficulty providing transport. So if we have a patient that is getting discharged, said sometimes we get discharges at one in the morning. It's very difficult to find a loved one to give them a ride home. Then the next best option is private companies like Uber, they have an Uber assist that we use, sometimes that can help with discharges and then for ambulances charges that's not covered anymore under Medicare. So they get stuck with the bill if that's there. Only way of having transport home usually will provide them an area to stay in a comfortable area to stay until the morning when the loved one can drive. But sometimes they'll have a loved one that can't drive at nighttime."]
+[3.759538412094116, 8.507003784179688, "Wow."]
+[-1.4666932821273804, -0.1424015313386917, "I think if there could be more options for healthcare facilities, especially emergency departments for arranging transport home after the 8pm hour, it's kind of challenging to find a company that will provide a safe transport home, especially if there's any type of medical needs from the patient, whether it's oxygen or, or a wheelchair. Ideally, we always try to have a loved one provide that ride. It's not always appropriate or available. So we have a lot of difficulty finding transport home for these patients after hours."]
+[-3.9349544048309326, -2.035048723220825, "Okay, different experiences for different group of older adults from different backgrounds."]
+[0.1702413409948349, -2.530763626098633, "I'm not sure No, I don't, I think that transport issue doesn't change at all based on their their demographics other than the age and how much family they have available in the area. It does become more challenging a younger population, sometimes our younger end of the geriatric spectrum like a 60 year old, they are already familiar with using an Uber or feel comfortable with a taxi. But it's not uncommon for us to take care of and discharge patients that are 80s 90s, even 100 years old sometimes. And that's when transportation becomes a little bit more unsafe in a faculty like Uber or a taxi."]
+[7.181530475616455, 6.162603378295898, "What do you suggest is the best way to address this issue"]
+[-1.225401520729065, 0.0038216274697333574, "if there was more private companies that could provide after hours transport that had trained staff to assist with medical devices, to ensure they get back into their home, where a caregiver caregivers their to receive them. And there's documentation of that, that would really benefit our I think the entire county."]
+[-2.1999757289886475, -0.8565917611122131, "When you think of caregiving how or why older adults struggling with this issue."]
+[-1.209134817123413, -0.6415551900863647, "There's a lot of times, our elderly population, their caregivers, also another elderly spouse who's dealing with their own complex issues. And sometimes they can get sick all of a sudden, and then they don't have any backup for caregivers. So there's many times we have a patient, our ER, that's receiving care, but they're the primary caregiver to their loved one. And now we're we're working on social work and case manager to find resources not only for the patient being treated, but for their loved one that they're the primary caregiver for"]
+[-0.6247387528419495, 2.6535303592681885, "what barrier assists to see improvement in this area."]
+[-1.0545591115951538, -0.39731428027153015, "Think access to community resources is a big one. We have a really good team of Social Work and case management that can help facilitate finding support for the patient as the primary caregiver to their loved one. But I don't know all the details around that I'd have to refer to our case managers and our social workers. But I know we do have trouble finding resources available all the time for for those type of scenarios."]
+[-4.184277057647705, -1.9246602058410645, "are there different experiences for different groups of older adults from different backgrounds."]
+[0.06884916126728058, -2.5647330284118652, "i Yeah, actually for transportation, too. I wasn't thinking about the economic diversity. But yeah, for lower socio economic families, it is more challenging transportation when there's the cost of transportation will usually cover the cost of a taxi or Uber if they can't financially pay. But as for the ambulance, it's it's quite an expensive cost, if that's their only form of transportation home. And then same with resources in the community. It's it can be quite expensive to find caregivers."]
+[-0.8823164105415344, -0.8694308400154114, "I think having more partnership from acute care facilities with the resources that are available, whether it's at home caregivers or Respite homes. Like I said, our experts are case managers, our social worker, and I know they do have a lot of partnerships and connections in the community. But I think those could probably be increased, especially with how many older adults we see every year and with the population getting older and older."]
+[-2.733121395111084, -1.585357666015625, "When you think up behavior and mental health how or why older adults struggling with this issue"]
+[-1.3687363862991333, -3.524137258529663, "can be really complex with older adults, because we do see older adults come in with anxiety and depression. But then they also have layers of other health issues that getting them to appropriate psychiatric facilities can be challenging. So psychiatric facilities in Orange County, most of them are equipped to deal with the psychiatric emergency piece of it, but they're not well equipped to deal with chronic conditions like heart failure, diabetes, or COPD. So we end up having patients who have prolonged stay either in our ER or in our emergency department, because those facilities that have expertise and caring for mental health can't necessarily care for the complexities of somebody with several chronic conditions. So they kind of are stuck in the hospital, which isn't the best setting for their mental health crisis that they're having, but we need to care for their era, you know, chronic condition."]
+[-0.6123928427696228, 2.679400682449341, "What barrier assists to see improvement in this area."]
+[-1.3251415491104126, -3.6359164714813232, "major barriers, just the options of places to send older adults that are having mental health crisis, there's really not a whole lot of psychiatric facilities in Orange County that specialize in geriatrics, like psychiatry, especially, there's really not a whole lot of facilities that can manage chronic conditions and the complexities of older adults with chronic conditions plus the mental health aspect."]
+[-3.929330825805664, -2.0350403785705566, "Okay, different experiences for different group of older adults from different backgrounds."]
+[-2.0676825046539307, 0.5361964106559753, "Yeah, same with the other ones, you know, insurance socio economic status. Family support, yeah, there's some other factors that can weigh in, it doesn't really change, how we treat them at our hospital or how we try to arrange for them to go to the most appropriate facility. But yeah, the socio economic can be another factor for outpatient treatment and long term treatment for mental health to"]
+[-1.3502895832061768, -3.564462423324585, "If the county could put in additional resources for mental health for older adults, especially in South Orange County, there's not a whole lot of facilities or outpatient areas where we can refer these patient populations to I think, yeah, just support from the county and from the state to increase access to mental health. Practitioners."]
+[-1.2537286281585693, -4.271986484527588, "Can you please describe how assessable and adequate geriatric care in Orange County"]
+[-1.294915795326233, -4.043824672698975, "You know, I can't speak for North County or I know South County we have what were our hospitals a Age Friendly Hospital and we're a geriatric emergency accredited department. So we have pretty good resources for geriatrics in South Orange County. I don't not sure about North County or, or across the county in general, but in this area around Saddleback, we do have geriatric specialists, we have outpatient areas for them. I think access in the acute care setting is I mean, they have a geriatric emergency department in in us in Laguna Hills, I'm not sure about the outpatient arena with specialists that have available appointments that are easy to get in with them. I can't really speak on that."]
+[-2.737962007522583, -0.2412337213754654, "Once again, I actually don't have much experience with this aspect of the continuum of care. I think our case management social work department are the experts in that we do have there is challenges and finding Long Term Care for some of our older population, which prolongs their stay in the hospital. But I'm not really an expert to talk on accessibility of long term care."]
+[-1.2570087909698486, -3.5639686584472656, "I think the accessibility is not where it should be. I think we could improve the access for mental health and drug and substance abuse as well. There's barely pretty limited facilities that we can refer patients to especially in South Orange County."]
+[-0.8527528643608093, -3.891700029373169, "Can you please describe how assessable and adequate human social services in Orange County"]
+[-1.3656736612319946, -0.20438404381275177, "in a acute care setting, we do a great job we have social work available 24/7 Not sure what that looks like when they are discharged and leave our facility."]
+[7.169853687286377, 4.6400146484375, "Thank you for sharing."]
+[-3.1434240341186523, -0.5549169182777405, "I think having enough practitioners and facilities that specialize in geriatric care because it's a really unique, complex area of medicine, just because the older adults have more chronic conditions they have more polypharmacy. They're on more medications in the standard and they just require more detailed workups from physicians and and I think there probably could be a lack in that in the future, especially with our population getting older and older. I'm not seeing as much emphasis on geriatric specialization in the medical field or in the nursing field as well."]
+[-3.168177366256714, -0.5342084765434265, "I think providing additional resources or financial incentive to increase specialists in geriatrics whether that's physicians or nurse practitioners or or facilities that participate in geriatric programs."]
+[-0.019166456535458565, -4.804894924163818, "Thinking about are the older adults resident in Orange County who is getting the least amount of attention"]
+[-3.051575183868408, -0.5101028084754944, "I think probably the, the older end of the geriatric population that's also in the lower socioeconomic status. Just because they don't have they're not usually as established with physicians and outpatient care. And when they present to the hospitals. They're usually not as well cared for their medical conditions as someone from a higher socioeconomic status."]
+[0.16036060452461243, -0.7383264303207397, "Let's see, I'm trying to think I once again, I think maybe the under the economic security bucket just access and current state of living for lower socio economic, geriatric population, especially ones that have limited families and social support."]
+[-1.5069079399108887, -2.8552749156951904, "Is there anybody that's serving older adults or any organization that you think that we should talk to, to get the input in the project,"]
+[-1.371605396270752, -3.720445394515991, "you know, the American College of Emergency Physicians, they have their own accreditation that we went through six years ago, and we've renewed since then, as well, what's called the geriatric emergency department accreditation, they really help build guidelines and show you how to put policies and procedures into place and in emergency departments to help care for geriatric populations. And especially at risk, geriatric populations, like our lower socio economic cohort. There, they have a lot of great resources. We also partner with a organization called Alzheimer's OC, and they've come in and they've done specialized training for our nurses and our physicians on how to care for a patient that has advanced dementia because it's a whole unique care process compared to older adults or other patient, you know, an older adult that has advanced dementia in an acute care setting like emergency department requires a lot of specialized care and training on the staff part. I know we're doing that out of our own pocket. It's not a requirement by EMS, or by the state or by the county. We're doing it because it's the best thing for our patient population. We do see an older population than most hospitals in Orange County because of our location and Laguna Woods. So I think that's a great organization, Alzheimer's, OC, they help us with a lot of our Age Friendly Care."]
+[-3.084663152694702, 0.008395018987357616, "And the first one you mentioned is American College of Geriatric emergency. I think I'm missing a war."]
+[-2.285494089126587, 0.3734222948551178, "Oh, sorry. No, it's the acronyms ACEP or ACEP. It's American College of Emergency Physicians. So ACEP"]
+[4.906433582305908, 3.345471143722534, "ACEP. Okay, thank you. Physicians. Thank you. So this concludes our interview. If you think of anything that you'd like to mention, you can always reach out to me and reach out to us. I'm gonna stop the recording now. Thank you so much for your time, and I'm learning so much today."]
+[4.800957202911377, 4.174237251281738, "Oh, yeah. Thank you, Katie."]
+[-2.4393978118896484, -3.5539276599884033, "Yeah, I just really like during the interview, I cannot really say anything that would encourage any kind of response. So I have to keep it pretty monotone. Like they'll be really touched my heart when I know that, you know, the senior doesn't I mean, they don't have transportation late at night or like caregiving. So that's something I'm going to take no up and hopefully we'll put that in the report."]
+[-0.004009473603218794, -2.621898651123047, "Yeah, that one's definitely the most challenging and the most upsetting on our end to when we have a patient that's, you know, 85 years old and we have to arrange an Uber at one in the morning. Just to get back"]
+[4.852664470672607, 3.464077949523926, "No, I'm excited about the interview."]
+[-2.7182910442352295, -3.2922394275665283, "Thank you. The primary goal today is to identify what needs you think are most important to the older adult population you serve. Those who are 60 and older, we want you to think as broadly as possible taken into consideration the older adults, caregiver, family and community. I'm going to share my screen so you can see a list of common issues and concern impacting older adults. Please take a few minutes to read through this list and let me know when you are ready to begin."]
+[-0.0789208635687828, 0.9889332056045532, "Hello, Katie, I can only read down to Okay, perfect. Economic No, okay, perfect. Okay,"]
+[5.457260608673096, 6.410811901092529, "Okay, I'll let you know."]
+[3.7399630546569824, 7.132685661315918, "Okay. Yes. Okay. Good."]
+[2.48651123046875, 3.9667022228240967, "One more, maybe just like up to the Okay, got it. Okay, that's good. All right. And then you're asking me to rank the top three."]
+[-1.1766722202301025, -3.372262954711914, "Okay, so my name is Carol Dupee. I am a Senior Advocate. I actually have a long history of working with older adults in the Orange County area and a wide wide variety of ways. Everything from elder abuse, to fall risk to caregivers. Certainly, to mental health concerns, that's a passion of mine grief. Honestly, just a lot of different ways, including telehealth and health care access. Telecommunications with older adults, etc, etc. I currently am a member of the Orange County Behavioral Health Advisory Board and I chair, the Orange County older adult Behavioral Health Advisory Council. And we have developed a wide variety of different resources for older adults, including a mental health training program that we developed for community members who may encounter older adults such as emergency responders, shelter workers, etc, etc. As well as a mental health resource guide for older adults. And, and even more, but that's enough for now."]
+[0.0920209214091301, -4.182769298553467, "Yeah, you got it. Okay, so for the next question, thinking of Orange County and looking at the list of common issues and concern impacting older adults."]
+[2.3428361415863037, 4.8710832595825195, "No I don't think so. I don't think anything is missing."]
+[2.5422160625457764, 3.8545641899108887, "Thank you up the links on the list, Please rank the top three that you feel are the most important."]
+[-1.1400548219680786, 0.722589373588562, "So that's so just because these are the top three doesn't mean that there aren't other ones that are pretty close, easily the top three, that just about everybody is going to say first one is going to be housing. The second one is going to be healthcare access or transportation in general. And then the third one very likely may be caregiving and or caregivers. Caregiving in some in one way or another whether they need it or whether they're doing it."]
+[1.6160489320755005, -0.7215925455093384, "Okay, so to clarify, so first will be housing and second is"]
+[-1.4691948890686035, 0.4130662977695465, "health care access, how can access and about transportation,"]
+[0.9302618503570557, -1.3216707706451416, "and transportation, and third will be caregiving. There's so when you, when you think about housing, how or why older adults struggling with this issue,"]
+[0.5580903887748718, -3.1941721439361572, "for a number of reasons, one has to do with affordability. That's many, many, many older adults are living on their social security. And just so that, you know, and Katie, maybe you know this, but the average Social Security check is between 15 and $1,800 a month, who can possibly live on that, and, and pay rent at the same time. So, older adults, but they don't just need affordable housing, they probably also need ADA approved housing. So it's not just affordable, but it's also ADA approved. And there's very little of that period, in Orange County, very, very, very little of that."]
+[-0.7737062573432922, 2.2610154151916504, "What barriers are assessed to see improvement in this area."]
+[0.00017916208889801055, -2.111868143081665, "But there's a lot of housing that is going up everywhere you look at your I'm sure you see lots and lots of housing going up. And mostly these are apartments, condos, that sort of thing. Or some and some of them there, we have a lot of assisted living facilities, residential housing for older adults, that that's going up, but it's not affordable. That's the problem. That's a barrier having it be affordable. For older adults, that's that's a huge problem. And the other one has to do that, as I say with the ADA piece. Not all older adults need ADA, but so many of them either do or they will need something that and ADA is going to be so larger doorways so that wheelchairs can go into and showers that are called roll in showers so that they can roll into their whether it is with a walker, whether it is with their wheelchair into the shower, but not just that lower kitchen cabinet, kitchen cabinets, and kitchen counters. But I mean, there's a wide variety of of those types of ADA requirements. Again, I think there'll be a question and I'm not sure that I'm answering it."]
+[3.0767006874084473, 4.8886518478393555, "Yeah, I think those are actually very insightful."]
+[-0.8245412707328796, -1.8289263248443604, "Of course, of course, there are, of course there are. So that's one of the that's one of the dilemmas too, with older adults. And Katie, if I get off track, you're just gonna have to pull me back on. And I really mean that because I may easily get off track. So older adults, oftentimes, oftentimes got to get lumped into one big ball. And they're there. They're older adults are you and I, they're everybody. So it's not just different ethnicities. It's not just different physical needs, but it's it's also community. That is to say, and then, and then this is this is typically an overlooked group of older adults that has to do with gender preferences, that is to say, many older adults have not chosen to identify their own sexual orientation. That's something that we really need to be addressing. But as far as housing is concerned, that's the community piece. Many older adults would, they would really prefer to be with other individuals who are like bind it in as, as they are, whether that has to do with language, or whether that has to do with ethnicity. Sometimes it has to do with, with religion, truthfully. And not that everybody has to be we don't. That's just a consideration. We just put it that way. That's just a consideration that we need to keep in mind. One last thing that happens with older adults is all older adults get lumped in together whether they are 62, or whether they are 92. And that's also not cool, because there that's a 30 year age, difference and many interests and values and preferences They're not the same within that 30 year age group. And all and older adults typically get all lumped in to one mass bundle. And honestly, it doesn't make sense. But that's that's oftentimes what happens."]
+[7.070444107055664, 4.69333553314209, "Yeah, thank you for sharing that."]
+[-0.19039775431156158, -1.913985013961792, "Well, first of all, I think we, we need to, there truly just needs to be more affordability, that's the first piece, that's the most important piece is that it has to be affordable, even if it's not ADA. But that's the, that's the most important piece, it needs to be affordable. But then the second piece is we need to truly focus on on the ADA, housing, because if we don't, in many ways, we're we're asking for trouble because people, if it's if it is neither affordable, then they can't have it. And then then we just have all kinds of other problems at this group, this age group is just growing. By leaps and bounds, it's not going to that's only going to become more apparent as time goes by. But then the second piece is, if we don't look at the ABA piece, we're going to have a lot more injuries. And then there's more hospitalizations, and more problems with healthcare in general. Because when older adults try to reach counters, cabinets that they can't, that they can't reach. We're gonna have more falls. And that's, that's also just that's not okay, we're gonna have more deaths, because older adults die when they have hip replaced when they have hip fractures that time of course, but that's, that's often one of the things that happens. Infection sets sets in there all kinds of other problems anyway."]
+[-2.296804428100586, -1.1562985181808472, "So when you think of access to health care, how or why older adults struggling with this issue,"]
+[0.2606491446495056, -2.696962833404541, " so for a couple of reasons. One has to do with having personal transportation. So it I don't know how old you are, Katie, but I can just tell you that they're there two times in an individual who lives in California. And I mean, in California, I don't mean in Kansas, we're not talking about Michigan, I don't mean Arizona, I mean, California, there are two times in an individual's life that are absolutely life changing. Life changing. First one is, when you get your driver's license, Katie, oh, my goodness, it changes your life, it changes your life. Because here in California, our public transportation system is not very good. We just, it's really pretty bad. And part of the reason that it's pretty bad, it has to do with the fact that because we are so independent, here in California, we like to be able to go wherever we want to. So the transportation, public transportation, they're kind of like ham strung because they don't have the money because people don't use their their services that much. So then they end up having to be cut their services end up getting cut back and cut back and cut back. But so transportation, that's the first most important milestone for any anybody, for almost all individuals is when you get your driver's license. The second one is when you take it away, completely changes your life, life changing life changing days, when you get it, and when you lose it. And if you win, you lose your your driver's license. That means you have to depend on other people. And nobody likes to do that. Yet, I am having surgery on Thursday, and I'm not going to be able to drive for a week or 10 days. The doctor is telling me a month but my point is I'm resistant to taking a month because I don't want to have to depend on other people. But a few seconds before I got on this call. I was making arrangements for some doctor's appointments for next week after my surgery, and I don't want to have to do that. No, no, I've got a perfectly good car. I'm a good driver. And and I don't want to have to depend on other people. That's what happens when people don't have their their either their own transportation or when they don't have a driver's license. So that's one thing. The second thing it has to do with finances, because let's say, let's say that they do have their own car. And they can drive, because a lot of older adults can and do. But it's expensive. And they, they are already counting out every penny, and having to come up with the, the maintenance that is involved with a car, whether it's gas, or insurance or whatever, that's another big expense for older adults. Let's say they don't have transportation, and there they are using OC access. That's not a whole lot. Okay. Unless, unless you have and that's but that's $5 to the doctor's office, and then that's $5, back from the doctor's office, and it's actually I think it's $6. But my point is, that's 12 bucks. If you go to your doctor's office, I don't know where your doctor's offices and it doesn't matter, it's not going to cost you that much. And what if you have to go to the doctor's office, let's say half a dozen times a month, and that doesn't count how many times that you also need to go to the grocery store, or employee number of other places, it really adds up for older adults. And that's, that's a problem."]
+[-0.678491473197937, 2.390453338623047, "So yeah, what barrier exists to see improvement in this area."]
+[0.22703677415847778, -2.8105807304382324, "Honestly, I would say a couple of different things. So obviously, there are and by the way, there are some very excellent transportation programs out there for older adults in the cities, the cities themselves have a number, not all but there are a number of cities in Orange County, who have developed great programs for older adults that involve that involve offering transportation within city limits to various locations, whether it is the Senior Center, or whether it is to shopping on like, every Wednesday and Friday, there are a number there are a number of different options that that are currently available out there, to some extent to some extent, but there's some good options out there. But here's the second thing that I would love. And that is I would love to see older adults have access to like golf carts or to or other transportation, really local kinds of transportation options that many older adults just they just need to go someplace close by. And if they had those kinds of options that would free them up to do to feel more independent and would alleviate probably a lot of different problems, including that maybe they need scooters. But there there are other things that that we can do to make older adults both more independent, as well as healthier too."]
+[0.2532431185245514, -2.6370770931243896, "what cities are doing a good job at providing those kinds of local transportation for older adults."]
+[0.6849392652511597, -3.0548999309539795, "But the cities so Brea is doing a really good job. Irvine is doing a good job. Let's see. Newport Corona del Mar is doing a good job. Newport Beach is doing a good job. Let's see. There's some there's some other North Orange County cities too that are doing a good job. Orange is doing a good job."]
+[0.8754791021347046, -2.780982494354248, "Anaheim is doing a good job. There I honestly I'd have to think about it. But there are there are a number of cities that are currently I think doing a good job. There's another one that is Oh, Fullerton, Fullerton is also doing a good job. Oh,"]
+[7.183285236358643, 4.657190322875977, "thank you for sharing that."]
+[-4.134091854095459, -1.9505451917648315, "Of course, there are lots of different experiences for older adults. And thank you for asking that question. Because that would be one area that I would want to shine a spotlight on is that there are different different groups of older adults. Again, whether we're talking about different ages, whether we're talking about different ethnicities, whether we're talking about different language groups, whether we're talking about different religious groups, there are lots of please, let's take those differences into account. When we talk about older adults, please take those into account."]
+[-0.22317057847976685, -2.600783109664917, "Yes. So one of the things the so I worked at St. Jude for about 15 years, with older adults. And one of the things that we started doing at St. Jude, probably, at least, and I can't take any credit for this. This was my boss, Barry Ross. But one of the things that that Barry Ross, I'm saying his name again, because I want it to be recorded. One of the things that he initiated, oh, probably in the 90s is, or maybe it maybe it was in the 2000s, early 2000s. But there was long before anybody was doing anything like this had to do with transportation for older adults. And he offered, he developed a transportation program for health care where we would offer transportation to seniors who needed transportation to any appointment at St. Jude, whether it had to do with occupational therapy, or whether it had to do with a grief group or whether it had to do with a visit to their primary care physician. He offered transportation, the transportation was I'm trying to remember how much it was, oh, I shouldn't say that. I know how much it was $2 a ride. And if you couldn't afford the two $2, we waived the $2. It's not like $2 was going to pay for the transportation anyway. It was just a no nominal amount. And he offered that long before anybody anywhere was offering transportation. That's one of the things so now insurance companies do offer transportation options, typically a limited number. It's usually around between 10 and 16. rides per year, which by the way is not enough. But it's something and it certainly is helpful. So that I think health care systems, whether we're talking about insurance, or whether we're talking about health care groups, like Memorial care, Hoag, Providence, where I come from, if those if those programs would offer transportation options to older adults, that would be that would be huge. And it's it's not easy. It's it's, I should rephrase that, that it's hard that I because I worked with the program. I'm pretty familiar with some of the barriers, the problems with that program, but I can tell you, it's also very successful, which is why insurances has started offering it, they just piggybacking right off of my boss, Barry Ross, and doing what he suggested he was very innovative. He came up with a ton of great ideas in general, not just for older adults, but in general who's great. Sorry. Didn't mean to get off on that."]
+[7.1674604415893555, 4.617156982421875, "Thank you for sharing."]
+[-1.4375805854797363, -0.683806836605072, "Lots a ton of reasons, there's no one reason. So if they need caregiving, it's hard to find dependable caregiving. Like I say, I'm going to have I'm having surgery on Thursday. And so and the type of surgery that I'm going to have, it's pretty major and, and I have been told that I'm going to need to have somebody with me absolutely. For the first few days after after my surgery. We're gonna have to go someplace. I'm gonna have to either be out of my home or have somebody come into my home to help me well, I'm fortunate that my son and his wife have said, of course Mom, come and stay with us. No worries. But that's not how it is for everybody. So finding somebody or even being willing to be dependent on somebody else, that's really huge. But let's, let's turn it around. Let's say that that I'm married, and my husband needs a caregiver. Well, you know what that's going to be me. Like, regardless of what my health is, I am going to be the one who's going to be responsible for him, you, you very well may know that when a partner is the caregiver for their partner, more often than not the person who is the caregiver, they're the one who they're the ones who end up in the hospital, and they end up in the hospital because nobody's taking care of them. The person that they're taking care of, they're okay, because somebody's looking after them. But the caregiver gets worn down, they actually literally lose their life, they become invisible. And because it's not about them, it's about the other person. And they all have their needs become secondary. And that's, that's unfortunate too"]
+[-0.6808530688285828, 2.418727397918701, "what barrier exists in seeing improvement in this area."]
+[-1.2723537683486938, -0.8780632615089417, "So here in Orange County, again, we're very fortunate because we do have resources. There are quite a number of resources available, including the Caregiver Resource Center, but Alzheimer's, Orange County, as well as the Alzheimer's Family Center, as well as Alzheimer's. Foundation, of course, they, they, they also offer caregiving kinds of assistances. But one of the things that we need more is we need more respite. for caregivers. We need opportunities for caregivers to be able to have a break, they just need to have a break, whatever, whatever we can give to them is not enough. Currently, if you are on if you're Medi-Medi, you're likely. Alright. Jack, thank you. Thank you. Okay, pumpkin. Sorry. I'm having my street paved out friend, and they're just all kinds of things happening out front of the house here. He's very interested in this. So I was saying What did I say respite, but caregivers need. I got sidetracked. One of the things that caregivers need is they need training. So oftentimes, let's say that I was having to be caregiver for my husband, and I was until he died. He may need to be transferred from the bed to a wheelchair. Well, if I don't know how, what the proper techniques are, for transfers, I could injure both myself and him easily. So there are fall risk training, there are all kinds of trainings that caregivers could benefit from having who are family caregivers, but they could Oh, I would say that they could qualify if there are Medi-Medi they can they can qualify for IN HOME supportive care, IHSS services, and they could get a caregiver. And and that can be also very helpful. But oftentimes, they will have to pay a share of cost for that caregiver. And that can be for them to even if they qualify for Medi-Medi, they very well may have to pay a share of cost. And that that's just one more, even if they need it. Badly. That can just be one more burden."]
+[3.6869466304779053, 15.52882194519043, "Yeah."]
+[-0.5306682586669922, -0.7735390067100525, "Yes. So one of the one of the differences. Katie has to do with tradition. So in in, so I'm Caucasian. And so I think I've said that. I have two two, I have two children. And they're both they just step right up. And if I need whatever it is that I need, I'm going to stay with my son and his wife. My daughter is going to be transporting me to and from doctor's visits. That's great. That said, the I'm Caucasian and the tradition in many white families is that absolutely let's let's do these things for you, mom, but are you thinking of coming to live with us Mom, I'm not so sure that we're we're We set up for that, or how long are you going to be here with us. That's, that's not something that in my ethnicity that we do quite as easily. But there are many other ethnicities, both of the Latinx communities, both as well as the API, the Asian Pacific Islander communities, they're much more likely to say, mom come and live with us, or I will come and live with you. They take it very seriously. And I don't mean to suggest that it's not taken seriously. Within the Caucasian. European background, but there's differences. That's really what I'm getting at here are different. And, and the responsibilities are seen in different ways, too."]
+[7.132081985473633, 6.208590030670166, "Thanks. Thank you. So what do you suggest is the best way to address this issue"]
+[4.518434524536133, 5.355287075042725, "And don't just look at it from one angle, because that's not going to work."]
+[-1.2532844543457031, -4.248456001281738, "Thank you for sharing. Can you please describe how assessable and adequate the following care or services are in Orange County geriatric care"]
+[-3.3547158241271973, -0.3279638886451721, "it's just, it's really too broad that's too broad of a of a term, just so that, you know, for one thing, so I really don't even know what that means. Because that could that might have to do with food insecurity, or maybe that has to do with transportation, maybe that has to do with loneliness, maybe that health care. So let me just also say that the term geriatric is currently it is typically only used that term is typically only used in healthcare settings. It's an old term old. The more invoke term would be to say, older adults, or seniors, geriatric or elderly. That is not, that is not a current term. And it's not a term that older adults like to hear. They don't like to hear elderly, and they don't like to hear geriatric."]
+[2.812905788421631, 8.446426391601562, "Yeah. So what better term to"]
+[-2.0967624187469482, -2.7515432834625244, "Or you could say seniors,"]
+[-1.89867103099823, -2.7916712760925293, "senior, thank you for that."]
+[-1.6355137825012207, -0.7954098582267761, "Okay, so two different those are two different questions. Accessible, there is. It's pretty accessible, truthfully. If you need but you have to be it's accessible. It's it is available. But whether or not I can access Long Term Care financially, there is it is accessible is there but whether or not I can access it. That's another story. There are any number of adequate long term care facilities, whether we're talking about a residential care facility or or skilled nursing facility. They exist. Not that doesn't that's not true in every area of the state of the United States. But that's is absolutely the case here in Orange County. Whether or not older adults can actually use it. That's another story. That's not always as easily to access. And as far as the out of adequate is concerned. Again, it really depends on what we're talking about. In terms of the financial situation. There's everything from really, you would absolutely it may be considered adequate. But it's really like a you know, if you're grading it on a on a scale of ABC, it's really a D. You would certainly not put your own flesh and blood in one of those facilities even though they are licensed and accessible financially. And then there are other ones that are that are okay and they are also accessible financially. And then there then there is the third tier, which is no, these are beautiful facilities, and you'd be happy to stay there yourself and when you move in, but so there's kind of the whole, the whole spectrum here in Orange County, which is not the case. Nationwide or even statewide."]
+[7.09008264541626, 4.627002716064453, "Yeah, I think they have quite insightful. Yeah. So thank you for sharing."]
+[-1.3756778240203857, -3.457465171813965, "No. Yeah, can easily I'm jumping in before you even finish because there are, oh, my goodness, don't even get me started on the mental health piece. Because there there's very little here in Orange County for older adults having to do with mental health. Very, very, very little. And that's a huge bugaboo of mine. So counseling, preventive, preventive services, there's almost nothing nothing. Katy scan offers some, some in home counseling, and they will do that for free St. Jude offered in home counseling also for free. And Council on Aging does some does some things. But having said that, it's still incredibly limited. The Orange County health care agency, HCA they work with they offer services, they certainly offer services to older adults who have what are called severe and persistent mental illness, such as bipolar disorders such as schizophrenia, schizoaffective disorder, that type of thing. But you have to be MediCal. And then you also have to, you have to qualify in other ways as well. And it's just incredibly limited. Beyond Belief limited. That is not how it is. Certainly, that's not how it is for children and youth. And by the way, that's fabulous. I love that children and youth services are available. I love that, in my private practice, I see a ton of kids. So I'm certainly not, you know, upset about what we offer to families and children. And youth. Certainly not upset about that. But we don't offer that for older adults. And there aren't preventive services out there either. We need a ton more outreach and engagement workers a ton. So we we probably have I don't know. I don't know how many. But you can call you can I can I could give you a number that it's like a double digit number of outreach engagement workers for older adults. And that number would be probably, I'm sure it's way less than 30, 30 Isn't generous, or there aren't 30, there's probably maybe they're maybe they're 12, or 15. We have so there is one RFP in Orange County, there were technically there are two because there's Council on Aging, because in the end, they have a couple of programs for older adults, and I'd love Council on Aging. So they do a terrific work. It's just incredibly limited, so unbelievably limited. And then there is oasis. That's one RFP that works with older adults. And And again, there's a very, there's a small group of older adults who again have to meet certain certain criteria before they can qualify for the program. And believe me Oasis stretches that criteria, because they because they want to serve as many people as possible. But there's one program and that's Oasis, and council on aging. And so I'm not. I'm not forgetting about them. And then there are other smaller, smaller programs and Mecca has some programs. And then there there's a US VETS program that is currently working with older adults who so it's not like there's nothing very, very, very little, very little. If you're looking at what but Children and Family Services has. There's there's no comparison, because I don't think you can even count how many services are out there for children and families. And again, it should be but there's There's one in orange in Orange County, and that's a waste. Smaller, they're small programs that other agencies have. But there's one but there's only one RFP. That's it. Not kidding. I'm not kidding. That's not an exaggeration. There's one. Oasis. That's it. Wow."]
+[3.198300838470459, 8.444563865661621, "Oh, my goodness."]
+[-1.3476601839065552, -2.2311336994171143, "Well, it's just not there's not much to be accessible to. It's certainly not adequate is certainly not adequate. And again, one of the things that that we're there's the biggest deficit has to do not only with mental health, and substance use, which is that's the combination of behavioral health services that are available for older adults, but also the prevention the p&i, the p&i that's not available either. And that's, that's huge, that there aren't those kinds of services, there are some services like, as an example, the cities work hard to do a very admirable job with the senior centers. And the seniors provide a wonderful service for many different kinds of for older adults, everything, again, from nutrition, to transportation, to just just the sense of community that is available. But if you look at the number of people who actually attend those services, who are truly engaged in the senior services, it's not very high in comparison number of older adults in any given city. So again, I'm not knocking any of the senior centers or any of their services, because they do a terrific job. And they work really, really hard. What I would love to see are more local, localized services. So that is to say, I would love to see services that come to senior housing. Apartment, yeah, complexes, so that the service has come to them, whether that has to do with something like a grief group, or whether that has something like an exercise group that comes to that senior housing facility. Things like that. Or I'll meet you meet at a at a local park. Though, to me, those are preventive prevention services that, that I'd love to see offered to, to seniors, but they need to be more localized because seniors, particularly Katie, I'm sorry, I just keep going off on tangents. But one of the things that happened during COVID was we said to older adults stay home. Don't go out while people got used to that. And now getting them off of their couches. Not that easy. Wow."]
+[-1.8643919229507446, -2.0885488986968994, "I keep saying they I'm a senior I'm 73. So it's not but So technology is a huge barrier for my age group. For for us as seniors I've been next door neighbor who is a year younger than I am. And he has a cell phone. He never texts. He doesn't he doesn't know how to text he doesn't. And he he does a lot of other things. But you certainly never looked anything up on on Google or YouTube or anything never. It wouldn't even occur to him to do something like that. And those are the kinds of things many older adults either don't have. So you already know this. I'm sure I'm not saying something that you don't already know. So here's the these are there are three main issues with technology. First of all, older adults need to have they need to have the device so they need to have whatever device they need to have a device, but that that's not enough. They don't just need training, they need training, but they need ongoing training or access to somebody who can help them change their password or whatever. But then the other thing that they need Wi Fi so it doesn't matter if they don't if they don't have Wi Fi if they don't have access to the to the internet. And, and they have to be able to pay for that. So then there's a financial considerations. I'm not saying something that you don't know, I'm mostly saying that just to make sure that it gets in into the data. These are known areas of concern. And there, and there are programs that are out there. We did. We certainly did something during St. Jude in terms of offering all of those things. But weren't, we weren't the only one, the county of Orange did some things as well, to offer all three of those problem areas. Council on Aging did some also offered some programs. So it's not like there aren't some programs out there. There's just so much more that needs to be done in terms of identifying older adults who need those services, or persuading them to use them. so that's another another issue."]
+[-0.8610131740570068, -2.467282295227051, "The role needs, one of the things that I would love to have happen is to be able to identify the older adults who have needs. And then the second thing would be to determine what those kinds of needs are both both things we don't we shouldn't just guess at what the needs might be. We we need to have some clear information, some clear data, demonstrating what the what the needs are. And that's something that the government could do, the local government could do. But we need to identify. And that's where the Outreach and Engagement workers come in, identify those older adults, because like I say, many of them are sitting at home, on their couches. So they're it's not like they're out there. They're they're not, it's not easily easy to find those people we need to go to trailer parks and, and knock on doors. That type of thing. And that there aren't enough. There aren't enough Outreach and Engagement workers currently to do that. By any stretch of the imagination."]
+[3.8244972229003906, 5.414247989654541, "Yeah, so we have Yeah, well, we have five minutes that you have to go. So yeah. Okay, I have two more questions. I just want to let you know, so we'll just go through it quickly."]
+[-0.5766816139221191, -1.427472472190857, "Which ones are Yes. Okay, I think that the Asian Pacific Islanders, those are. We have, I think we also have a number of older adults, who we don't know anything about who are from the Middle East. And we don't know anything about what they may be from Sudan. They may be from Syria. We don't know anything about those individuals. And and we need to identify those, those people and what the what their needs are too, and what the needs of their caregivers are as well. But people whose both are ethnicities, but their language prevents them from really being well integrated into services that may be helpful to them, who aren't aware of the services that are available."]
+[0.09569922834634781, -3.8978261947631836, "Thinking about all the issue facing older adult in Orange County, what issue is being overlooked."]
+[-1.644852876663208, -1.5392647981643677, "So I'm going to say issues having to do with I'm going to say mental health, and I'm probably the first thing I'm going to say is loneliness. That's a huge area. And there are that's something that a number of different agencies and organizations here in Orange County, have been kind of focusing on for the last several years is loneliness. But but it's not. We know, in the older adult, agency community, we know that that's a big area of concern, and opens up to so many other problems, whether it has to do with substance use, whether it has to do with suicide, whether it has to do with elder abuse, fall risk, any, any number of UTIs all of those things actually can be synthesized back down to loneliness. When people are lonely. They're much more likely to contract a UTI. One of the one of the things that happens with older adults who are lonely They have many more visits to the ER, many more visits to the ER for again, for what it's too many reasons for me to say in that in the next couple of minutes, but loneliness is a big area that we are overlooking."]
+[5.099369049072266, 3.5010948181152344, "Thank you. So this concludes our interview. I'm gonna stop recording now. And I actually I, you know, there you have another time I hope to maybe go further in some of these issues, because then some of the population that you mentioned are some that we actually have a hard time outreaching to you and I really want to get your input on like how we can better"]
+[-2.575758218765259, -2.7638254165649414, "Okay, great. No. Okay, great. So, again, as I mentioned, the primary goal today is to identify what needs you think are most important to older adults. And we want to, we want you to think as broadly as possible, you can rely on your personal experience, but also take into consideration the perspectives of caregivers, right. And they can be family, friends, neighbors, professional caregivers, like doctors and nurses, and also their community. Right."]
+[-1.1651842594146729, -2.166795015335083, "Wow, a little bit about myself, you know, when you're, I just turned 73. So when you have 73 years, you have like all these different chapters. And I guess, I'm retired, I've been retired about 10 years, I was a flight attendant for Northwest and Delta Airlines for 31 years. And so I've traveled quite a bit. Now that's all gone out to me, I don't want to travel. I like my nest. I live in a community an over 55 community, and I'm quite involved in my community. I just served six years on the HOA, and I'm with the mobile home advisory board for the city of Huntington Beach. And I'm also on the, you know, Huntington Beach mobile home resident coalition. And so we're, you know, I'm, I guess I've become kind of an activist in my last few years. And while I eat sleep and drink housing issues for manufactured homes, and sometimes I'm, you know, you know, how when you're doing any kind of good deed, sometimes it's overwhelming. But then if I think of leaving it, I know I, I can't I know that it's, it's big, and it's important and, and it keeps my mind on something. That seems like it makes me happy, I guess to be of service. So and not like a Mother Teresa or anything like that, but and people like you, and like Ada and like ADA who's who is our president for the HOA. For years. People like that are my news is in my inspirations because it's amazing, the wonderful people that I bumped into in this walk right now. Yeah. And I think that's about enough about me."]
+[0.011180375702679157, -4.091568946838379, "Well, thank you so much. So now thinking about Orange County, and I'm going to show you a list of common issues and concerns impacting older adults. So I want you to take your time and review this list. There's a lot of things on this list. And when and when you're ready. Let me know. And then I'll ask you our first question. Okay."]
+[3.463040828704834, 6.890447616577148, "I can. Okay, is"]
+[4.665566921234131, 5.428064823150635, "Let me know if it's too small. I'm trying to show the entire page."]
+[3.946633815765381, 6.225505352020264, "No. Yeah, let me yeah. I've got magnifiers on but it's still"]
+[4.17164421081543, 5.241965293884277, "kind of, Oh, I know. I know. Don't worry about it. Let me make it bigger. And then I'll scroll. Okay. That perfect. Now. Let me know when you're ready for me to scroll. Okay. I'll keep this list on the screen so you don't don't feel like I have to. Don't feel like you have to memorize it. Okay, you can scroll please."]
+[4.132251739501953, 5.178670406341553, "And just put them while these are really, really good reference points. Heavy stuff you can scroll."]
+[0.07933647185564041, -3.977581024169922, "That's it. That's the part one and part two. Okay. So now thinking about Orange County, and looking at this list."]
+[3.387521505355835, 4.074777603149414, "I'd have to ponder that. But this is uh, looks like a pretty complete list to me."]
+[4.744804382324219, 8.04194164276123, "Okay, I'm gonna go back to the top here just to make sure."]
+[-0.3709545433521271, 1.2268732786178589, "Yeah, the economic security I think is pretty important to people. So I was gonna say financial, I had written down earlier. So that's the same thing. So"]
+[2.4292824268341064, 3.873286724090576, "So please write for me your top three things that you feel are most important."]
+[-1.1519951820373535, 1.0855904817581177, "Well, I would say economic security would be probably number one. Okay. Housing is number two. Okay. I'd say behavior, behavioral and mental health, that would be three. Okay. And they kind of you know, they slide over and just some other columns. Sure. Like caregiving. Yeah, no, well, we'll stay with those three."]
+[-0.6621177792549133, 1.3886581659317017, "With those three. Okay, perfect. So I'm going to ask you the following questions, and we'll take those three items separate. Okay. So the first thing that you listed for me was economic security."]
+[0.36714687943458557, -1.3266781568527222, "I think part of the problem and where I live, we're over 55. But there's a lot of women. And I think what happens is, as women get older, you know, and they start to retire, they don't have as big of a safety net, as a male would have, obviously, in fact, some of the women that I know in my community were housewives, or they didn't have a very big, a long job history. So they don't have the pensions, they don't have the big social security, they don't have savings sometimes, or their savings, everything went into buying the manufactured home. So oh, man, I, I listened to what they're trying to swim hard against. And I know, the rent, insecurity or the housing insecurity is, is kind of tied into this. So how and why did I tell you the Why yes, yes, yes, yes. Yes."]
+[3.5319488048553467, 5.643783092498779, "I mean, you know, we and we can move on. And you can always add later and refer back to it."]
+[-3.0028135776519775, -1.9098801612854004, "And I keep seeing it from the vision of an older woman with barriers. Yeah,"]
+[1.3868876695632935, 7.5951247215271, "Well, I"]
+[-1.6716878414154053, -1.4790120124816895, "think older adults, there's, there's a few things here. First of all, they're not very social media savvy, a certain age up. And I think sometimes they're too proud to say that they have a problem. And I think that could have been a cultural thing from I know, my mom said to me one time, oh, I wish I had had someone to talk to like you do sometimes. And I'm like, wow, I never occurred to me that her age group would not have someone to talk to like a therapist or a counselor when things get overwhelming. So I think the barrier, the main barrier is not being able to reach out for help. Even when, even when it's right, like when somebody offers it to you. And then, because I've got a neighbor to that, to her mother just passed away who was 94 and they were very close. And I have been giving her so many things to help her get through her loneliness. And then just yesterday, she was telling me again, how lonely she is. No, it's It's I don't know if it's just a habit dying hard or as I said, before, that cultural laying there and and it's hard for them to reach out and you know, say, Oh, I am having troubles. You know, that my brave faces and so underneath so brave. Yeah."]
+[3.4277472496032715, 9.07384967803955, "Yeah, yeah."]
+[-0.3164112865924835, -0.7804970145225525, "Yes, yes. And I think Caucasians would have, of course, would have a different background and work experience than someone of color, because I've met some people here in my community, in particular, Vietnamese people moving in, and, boy, we've had some good talks, and I realized, we are completely different is so so different. On some levels, some other levels. Of course, we're all struggling together. But I think, say the question again."]
+[-0.38814958930015564, 1.2630302906036377, "Well, I think you answered it, because I asked you if there are different experiences with regards to economic security for different groups,"]
+[-0.42457956075668335, -0.350391149520874, "I think yes, I definitely think culture."]
+[0.2927168607711792, -0.4547903537750244, "Because I don't think we hang around enough together. You know, we've been talking about having some diversity. And Huntington Beach, you know, is a great example of 99%. Whiteness and anyone and it's I shouldn't it's not 99% for population, but it's like 99%, everything is geared toward Caucasians here in Huntington Beach. And we've been really working on that, because I really would like some diversity. I think it makes such a colorful, wonderful world to have diversity."]
+[3.4393560886383057, 9.08281421661377, "Yeah, yeah."]
+[-0.6079774498939514, -3.8256077766418457, "Hmm. I think offer respectful. You can't you know, you don't want to be giving advice unless it's asked for. And a lot of times, they'll say, Oh, my God, I can barely make it. So I have a pamphlet, that's all the different opportunities in Orange County with, you know, different places you can call like, the Senior Center and like the Council on Aging, with directions, you can go if you're having challenges, and a lot of times people will say, I didn't know that was available. I think I'm gonna go drop in. So I don't Yeah, I don't want to be. I'm really careful about tromping on someone's you know, like, Oh, you look like you're getting poorer. Yeah. That's a tricky. That's a tricky place to be."]
+[1.0053383111953735, -1.3233882188796997, "Yeah, yeah. So once again, how are older adults struggling with housing."]
+[0.7251253128051758, -1.3588248491287231, "And I speaking from my last nine years of living in a 55, and over manufactured house community, and seeing that the rents are, in some places skyrocketing, because, you know, we, we are involved with 17, mobile home parks here in Huntington Beach, some are corporate owned, and they have horribly, terrible rents going in, some have gone up two or $300 a month. And so I think that housing insecurity, not being able to exhale and think about your future being okay, is very, what I want to call it Well, I'm sure you know, affects your behavioral and mental health. Because if you look at the happiest countries in the world, they're taking care of from cradle to grave, then you look at our country. And we seem to everything runs on money. And we might pretend that it's God, but I think it's money. Um, I think I might getting sidetracked. No, you're right. You're right. Yeah. So I think it's the housing insecurity. I think people thinking they might lose their roof. I mean, I think that's getting close to homelessness, for people. And that because you know, you can't buy a house, you're not gonna buy a condo, all those will be priced out of the range. So apartments are pretty darn expensive here, too. So yeah, that that housing insecurity is just, I think, very scary for people, myself included."]
+[3.739816904067993, 15.449891090393066, "Yeah."]
+[0.6685796976089478, -1.8083627223968506, "Well, personally, for what's going on with the mobile home groups here, it has to do with the park owners, and there's such a chasm between us. It's like, we don't understand each other. You know, I, I work. Well, if there's reasons that rent goes up, you know, maintenance and all that, but then when you talk to a park owner, you park owners sound like oh my gosh, if the remt is stopped, we're not going to be able to maintain the place. And that's shown to be not true that other cities with rent stabilization ordinances or some kind of a rent control, they still have rent review boards and they have rental registries. So I think part of it is that there's the groups are against each other and don't want to listen to each other. And I would like to see more communication. And really listening with open with open minds and open ears so we can collaborate even though it's you know, we're on different. We're, but our endgame is still we still want to have a community that works. And we don't want people you know, on the streets, and I don't think the park owners want people on the streets either. No. So yeah, I would like to see more collaboration. But I don't know how that would. I don't know how that because I've been speaking at city council meetings here in Huntington Beach. And collaboration is one of my favorite words. And I don't see collaboration coming back. frustrating."]
+[0.309969037771225, -1.3052315711975098, "Right. And, and now and I know you mentioned diversity earlier, but in thinking about other groups to like people with disabilities, right, or, depending on you know, maybe not so much in Huntington Beach, but maybe in different cities. Do you find that housing is different for different groups of people, and in particular, you know, people with disability or in other cities other than Huntington Beach are different."]
+[0.11218851804733276, -1.0508536100387573, "I don't I guess I can't speak to other cities than Huntington Beach. I, I have done some field trips at manufactured homes, and other cities like Anaheim, San Juan Capistrano, Oceanside, and it's so much it's so similar, that I almost can't find. I can't find what's different. And yeah, the diversity thing is a problem with almost every community I go to. Yeah. Because I think a lot of different groups cultures have, you know, like, like, the Hispanic people are such wonderful family people. And I think the big house with all family being close to each other is such a beautiful in the past lifestyle. I don't know if that still is existing. Yeah. Yeah."]
+[-1.2310799360275269, -1.9487712383270264, "Wow, that's a heavy question. The best way to address the issue the housing needs of older adults. Hmm. Wow, if I had answers, I'd be I guess, we're trying to have strength in numbers. We're trying to get groups together. We have these open meetings at other manufactured home communities where we have questions and answers. And we listen to what you know, people are saying, as I said, we're so much more alike than different when it comes to our housing. And that's the best way to address the issue. I guess communication, education. I think people need to talk to each other more. I think, and as I said, I'm talking to you mainly from of course, my 55. And older over older community. A lot of times the people here they've retired and they don't want to get involved. They just want to be able to rest and not. But the thing is, you have to be involved, at least the very least you have to know what's going on. Or it's going to sneak up on you here and its not even gonna  sneak up on you. It's gonna hit you. Well, we've told you three times, you know, there was a big new roof put on the clubhouse. I didn't say that. But I thought that and yeah, a I like i said  education, communication. And I think people need to realize that just because you've retired, as I keep saying it's I'm talking to you from the over 55 group. I just because you're retired doesn't mean you're checking out life. You know, there's I think sometimes it surprises them. Yeah, no, like there was a plan that you got a free iPad, if you called a certain number. I think you had to be 60 and over and of course show what you know, a very low income. But the low income was like under $75,000. Like,"]
+[0.02526276186108589, -0.6950409412384033, "really not as retired you would fall into that category."]
+[-1.7353107929229736, -2.077556610107422, "Yes. Yeah. Even and they even had some classes that came along with the iPad. Yeah. That's a great program. Yeah, yeah. I mentioned it to a few people. They didn't call right away or by the time they call the iPads were all gone. It was like,"]
+[3.411513328552246, 9.05738639831543, "yeah, yeah."]
+[0.3505847752094269, -1.9522627592086792, "Yes, yes, yes, yes. And we're not talking about Section Eight. I'm thinking that some help with buying our communities. So we have somebody called it a horizontal Co Op, but a resident owned community. Yeah. I think the resident own community is a real wave of the future. But now I don't know about California is the only problem. I see it happening nationwide. But California's so flippin expensive that I, but I see that as a real big push. And so then if the local communities or the federal government put in some help, and then everyone, you know, came together and ran the place, you know, with help. I think that that's a real one of the few real good calls for the future."]
+[3.155025005340576, 5.360514163970947, "Good, good, good. Okay. So now we're gonna switch gears and go over to your third item."]
+[-2.2121403217315674, -1.3119796514511108, "Oh, my gosh, I have seen people getting scared. And I mean, they get scared over everything. And of course, the news makes you scared. We had a presentation Tuesday night about mosquitoes. By the time we left. I mean, everybody was so afraid. They were practically hearing voices. I mean, it was like, Yeah, right. I think part of part of it is that traditional memory loss and forgetfulness that I see in your column here. That's true. It's not that the world is always falling in, it's okay, we have a problem. But then let's make a solution or let's talk solutions. And I think we don't get to solutions as as a traditional way of reacting to a problem."]
+[-1.5870389938354492, -1.6174052953720093, "Oh, loneliness is a definite if they're talking about it being an epidemic, it is a lot of isolation. And part of this from the pandemic. People I noticed here, people stopped inviting each other to dinner, stopped having little dinner parties. And now that's like a habit. People are just not socially interacting, like they used to all of our groups seem like they have lower numbers. And so yeah, that loneliness thing, and then people not maybe having families nearby, you know. And, you know, you probably know all this stuff yourself, but but I see it where, you know, like Mother's Day, I talked to have several of my neighbors that were very, very sad, because maybe their kids forgot to call or they called already, but they see that their other neighbors are going into someone's house. And yeah, that loneliness thing, that's going to be huge. I think it's going to get worse too. Because part of it too, is when a seniors, people over a certain age, the age I'm at, you don't have as much. I mean, you're like, I'd like to maybe go country dancing, let's say learn line dancing, but you know, my body's not as willing as it used to be. So that's kind of sobering, that, you know, the flesh is I mean, the spirit is willing, but the flesh is not. So, you know, I'm saying,"]
+[3.3506505489349365, 8.76083755493164, "yeah, yeah, for sure."]
+[-1.492324709892273, -2.384044885635376, "I think sometimes peer I think it has to be sometimes your peers that are offering some of the classes. I think I've had some, some, some of the seniors say, Oh, I don't want to take it from that young girl. She's the one that's a great little SilverSneakers teacher. Well, I'd like to see someone my age group teaching senior exercise. That's a good point. And that's an interesting point. Although I don't have a problem with anyone's teaching anything. Hmm. What else would be I think maybe more classes But, uh, you know, I know the senior center does some wonderful classes. But I think sometimes these classes like the sands, which is our, our local classes are kind of expensive. And if we're having economic problems here economic security, you know, a class that cost $125. That's out of the question. That's not on their radar. Yeah."]
+[-1.723198652267456, -1.3824679851531982, "Yes, yes. I think I mentioned to you earlier, my, my neighbor whose mother just passed away and is 94, she came home from the hospital and was two weeks in hospice. So that was pretty scary. And then she passed away pretty fast, and go fast, fast to her not fast to the rest of us. She's 94. And I can see her grit getting very weak. But now she's very, very lonely. And she just kind of keeps to herself. I keep inviting her social things. So there was a garden tour. She did go with me on that. But that's the only thing she said yes to. And I see where I offer ideas for you know, go to the library, go down, just sit by the beach on a bench and let that ocean speak to you. I mean, that we pay. We pay Huntington Beach prices. Might as well go see the beach once in a while. Yeah. And I see I see her car sitting there sitting there sitting there. She's just not getting out. I even mentioned to her something about a friend told me that her cat had kittens. She's allergic to cats. Stuff cat. I just thought she maybe needs a friend's since now."]
+[4.059882164001465, 6.853354454040527, "Yeah. Go ahead. That's good. Well,"]
+[-1.6440843343734741, -0.8699405193328857, "I I loved her mother was just the sweetest lady when I moved in nine years ago. So it's, I feel it too. Yeah. And, you know, I think she thinks she's alone. But I keep telling her we're all walking this together. You know, we're all walking each other home. So she's not alone."]
+[-2.9044675827026367, -2.253990888595581, "Good, good. And then possibly drug and alcohol use among older adults."]
+[-1.9056313037872314, -1.7601191997528076, "Yes, men seems the drug and alcohol addiction. Yeah, I see them. Some of them, not all of them, of course, reaching out for alcohol, and then, you know, making themselves a little embarrassed later in the day, and it's not helping their forgetfulness and their memory loss. So yeah, I and I think to the people that tend to be kind of not as outgoing, or they say they're not as outgoing sometimes I someone will tell me they're, you know that they're not outgoing. And then I think, wow, you're very talkative. Being outgoing. I think sometimes people think they're shy, or they think they're not. Because make say, say several people are talking about college, and maybe that other person in the group didn't go to college. And I can see where that makes them feel like they're not as, as something as the other people, which is not true, because they have amazing life experiences, too. So yeah, wow, this is a heavy this is a heavy column. Yeah. We had be well OC come out night before last too. Now. I was really impressed with the things they cover. Like, you know, if you watch your neighbor, and you notice that their routine has changed a bit, like maybe they're acting a little different, like so maybe it's a they've forgotten to take medicine for diabetes, or I thought what a great thing that you know, you're not calling the police. You're calling be well OC Yeah. And they were saying that they park a few doors away from your house. So it's not like oh, my gosh, attention. Yeah. Yeah, there were much more subtle. Yeah. I was very impressed with the offers, I mean, the services they offer. Definitely, definitely going to Use those those wellness checks that they have. Yeah. Yeah. Great idea."]
+[4.32675838470459, 7.202429294586182, "Great. Great."]
+[-0.569678544998169, -2.0972230434417725, "Wow. That's a hard question. We have some groups in our community one is called CAP, which is a community action program. And we have gas cards, we have grocery cards, and we'll take you to some things if you like, we had a man whose wife was in the nursing home, and he needed right rides, and we took him. Yeah. So we try and simple things we try and, you know, get together. So we've got a pretty good amount of money for that, too, we've got quite a few people in the community who have, you know, donated. So we probably have maybe almost $1,000, set aside for grocery cards, gas cards, etc. So I think having community action, and also, we have a big bulletin board with a whole lot of things on it. If but the thing is some of these people, these people, and I don't mean to make it sound like I'm, you know, putting people in boxes, but the some of the people never come out of their home. We have 141 spaces here. And they some people, I've never, ever seen them come out of their home. And I'll ask the manager, and he says, oh, yeah, they're paying the rent. Well, I guess I mean, they're, they can have their own lives. I'm not trying to change their, you know, if it's if they like to watch TV, and whatever it is they do. That's fine with them if that's if that works. But um, we've had actually, we had a SilverSneakers program going on, and another lady and I went door to door, three Saturdays in a row door knocking to try and get people involved. And that was a that was an eye opener. Oh, I did not realize, yeah, I didn't realize how poor some people are in this community. You could, when you go up to the door, and the steps are all broken. And you know, and you're knocking on the door, and then you're telling them about SilverSneakers exercise, and I can see that they're, you know, they're on oxygen. And you know, I almost felt but but but that SilverSneakers older group was anybody could go, you could go, you know, bring your caretaker. And that was great. So that was an eye opener."]
+[-1.861825942993164, -2.7327001094818115, "That's almost should be like a regular check in. For these seniors."]
+[-0.9041008353233337, -2.1251423358917236, "That's a that's an idea that you're just you just because I was thinking, it's funny. I was thinking like a not a prayer chain, but like a prayer chain, where something happens. So you tell your next three door, your next door neighbor or two or three doors down, then they pass it on, but then I was worried that it'd be might be like telephone, and it might get. And then halfway through the block. We have neighbors that don't like each other who don't speak. So I started thinking, Oh, maybe I'm not thinking this out. I'm thinking, Oh, this is an easy solution. We'll just like wildfire get information out. It's not exactly that easy."]
+[-1.2643541097640991, 1.1322400569915771, "Yeah. Yeah. Yeah. That's great. Okay, so I am done with this list. And unless you want to share any more about any of those three things that you mentioned, economic security, housing and behavioral mental health."]
+[3.9490201473236084, 5.493202209472656, "At this time, I don't have anything. Okay. Probably I'll get off the phone in about two hours. I should have said this. Oh,"]
+[-2.1704962253570557, 0.27877435088157654, "Yes, you can. And but I have more to ask you. So I'm just I'm just done with the list. Okay, so. So now I want to ask you about health care, and how you access health care. Okay. And do you find that the care is adequate."]
+[-2.3132944107055664, -0.2899618446826935, "I have a scan. I go to Hoag which is Dr. Nancy love. Now who doesn't love a doctor named Dr. Love I know, oh my god. So wonderful. In fact, in the last couple of weeks, I've she encouraged me along with the nurse practitioner to get all caught up on all my tests. So I had my first bone density, which so lucky, I'm okay. Most people bone density is a problem. Right and then, you know, colon tests your mammogram. Mmm, you're all the different tests. Well, she's absolutely fabulous. She gives me like six pages of references of where I'm supposed to go next, and who to call. And I find it. I actually, and I'm not a big organized person, but it's very organized for me. It's on your, you know, they have a thing online. It's called My Chart. Yeah, but I find health care. Absolutely fabulous. I love scan. I can't say enough good things about scan. Neosporin. I'm just like, impressed with that. Yes. That's such a great thing."]
+[3.814567804336548, 15.44326400756836, "Yeah."]
+[-1.763997197151184, -1.2537661790847778, "No, no. Alright. She hadn't been to the doctor in 10 years. Wow. 94. Yeah, I was shocked. So her health was really poor. Because they're like she had, she had a dislocated shoulder. She didn't even know she dislocated her shoulder it looked like the back of a flamingo or something. And it was, you know, so it shocked me because Because health care seems like. And I'm lucky I don't have diabetes. I don't have any of the stuff that some people have walking here. But I couldn't believe that she hadn't made use of her health care. But her husband had passed away, golly, 20 years ago. And she felt like when he got more medicine, he got worse. Right. So she had a mental thing about health care. And, and actually, when they took her to hoag on the Fire Department took her to hoag. I think she thought it was the end because she was going and could be mental. You know that that could have been a part of her demise. Yeah. So yeah, not everybody looks at it the same."]
+[-2.1933224201202393, 1.1378356218338013, "Right, right. And then earlier, we talked about accessing mental and behavioral behavioral health services."]
+[-0.8834629654884338, -0.07650808244943619, "I when I was a flight attendant, they had something called EAP, which is an employee assistance program. And if you were having a hard time, say there was an accident on board or an altercation with a passenger is something you could call this number and they would refer you to someone in your area. And you could talk it out, which I thought was wonderful. I, I haven't actually needed anything. I'm sure there's an availability. Hmm, yeah, I don't know. No,"]
+[2.234708070755005, 6.13508939743042, "I don't. Yeah,"]
+[2.4682161808013916, 6.188200950622559, "I'm ashamed to say that I don't know."]
+[2.516765832901001, 4.708686828613281, "yet. No, that's okay. I mean, I think there are a lot of things in the community. We don't know about right. And, and so it's just nice to be able to gauge whether or not people are aware."]
+[-0.936710000038147, -2.3081536293029785, "Well, I haven't usually needed any of those things. But I've helped other people if it's your neighbor, and I didn't think they were as easy as I had hoped they'd be. Yeah, seems to be like, there's lists of things. But when I called for meals, the Senior Center said, Oh, we're really backed up. We'll call you back. No call back. Yeah. What Yeah, I know, there's food banks, and I've gotten a few people to go to the food banks, you know, Sunday of the month, or whatever. And that seems to be helping some of the folks because a nice bag of fresh produce and some canned goods seems to make them pretty happy. Right makes them feel a little less scared. I think. The ooh Senior Center does have a wonderful ride service though. My friend that's partly blind in this community. Maybe she's on your list by Bobby King Barbara King. She's, um, she uses them fairly frequently and loves it. She thinks they're very helpful. So I'd say that is a two thumbs up two thumbs"]
+[4.216237545013428, 4.263017177581787, "up for her. Yeah, yeah. That's great. Oh, boy. So I'm going to ask you to think ahead a little bit into the future."]
+[3.352910041809082, 9.013229370117188, "Yeah. Yeah,"]
+[0.256561279296875, 0.3290223479270935, "I think, to be ablre to afford everything,"]
+[0.630641520023346, -0.7496686577796936, "because if you look at what inflation is doing, what gas is doing what everything is, everything is going up. I pick up something at the store, you know, like, I have a dog, and her treats used to be 199. Now they're 299. So here's another dollar. So I think God 5-10 years from now. I don't see it going down. Yeah, yeah."]
+[0.9955236911773682, 3.852785587310791, "That's, that's tough. That's tough. And those things come. They're very unpredictable, too. Yeah. Yeah."]
+[0.338495135307312, -0.9816498160362244, "Well, I think hacking on Social Security is not government's role. That because people paid into that. So but I think, rather than fighting among themselves in the millionaire's club, and Congress and Senate, they should be looking at the little people that live and work in the United States that are retiring. Their, you know, it's very iffy. And very, I think there should be more help for people on the road to retirement. It's like $7. How do People live on that. I mean, $15 an hour is pretty disgusting. But seven, and then those guys, they vote on their own salaries, they vote on their own pay raises. So are you going to vote yes, exactly. Yeah. They need to they need to get involved with the real little people. Which they pretend they do every time they get elected."]
+[3.459791898727417, 8.096968650817871, "Yeah, yeah. Good. Points. Good points."]
+[-1.9764550924301147, -2.629117250442505, "Yeah, and it's, I suppose you're going further seniors of color. Oh, my golly. Oh, my gosh."]
+[1.7590126991271973, -2.752647876739502, "Well, I'm, you know, I've seen some homeless ladies walking around that looked like they're Hispanic. Yeah, that's kind of new. And I did read something that the biggest. Maybe you already know this, but um, the biggest group of homeless is going to be senior women. Yeah. Ah,"]
+[2.4326937198638916, 7.495270252227783, "I know. Shocking. I know. Scary."]
+[0.6686152815818787, -3.247075080871582, "Very scary. That is an unsafe I mean, talk about a man being unsafe. No, no, no, no. I don't care how old she is. That's terrible. Just terrible. Yeah. Yeah. No, I've been, I've been noticing senior women of color. And hopefully the navigation center, the Mercy house here in Huntington Beach. You know, but but the thing is, that place has men mainly. Yeah, I think three fourths of them are men. I don't think that women are served there."]
+[1.6031728982925415, -2.5553507804870605, "There are a few women's shelters, but you're right. I mean, even in shelters where they have men and women women often feel very unsafe at those shelters. Because they can take be taken advantage of in many different ways. And, you know, regardless of how old you are, and in particular, when you are homeless, there's difficulty in just getting by day to day With everything that you need to do just help needing to get by every day from taking a shower to getting your medication to, you know, just everything right. Yeah, so, so thank you for that. We talked a lot about different issues today."]
+[-1.4890180826187134, -2.196619749069214, "You know, I got this a bit of a thing that I've noticed about people being close minded to new ideas, but I don't know. I don't know if that's something that's overlooked, probably most people. If you talk to seniors, you start realizing, wow, you're kind of set in your ways. Okay. And if it's not, maybe we need some new seeds in that plant field work, whatever. I think being set in your ways to be to be an all of us have it, you know, I like I like my coffee like 630 in the morning, you know, right. I think I more philosophical ideas, versus you know, we want to put the, here's some money, here's some food, go forth, and everything's gonna be fine. Or medicine. I think we need to get up here a bit more. That's a hard one, too, because, you know, we all have different ideas on how to do that. Yeah."]
+[1.6426124572753906, -0.9412373304367065, "Yeah. So earlier, we when we talked about housing, which is how I know you and how I know, your work and advocacy."]
+[0.89881831407547, -1.8278381824493408, "Oh, well, I think it rent needs to be fair and equitable. I think there needs to be a rent Review Board. So the rent Review Board would look at rents and see, does this landlord really need to jack up the rent that much. And also have since it's a rent Review Board, you'd have both sides. So you'd have the renter there, and you'd have the landlord there. I would, I would love love, love to see something fair and equitable come down as a policy from our city. Ah, I don't know if you know how Huntington Beach is right now. But we're very, very, can I say very conservative, all of a sudden, we just had four new people go in. They're horrible. They're just horrible. It's all about the money all about not in my backyard, all about not helping. And so that's not a very nice way for the city to portray itself as a good place to live. They say we're a great place to live. And it is a beautiful place to live. But underneath, it's not a very nice place to live, especially if you don't have heaps of you know, millionaire houses. So I would love to see the city. Be a little more proactive and get out there. Now. I don't know if you know about our city council and all this. Like now little"]
+[4.645407676696777, 4.103947639465332, "bit. Yeah, I know. Moser is Yeah, yeah, I know, Natalie Moser."]
+[0.8988473415374756, -2.9727249145507812, "She's wonderful. Oh, my gosh. She's had some really because she had like a diversity Fair last year at the park, Central Park. That's a pretty cool idea. She does a community cafe once a month. It's a library. Yeah. What's great about"]
+[0.8514925241470337, -2.86303448677063, "So I love these community cafes because it's a police. You know, the chief of police will be there, the chief for the firefighters, and we're all talking. Just normal stuff. It's just great. That's why I'd like to see more of that but I don't think Natalie is going to be Natalie's really getting pushed to the back. And I watched City Council on Tuesday night. And poor Natalie. She's trying but yeah, the four that have come in and I call them the nefarious four they're against everything. That's, that's for the little people. It's all for the rich people here."]
+[-2.742560386657715, -2.098914623260498, "Yeah. Well speaking of that, do you feel that older adults are respected."]
+[-1.519020676612854, -2.2380211353302, "No, I think we've become invisible. Yeah, no, no, I think. No, I don't think so. I mean, and it's weird, because since we're just talking about this, here, we have two people that could possibly running the running for president. And there's so much older. And I don't understand. It's like we're not, you know, older people are not very much listened to, I feel. And in here they have, we have some people that are the head in the country that are so old, and not that I have anything against anybody. But we just need some freshness in there. You know, I think their ideas are old sometimes. And like, I don't care how old you are, if you if you're paying attention to what's going on, and you're maybe coming up with some fresh ideas. Yay. Yeah, I think I think seniors, as a as a group are much, much more invisible, when they retire, and when they're out. And"]
+[-1.4707975387573242, -2.220229387283325, "Wow. Or the Oh, yeah. Because Hello, we got a nest of us. Wow. Hmm. I think maybe more community cafes where we have intergenerational groups together. I, I miss sometimes, because I live in over 55 community, the sound of a child or a teenager going by on a skateboard or something, you know, I take my two dogs to the park. So at least I get a little bit out. But anybody else who's sitting at home watching TV, they think the news is what's going on in the world, which better get out there and see if there's a lot more world than that. Yeah. Yeah. Yeah. I think, you know, some in here earlier, I said, I'd like to see more. The age group is, you know, the teachers being a little older. But I like the intergenerational thing, too. So I'm kind of going back on what I said earlier."]
+[0.15595592558383942, -0.5400682687759399, "No, just you're saying maybe more events where we have more diversity and ages as well. Yes. Yes. Yeah. Yeah."]
+[3.5155625343322754, 8.377806663513184, "Yes. Yes, sir. Yeah."]
+[3.3264737129211426, 5.845301628112793, "Well, that was my last question. So thank you so very much."]
+[3.693692207336426, 5.520223140716553, "And we have four minutes."]
+[-0.4826621413230896, -2.183716297149658, "I know, I know. We made it in time. So But if, at any time, if you want to reach out about something else, oh, I forgot to mention this, just either send me an email or give me a call. And, and we can talk some more. But I am reaching out to Ada to see if we could do a town hall with you guys. Yeah, I love that idea. Yeah, we'll bring some resources, we'll bring some goodies. And hopefully, we can make kind of an event out of it. And then we can talk more about these issues. And what I would like to do is, raise your profile so that people understand what your needs are, make sure that you're a priority. For you know, all these programs to make sure they come around to see you and to check up on all your neighbors as well. And make sure that all of you have all the information and all the programs that quite frankly, you're paying for and taxpayers, as taxpayers that you really should be aware of and make use of right because they're really there to support all of you. So I'm gonna reach out and see what dates we could do a town hall with you guys and I would love to come out and see you guys in person."]
+[4.294288158416748, 4.148526191711426, "We have another lady named Terry Olsen. She's head of the HOA now the president. Yeah. And I would encourage you to reach out to her as well. I will. No, no, I"]
+[3.974189281463623, 4.232818603515625, "have a list of all of your email. Oh, yeah, I haven't I have you guys all on my shortlist."]
+[4.789800643920898, 3.207866907119751, "Wonderful, wonderful. Ada. Ada did ask me to ask you. I say yes."]
+[4.311254024505615, 4.197028160095215, "Yes, I can send her something."]
+[4.402647972106934, 4.113814353942871, "He was always she's always working she said And I love that. She's unbelievable. She is well, yeah na sees well my heart's in the right place but she's really she's an organized person. I wish I could be half as organized so"]
+[4.583501815795898, 4.572625160217285, "well, such a pleasure to spend time with you. I'll be in touch with it and we will get cooking."]
+[2.993680000305176, 7.1960248947143555, "I'm your girl."]
+[5.010837554931641, 5.241665363311768, "Thank you so much. Okay, bye bye"]
+[-2.657386064529419, -3.0942063331604004, "primary goal today is to identify what needs you think are most important for the older adult population you so those who are 60 and older, we want you to think as broadly as possible take it into consideration the older adult caregiver, family and their community. Okay, I'm going to share my screen so you can see a list of common issue concerning impact. Older adults. Please take a few minutes to read this lesson. Let me know when you are ready to begin. Okay, I'm going to share my screen"]
+[4.268718719482422, 5.359055995941162, "and when you want me to scroll up and down, just let me know."]
+[4.318763256072998, 5.385241508483887, "Okay, you can scroll up"]
+[5.5817461013793945, 8.79859447479248, "okay."]
+[-1.5829497575759888, -0.8349024653434753, "Sure. So I am the Regional Administrator for Orange County Silverado hospice. Currently, in my role, I oversee the entire operations of our Orange County office along with our expansion area out in the Riverside San Bernardino area. My interactions are more so with the team that is visiting patients and overseeing each department. So I have a social worker, Director, Clinical Directors, sales and so forth. So I don't typically have at least now in my role that I'm currently in, I don't have day to day interactions, but I do spend time reaching out to families and or patients via phone when they come on to service to check in and see how things are going making sure when they do come on to hospice services that the team has reached out to them, they've gotten all of the equipment, medications, things like that, that they need, if there's any additional education that they may need from the clinical team, things along those lines. And other than that, it's really just managing the budget to make sure that we're falling in line with the parameters that have been set for the year."]
+[2.2430951595306396, 5.673532485961914, "Um, not that I can think of"]
+[1.952444076538086, 3.694389820098877, "of their needs on the list."]
+[3.6343319416046143, 6.437339782714844, "Okay, let me look at it one more time."]
+[-2.422332286834717, 0.12593887746334076, "And then do you mind scrolling down just so I can see the other just to make sure. Okay, um, I would say where we're lacking would be a personal care management in the sense of older adults having the funding available, or when they are declining. I know that that's tough for a lot of families that we see where they can't afford to have those caregivers come in and help provide the additional support they need in the home. It would be great if that was something covered under insurance or Medicare benefit. Hopefully one day but that would definitely be a top one that I see a lot of mental health, I think in general is a big one as well. And then let me just the third one would probably be to mind Scrolling back up again. Yes, thank you Sorry. Gosh, oh, I guess that would have been caregiving. Haha. So maybe caregiving and personal hygiene kind of go hand in hand. Those are probably the three big ones that I see the most struggles with."]
+[-2.274588108062744, -0.8782751560211182, "When you think about personal care management, how a lot I older adults struggling with this issue."]
+[-2.348839044570923, -1.1157878637313843, "I think just with their overall decline in health, it becomes a lot harder for them to be able to do that, especially if you have someone maybe with Alzheimer's or dementia. And if they don't have the support system or the funding to bring that in, we see that there's a decline in that area. Which is unfortunate. So"]
+[-1.5256767272949219, -0.5463261008262634, "I would love to see caregiving covered under insurance, whether it's Medicare, or commercial. I know typically, with older adults, they're on Medicare. But a lot of times it comes down to funding and it's not covered under insurance. So they can't, they can't afford it."]
+[-3.9588663578033447, -2.047290325164795, "I've had different experiences for a different group of older adults from different backgrounds."]
+[-0.9065995216369629, -0.4038224518299103, "I'm not necessarily a kind of see it a wide range of people who have that, whether it's funding or they don't have the family support to come in and help them. So I know that Oh, go ahead."]
+[4.1141839027404785, 6.286746501922607, "Oh, please go ahead. Finish."]
+[-1.6297926902770996, -0.6221631169319153, "I was just gonna say on some of the extreme ends. With hospice, we're obviously mandated reporters. So there's even been times where we have to report APS just because they're not getting the care that they need, and it's a safety risk."]
+[-1.7869058847427368, -0.2623633146286011, "From the county standpoint, and the government, I would say, more people advocating for it to be a covered service under their insurance benefits. I don't think they have enough people advocating for them."]
+[-1.7688199281692505, -0.5780959129333496, "I think sometimes it starts early on. But I also think if they don't have the care that they need, they may not be getting the appropriate medications. To help with some of that. I see it more so with patients who are in facilities who don't have family members or a support system. And what's really unfortunate, I see it more on the hospice side. So when we get patients who are admitted into the hospital and need hospice, and there's mental health and behavior issues, a lot of facilities won't accept them. So they have nowhere to go. And nobody caring for them, it only ends up getting worse."]
+[-0.6169310212135315, 2.6514508724212646, "What barrier assists to see improvement in this area."]
+[-2.0280709266662598, 0.1590994894504547, "Outside of more fundings, I think if there were more facilities and places for them to go, specific to mental health, that would benefit them a lot of times, there's just facilities don't specialize that in that. And they are fearful of how they could potentially endanger other residents, patients, so they just don't take them."]
+[-4.177752494812012, -1.9476325511932373, "Are there different experiences or different group of older adult from different backgrounds."]
+[-2.294429063796997, -0.4986483156681061, "Not necessarily we've just seen, you know, unfortunate situations where patients with behavior and mental health issues they're, you know, being strapped to beds, and it's just a it's a very sad situation, because there's not a lot of people out there who know how to manage them appropriately."]
+[5.002915859222412, 6.2613348960876465, "Wow, I didn't know that before. That's very, that's heartbreaking."]
+[3.425727367401123, 8.643989562988281, "Yeah, it is."]
+[0.6395177245140076, -1.9914132356643677, "Um, I would think continuing to advocate for, you know, government funding, especially because a lot of times we see it with a very low income residents in the area."]
+[-1.5469176769256592, -0.1367405205965042, "I'm gonna I know you mentioned a little bit on the caregiving already, but I want to just go through it again. Okay."]
+[-1.5149331092834473, -0.519024133682251, "Well, with the finance piece, that's a big thing. But lack of caregiving leads to additional health care costs, whether having falls in the home and ending up in and out of the hospital. You know, a lot of times when they're older, and they have a fall and you know, they maybe break a bone, you see a severe decline in their overall health too. Whereas I think some of that could have been prevented."]
+[-1.6628272533416748, -0.31578123569488525, "I think the same as before, just you know, having that coverage, I think would be really helpful under their insurance and their benefits. So that we could, they could have more of that one on one support when they are declining."]
+[-4.027242183685303, -1.998142957687378, "different experiences for different group of older adults from different backgrounds."]
+[1.1434797048568726, -0.8231533765792847, "Now, we obviously see it more with low income because they can't afford it. But other than that, no."]
+[-0.7034406065940857, -1.484802484512329, "I think the continued advocating and petitioning especially, you know, to the government, because it is, you know, mostly Medicare age, population."]
+[1.0048763751983643, 2.48911452293396, "Yeah, how accessible and adequate"]
+[-1.6552941799163818, -0.5966994166374207, "I think there's a lot of great companies out there a lot of resources. I think it's important to I think there's a lot of great companies. And I think there's some that don't always do it the best way, and are looking at it more from a financial standpoint, and how they can make money. And that's where you really see them cutting corners, or maybe they don't send caregivers out enough. Or maybe the caseloads are too high. And that's where we tend to run into problems. I see at least with hospice, where there's transfers, because they'll bring patients on and then they won't go out and see them for days upon end. And it's not really benefiting them. But they're billing Medicare for it and making money off it. So it's really sad. I was happy to see that they put a stop to any additional hospice licenses this next year, because there are so many companies out there, but there are a lot of good ones. And there's a lot of good caregiving resources that are very readily available if people have the funding to cover it. But again, it can be expensive. So unless you have long term health insurance, or you were a veteran or married to a veteran, those are really the only two avenues you can go where it's covered, without paying out of pocket."]
+[1.1057190895080566, 2.369889259338379, "Um, I think it's accessible. I don't think a lot of people have it, though. paid into it. And unfortunately, when you get to a certain age, it's very expensive to get it at that point."]
+[-2.2339928150177, -0.6688565611839294, "Um, I don't think there's a lot of it. I think that's why people end up going to the hospital more often than not, but then they, you know, don't keep them there for very long, and then will discharge them. And it's just one of those vicious cycles if they don't have the proper care, so I don't think there's a lot."]
+[-1.16890549659729, -0.24399571120738983, "Um, that, um, you know, I'm not really sure. I only experienced it in the hospice industry, being you know, we have social workers that are in place. So as soon as they come on to services, they have that support system wherever they may need that extra help, but outside of hospice, I don't know is, I don't know as much in that industry in that arena."]
+[3.6443045139312744, 10.972826957702637, "Um"]
+[-1.7725811004638672, -0.22508515417575836, "Oh, gosh, I don't know how much it will necessarily change. I think a lot of it is similar to what it is now. I'm having the funding and the coverage under their insurance to be able to properly care for them. Because healthcare is very expensive. So I only see that going up in cost, unfortunately, so there's probably some financial risk to cover their health conditions."]
+[-1.5879933834075928, -0.18480277061462402, "I think allocating more funding to their health care."]
+[-0.005291729234158993, -4.8838372230529785, "Thinking about all other older the resident in Orange County who is getting the least amount of attention"]
+[-1.0027886629104614, -0.6263328194618225, "probably the low income people who are living in skilled nursing facilities, because they only have medical the care that they get is very minimal."]
+[-1.522878646850586, -0.5180506110191345, "I think caregiving is overlooked. I don't think obviously, it's not covered. So I don't think they government necessarily sees the value as much. And I'm hoping that over the next, you know, decade, that's something that becomes a coverage point, because I do think it would actually in turn save a lot of money from hospitalizations, and readmissions."]
+[-1.615243911743164, -0.6313315629959106, "Yeah. Yes. Um, I think it just makes us a little more self aware of where we are lacking because we do have a lot of patients in skilled nursing facilities or who are very low income. And hospice is one of those few benefits that is covered at 100% under their Medicare benefit. So we're able to come in and really provide some supplemental care. But unfortunately, it is supplemental, so we're not, you know, typically around the clock, we are available 24/7. But that's really where we pull in on our social workers to help find any possible resources for families who may not have that the financial piece to be able to cover the additional costs"]
+[-2.7126011848449707, -1.3236135244369507, "Um, gosh, I'm trying to think I know the Alzheimer's Association is a big one. They're big advocates. They would be a great organization to talk to you as well."]
+[4.922237396240234, 3.407902240753174, "Thank you. So this concludes our interview. Thank you for your time. If you have any more to share, you can always reach out to us and our information is available on our website, and you can leave a voicemail on my telephone. So I will stop the recording now."]
+[4.765547275543213, 8.021673202514648, "Okay,"]
+[-2.7113614082336426, -3.206700563430786, "Okay, the primary goal today is to identify what needs you think are the most important for the older adult population you serve. Those who are 60. And older, we want you to think as broadly as possible. Take into consideration the older adult caregiver, family and their community. I'm going to share my screen so you can see a list of common issue and concern impacting older adults. Please take a few minutes to read through this list. And let me know when you're ready to begin. And if you need me to scroll, just let me know. Thank you."]
+[4.540843963623047, 3.081164836883545, "I'm still learning a little bit more about advance oc and the goals here. Yeah. So"]
+[3.1522765159606934, 8.901772499084473, "Yeah,"]
+[-1.5746338367462158, -3.111377239227295, "yeah. So so thank you for having me, Katie, and honored to be part of advance oc and what you guys are trying to do. And hopefully I can share some some ideas on how we can help older adults, I think we all have the same goal. I think a lot of people that work in the healthcare and senior industry, have a heart for seniors and want to do the right thing and be a resource and advocate for them. So I think our our goals and mission align. And so, you know, my background is, is 20 years in assisted living and living. So I, you know, did marketing some operations, I did new development, where I built new communities, in multiple states, primarily in California, and I did a lot of acquisitions. And so I was a VP for numerous companies. And, you know, our, our goal was to take care of seniors in these assisted living communities. And so being an assisted living, I got to learn about a lot of different parts of senior living. And and, you know, and how they're operated, how they're managed, you know, some of the different partners that we worked with, to provide great care for the seniors who live there. And then now, I transitioned into a new role about a year ago, where I'm a VP of Business Development for Senior doc. It's formerly known as Geiss Med. We do on site primary care. So basically, we have doctors and nurse practitioners and physician assistants, that go into seniors homes, in the convenience of their own home or assisted living community. And we provide primary care. So it's kind of that old school where the doctor comes to you and you know, we go to the homes and provides we're physician group that provides care in their home. So we do a lot of other things. But that's our primary core business today we're at, we see about 2500 patients a month, we're in about 380 Assist different assisted living communities in three states, primarily in California, we're based out of orange in the city of orange and in Orange County. So we're central with with your your, you know, market that you're serving in Orange County, I personally grew up in Yorba Linda and Fullerton and Garden Grove and so I have a lot of connections here and you know, have a huge heart for for this county that we're serving and in our offices here. So I'm really passionate about this and glad to be able to read through this and hopefully share some some ideas here."]
+[3.189892530441284, 8.907186508178711, "Yeah,"]
+[-2.6550848484039307, -1.240709900856018, "sure. So, um, you know, let's start with the top, Alzheimer's and dementia is, you know, in the in the folks that are part of this, the very first one is Alzheimer's and dementia, dementia, you know, and I'm not here to educate you and I'm not pretending to be a physician because I'm not. But it's, you know, dementia is an umbrella term, there's many forms of dementia, there's some that are more challenging like Lewy Body vascular and Huntington's disease. It's even more challenging than Alzheimer's, which is the most common. A lot of the memory care communities you know, do have a secured or assisted living communities do have a secured neighborhood for folks with memory loss. And I think they do a great job at engaging them and making sure they feel active and they're as independent as they can be. But there's just a huge challenge. There's a stigma still of moving into senior living communities, or even needing one on one home care in the private comfort of their own home and it's very expensive to bring In homecare, so there's great organizations out there that help people with Alzheimer's and dementia like Alzheimer's OC, there's Alzheimer's Association. So there's some great groups out there. And there's lots of support groups, which there's a stigma even attending those. You know, in a lot of it's untreated, it's undiagnosed. People don't want they know they're becoming forgetful, their short term memory loss, and they don't want to get diagnosed with that disease. And they don't go and see their doctor, you know, and I think what people joke about is, hey, hey, Katie, if I'm joking with you saying, you know, I have dementia, because I misplace my keys, that's different than me, that's different than me driving home from Ralph's, which is down the street that I've been driving home from from the last 20 years. And I get lost. And it's just down the street, and it's somewhere I've gone, you know, forever. And I get lost. That's, that's different than me misplacing my keys. And so I think people don't really understand the difference between dementia and in Alzheimer's. And I think one other important part is seniors oftentimes, self isolate, as they get older, many times they lose a spouse, their friends and neighbors move on and pass on their, you know, that they're retired, and they need a purpose, they need a reason to get up and get dressed to go down for breakfast, and they don't like to cook for themselves anymore. You know, a lot of their social groups are getting smaller. And we all need eight meaningful conversations a day, I think that's a great message and takeaway out of this whole message here with advance oc is to say, the seniors need eight meaningful conversations. And so, you know, everyone knows we need to eat healthy, we need to exercise we need to, you know, manage our medications correctly. But the eight meaningful conversations, we need a purpose. And so I, you know, finding in to prevent dementia, we need to not just work a pseudocode every day or not, you know, do the same thing over and over, we need to use different parts of our brain. So the experts will say, you know, learn a new language, even though we're seventy years old, you know, explore and go to different places, try new things, join the Senior Center, there's lots of opportunities out there, especially with the internet, to engage different parts of your brain so we can get to those eight meaningful conversations today is our goal. So diet, nutrition, fitness, I think that solves a lot of problems. You know, I think, you know, there's so much opportunity out there just through internet through, through, you know, telehealth options, through podcasts, through, you know, books, whether it's books, where it's reading to you, or, or just reading, but you know, there's doc talks, you can go to the Senior Center, you can go anywhere, and learn about nutrition and fitness and do group stuff, if you're not wanting to do fitness by yourself. And I just personally feel, again, I'm not a clinician, by any means. I'm not pretending to be, but I just think, you know, that's to me, if I'm picking three things out of this whole thing that that stands out."]
+[-1.4205881357192993, -2.312150478363037, "Yeah, I mean, there's a lot of these are very challenging. You know, another one that stands out, it kind of ties in with the respect thing, there's, there's something you know, that's called ageism, where a lot of seniors are discriminated against, you know, in the workforce, or through housing or, you know, lots of different means in I struggle with that, because I'm so passionate about seniors, and people will say, Oh, they can't pick up the digital piece, or they can't, but they there's so much value and wisdom and in many of them can are internet savvy, and could probably, they're an Excel ninja beyond what I can never do of numbers. They offer tons of value. And I think, you know, sometimes younger generation, generation X or whatever they, you know, they dismiss it, you know, we want to get someone that's going to come in and we're going to coach them and mentor him and whoever the younger person is, and we want someone that's hungry, that's going to hustle and in, you know, work hard and not bringing in bad habits and they're going in with that angle in that mindset, not thinking about the best practices, the experience, the life knowledge that someone who might be 75 that still has tons of value to offer an organization. So I don't think people necessarily know that they're discriminating I Um, I just think they get dismissed. And, and, you know, it's something I'm passionate about as well. So I already picked three things in nutrition, the Alzheimer's dementia in the respect, you know, as a physician's group, we're all about our company culture, are all about hiring and retaining and recruiting staff and talent, making sure our team's appreciated that our team has great bedside manner with our patients. And that we're checking in and checking out with the families, the POA is the communities that we're serving. If we do right and do a great job, good things are gonna happen. And in respect comes in a lot of different forms, both for the patients we serve, the communities we serve, and the families and our own team. So I think that's a great one as well."]
+[2.609128475189209, 4.280982494354248, "Yeah, I want to dig a little deeper into the three that you mentioned."]
+[-2.8890349864959717, -1.1945576667785645, "Yeah, I mean, there's multiple reasons of why people get it. You know, sometimes it's, it's real that it ties into my other thing with the nutrition or, or, you know, some of it's hereditary. Some of its, you know, it's, you know, things you can't control, they didn't eat, right, or they sometimes it's, it's, they had a bad accident, they were in a car accident, and they had some trauma. And it caused some form of dementia from it, it's really sad. And so the, I think a lot of the communities that are people that take care of people with dementia can be demeaning. And that also ties on the respect piece, meaning they do stuff for them, they want to enable them and, and let not let them do as much as they can for themselves. And so having systems training, quality assurance, and having, you know, there's a few people that come to mind, one of his deepest snow, where she talks a lot about how to treat people with memory loss, you know, that they still have a great purpose in life, and, and they still have the ability to make choices. And it may not be choices of, hey, you know, Brian or Katie, here's a menu to choose from that can be overwhelming with someone with memory loss. Or do you want a salad for lunch, you know, it, kind of simplify it and give them still the ability to do as much as for that they can for themselves without it, finding that balance of still being independent, but not telling them this is what they need to wear, you know, Choices, choices are really good. I think a lot of people are afraid to talk about sex, you know, just because you have memory loss, and you you know, can't remember if you had breakfast, but those sexual desires don't go away. You know, and so we talk a lot about consent. You know, what that means of when you have you know, it's also find that balance of if you if there people are married, you know, can the person consent, you know, who's the POA sometimes in memory care communities that I've helped manage, you have two people with memory loss that that wants to engage in sex and so, you know, it's, it's a challenge in are they at the same level, it's one taken advantage over the other person, you know, that ultimately they do have the right to have that time together. And so, you know, we have to notify the power of attorney and sometimes they're still married. And so you know, that that comes a whole other challenges and then there's, you know, we have to talk about STD prevention and a lot of this stuff. So, there's a lot that goes into memory loss and dementia and, you know, there's, you know, CBD and a lot of Eastern medicine options that are growing and becoming more popular, where it's not just the historical two medications that most primary care groups like us, you know, recommend which is typically Aricept and Namenda so you know, there hasn't been a lot of really strong medications that I've seen that have worked so slow this disease down in my opinion for for families and adult children and spouses, grandchildren and loved ones who are struggling with someone with who has memory loss you know, my advice is always just love them for the time that you have left and you know, take them out to a park go places play cards you know for for you do as much as you can for them and not overwhelm them. And but but still be able to do fun things you know together and celebrate your time together and enjoy that time because we don't know how much time is left. And so I like to personalize things personally. What's her favorite oil that's going to bring back dads, if dad's passed away, your dad used to wear brood, you know, how do we bring that scent back. And so there's so much opportunity to engage someone, through even through oils, like citrus will lift someone up if they're on hospice, and and then there's lavender that can calm people down. If they're sundowning, or they're agitated, there's lots of tips and tricks to redirect people who are agitated, who are really struggling with, I want to go home and their arms are crossed, and they're sitting in their home they've lived in for 20 years. But with memory loss, home might be for them, it might be where they grew up, in and they may revert back to someone who they were younger in life. And so they're really struggling. And so it's finding again, finding a purpose and finding, getting them engaged in something during that time where they might be coming agitated. So if we know when they're sundowning, literally when the sun's coming down, and they know they need to go somewhere or do something and they're really struggling with that time of day, that's the time with where we should go take them on a drive. Or we should, you know, put on some music or, you know, draw or work on some blocks or, you know, do some trivia, whatever. But, but the more they're just self isolating, and not not doing anything, the more, a lot of times that agitation will progress, especially if it's not handled right. And again, one other piece of this whole thing is, if it's a caregiver, like a spouse, or a caregiver, in a community or at home, everyone has different tiers of what they can do. And so some people just need a reminder for a shower, and they go in and take their shower. Other people, we're setting everything up, it's the right temperature, the shower, we're making sure they're transferring safely, and they can they can take their own shower. Other people were standing outside the shower or handing him things saying, Okay, we're gonna soap her body up, we're gonna wash your hair. And then other people need full hands on care. And so, again, we never want to, we never want to enable seniors or anyone with memory loss to, to do things for them, you know, let them do again, let them do as much as they can for themselves."]
+[-1.536625862121582, -0.7968915104866028, "It's education, it's advocacy. It's, it's, you know, people like Teepa, Snow, who, in David Troxel, who write books and do podcasts and educate people on how to care for people with memory loss. It is finding solutions to make, make it affordable to get the care that they need. You know, right now, the going rate for a one on one caregiver is probably $35 an hour. Even if you're wealthy, it's very expensive. And so if you, as a family say, Hey, we're really struggling with this idea that mom's becoming more forgetful. And I have a job as the son and If my mom were to become more forgetful, and, you know, I don't know what to do. I got kids and you know, I don't think she saved by herself. If, if I choose to hire a company, they're fingerprinted. They're drug tested, or life scanned. You know, I know that they're reasonably vetted out, I can call former employers. And I more than likely, I'm probably going to get a really good candidate. And I could even be specific about what if I have a preference on male or female caregiver or things like that. And then the length of stay, but I'm going to pay for it. It's $35 an hour is the going rate. Some are over $40 an hour. And there's more services that go into that. If I choose to find someone through a friend of a friend, and they're not through an agency or a company, I run the risk of bringing that person in and if that caregiver falls, maybe because my mom is, you know, is about to fall or she needs help and the caregiver follows that caregiver consuming. How do I not know that that person has done bad things in their life because they're just through a friend of a friend, but they're only charging me $20 an hour. So I have the risk of getting sued at the risk of them, you know, having a record. There's just there's no checks and balances, there's no oversight, you know, I can't you run a huge risk of going that route. So I don't recommend that. But, you know, at the same time, there's a lot of people out there that can't afford $35 an hour. The other option is you know, moving into a community where it's also very expensive unless you have you know, there's there's different government programs that help out But there needs to be more of them. And so I think, from a big picture standpoint, you know, with advance oc is to advocate for more grants more dollars to be sent to more, you know, adult daycares to give the caregivers a break during the day or more. More government programs are state funded programs to support, you know, the VA or, you know, Alzheimer's OC, or Alzheimer's Association and everything that, that huddled around people with memory loss. It's, it's only getting worse and more and more people are getting diagnosed. And you know, there's really no cure or solution, in my opinion. And so there needs to be more support around this this area."]
+[-4.048269748687744, -1.9736919403076172, "different experiences for different groups of older adults from different backgrounds."]
+[-0.6689696907997131, -1.2224774360656738, "Yeah, good question, Katie. So, you know, in some cultures, you know, they're they keep mom at home, you know, is, you know, there's Hispanic cultures, Asian cultures, where everyone has a grandmother living with them. And that's a beautiful thing. And it's very much of a cultural thing. And so, you know, I think, as advocates in the industry, I think it's, at the end of the day, it's it's seniors choice of where they want to live and what they want to do, whether it's living with family, or moving to a community. Either way, there's some family situations that are really good, and there's some families, so if situations are really bad, that neglect that senior, and they're just sitting in a room, and they're really not engaged or doing anything, and that quality of life is not good. And then there's some communities that, that do an amazing job. And a lot of them do, the vast majority do a great job. And, you know, after working in senior living for 20 years, I'm a huge fan of that option for a lot of people, not for everyone. In some people just do better in smaller environments, you know, whether it's just with the family, or what we call boarding cares, which are these residential homes where six people can live. I think it's, it's good to educate ourselves, if you're new to this. Of all things senior living, to know what your options are. In primarily right now, for the vast majority of seniors, they can either stay home or bring in home care, if they start needing care, they can move to a senior apartment, where it's just like someone my age, who you know, I'm in my 40s. But if I were to get an apartment, I would sign a year lease. And same thing with the senior with the senior apartment, you sign a year lease, and they may do a potluck, they may do some bingo, but I'm pretty much on my own if I was in a senior apartment. And then there's independent living, assisted living memory care, skilled nursing hospitals, l tax, there's a lot of different ways that that people can live. But I'm just a huge fan of education and advocating and letting people know what their options are. And, and then so they can make an informed decision. And unfortunately, you know, I think in some cultures, they really don't explore some of those options, when they probably should. You know, and the seniors, oftentimes wait until something happens before they need to make a move, meaning, you know, I want to be as independent as possible for as long as possible, and then they get macular degeneration they can't see and they have to lose their license. And, you know, they can't live independently anymore. And then what happens, they get groceries delivered, there's a lot of services that are, are helping, you know, there's Meals on Wheels, which is a great program. But then there's, you know, there's, you know, some seniors that need more than that, and then they wait until something happens, they have a broken hip, they have a TIA or a stroke, or, you know, God forbid something happens, then their quality of life and assisted living is not as independent as it could have been prior to that fall, or stroke or whatever. Because that shortens our length of stay in assisted living because they waited until it was a traumatic event where they needed hip surgery, for example, and then moved into an assisted living in the senior living communities want to advocate to get seniors in earlier in their lives to really enjoy the excursions going to the racetrack and the casinos, and museums and the theater and all the fun things that they're doing. You know, live entertainment with music. There's lots of clubs and committees and groups and they could be independent and have a great purpose. They're in these communities. Oftentimes, people wait, you know that the average length of stay in assisted livings two years in so it shortens that length of stay because they wait until something happens. And I think if more seniors did more homework earlier in their lives, they might be more open to that idea."]
+[-1.2472245693206787, -1.7796417474746704, "Yeah, I think, you know, they don't like to cook for themselves for one, you know, is they cook their whole lives for their families, and they get tired. And there, you know, a lot of times, not all of them, of course, but a lot of seniors, they're just like, I don't want to cook this big meal for myself. And so it becomes convenient for a lot of seniors to do the fast, not fast food, but, you know, the frozen food and the easy stuff. And they're not eating as much. I mean, it varies, obviously, this, this is a very broad topic. But the ability to exercise, you know, maybe they go on a walk, but they don't really take advantage of all the different groups, and, you know, senior centers and hospitals have, you know, the colleges have seen their programs, there's so much out there, that if they were to like, you know, just be a little bit brave one day, say, I'm gonna go try this exercise class out this this Zumba, or, you know, this yoga or whatever it is, they, they would probably really enjoy it. Yeah, I mean, I'm, again, I'm not a doctor, but I think it, I look at nutrition, fitness diet, I look at it as more of a holistic approach, whole body approach where this ties in a lot of different things, it ties in their sleep, depression, again, that that mental fitness of staying active mentally, as well. You know, I think those are some of the challenges and opportunities."]
+[-0.6192697882652283, 2.646019220352173, "What barrier assists to see improvement in this area."]
+[-1.259944200515747, -2.3515093326568604, "I think there's a ton of groups out there, and they'll do a good job of trying to market themselves, you know, whether it's digital campaigns, or, you know, direct mail or, you know, partnering with doctor's offices, or senior centers, or skilled nursing facilities, like, you know, all these different groups that have services, and many of them are free, you know, they all do a good job. But I think, you know, when people get mail, they just throw in the trash, you know, this is all junk mail. And I think it's, I think seniors need to be more open to opportunities to stay engaged, and stay active. And not just think everyone's out there trying to steal their money. Or how can they, you know, sign them up for something that they they're not interested in, and a lot of us local, there's a lot of stuff in their backyard that they don't even know. So I don't know what the solution is there. I think, you know, I think over time, you know, every, every year, the way we market, how we, there's geofencing, where we can target different places where seniors go, there's, you know, digitally, there's just a lot of things that we can do, but at the end of the day, it has seniors have to be open to it, because, you know, they have to be, you know, they get stuck in the routine. And, you know, it's just harder to change, it's hard for anyone, but, but at the end of the day, they have to be open and maybe that comes from the doctor, us, you know, saying, you know, you need to look at more programs to stay active, you know, and to live a great quality of life. And so, it's hard when they have memory loss, you know, they're, they forget what we tell him in so we're trying to navigate those waters with the POA but letting them still feel like they're in control. But, but we also take care of people who are 65 and better, who are still working and still very active and independent and still live a great quality of life. So So for our group, we do a little bit of everything. But I, I, I challenged young seniors to really listen to podcasts and read books and network with other seniors about, you know, things that they're doing and, you know, stay active and stay involved, you know, join a rotary club are the Gideons are one of the service organizations and have a purpose. And I think if if more people did those kinds of things to you know, hanging out with their neighbors, and you know, I think the years and years ago and the generation of the seniors that we're talking about, they were a lot closer to their neighbors, where a lot a lot of times nowadays, they're you know, they don't they don't talk to as many as they used to because they moved away and they just haven't made a priority to Spend time with them"]
+[0.41890883445739746, -1.6649895906448364, "Yeah, I mean, there's let's go financial first, you know, my background was more private pay. So is we want to merge the private and public sectors together to, you know, to make sure the seniors have what they need, you know, number one is they got to eat, they got to have housing, they got to have a roof over their head. And so, you know, that's an ongoing challenge. And I don't have an answer for that either. My personal background is I'm not as you know, I don't have as strong background in the public side of, you know, low income housing, or homelessness, it just wasn't an area that I spent a lot of time and so I can't comment too much on that. But, you know, for that middle market, person who, you know, didn't have a great job, but lived in had a home or even an apartment, but you know, was kind of middle market, there's tons of options that are out there, that are easy to vet out, you know, the communities, everything has reviews, nowadays, you can go in and tour you can call you can there's referral agencies that are these guides that are helped clients search and navigate and find senior living communities based on their budget. Or I have $100,000 in savings, and I have, you know, I get an income of, you know, five grand or three grand, and I, you know, have a little savings, little mistake, what are my options, and so these advisors will tour with me, and they'll show me around, whether I'm low income or not. If I'm independent assisted memory care, it meals or not meals, there's these advisors really help, you know, with educating people on what their options are based on their budget and geographics, and some of that kind of stuff."]
+[-2.692044496536255, -1.8600354194641113, "When you think about respect, how or why older adults struggle struggling with this issue."]
+[-1.3928134441375732, -2.2246756553649902, "I think the, you know, I think it's a generational thing. I think they come from a generation of respect. And, you know, I think sometimes there's plenty of younger people who, who can be respectful and are respectful, but then they come across a few people in even if it's just through media, or TV or the internet, where they perceive that think it just depends on where you go, and who you interact with, but I always believe if you're kind to others, good things are gonna come back and they're kind to you. You Yeah, I think training can be better in our industry, in the senior industry, where, you know, it's not just the initial training is ongoing education, it's company culture, it's little things like, you know, making sure your staff feels appreciated, you know, and that doesn't always have to be a monetary thing. It can be personal notes. And if the staffs taking care of I feel like even if I'm working at a senior center or a daycare, where that senior is going to go back home at the end of the day, if even if I work at a grocery store, you know, if the staff is better appreciated, better train and not just initial training is ongoing training and continuing education, how to talk to older adults, you know, if they're struggling with you know, I can't find my, my, you know, my credit card or something's messed up, like just to be patient with them. You know, so I think is as is an industry. I think crossing all industries, we can do a better job of being more patient with seniors and helping them you know, when we can there's tons of services, you know, that that help people like, there's remote patient monitoring, it's also called RPM where they can track you can track like your pulse, your blood pressure, how many steps your oxygen levels You're a lot of different things. So there's a lot of technology where it's really easy for the seniors who are not tech savvy to, to use to live a better quality of life. And it's all through the cloud where it can go straight to the doctor's office. Again, it's just about education. And it's all paid by Medicare, which is great if the, if the senior has Medicare, if they're 65 Plus, where, you know, there's, there's lots of services. And another big thing is psych, Psych. So if a senior has schizophrenic or bipolar, they're suicidal, they're pain seekers, they just have really challenging behaviors. There's behavioral health, which is paid by Medicare, again, through home health, you can have a psych nurse to one hour talk therapy with seniors, it's all paid by Medicare. But no one even knows even within the senior industry. No one even really knows this exist. And so what do they do, they wait until they're in crisis mode, and do a 5150 to get this person admitted if they're a danger to themselves or others. But there's plenty of other healthier options for everyone involved, the person that's around that senior and the senior themselves to, to, you know, try to minimize and reduce that risk of needing to get to that, to that level. And as an industry, we're also all have a goal to reduce hospital readmissions. So that's a big thing over the last few years of, you know, not having people admitted for the same thing over and over, it's costing the hospitals a lot of money. Now, the hospitals are being financially penalized for these hospital readmissions. So they're trying to do a better job through utilization, you know, in social services and case management to make sure when they're discharged, that they have a safe place to go and have a good plan to make sure they're not going to be readmitted for the same thing, whether it's physical therapy, occupational therapy, speech therapy, or this, you know, psych program, behavioral health program, sometimes is putting in putting someone on hospice, which again, is paid by Medicare, where they can provide, provide comfort measures at the end of life to make sure that they're pain free, and, you know, and can live a great quality of life, you know, through through that time of being on hospice, you know, whether it's a week or six months. So there's great services that hospice provide with educating families of what that process looks like. And, and again, making sure that they have the choices that that are available, and that they're pain free and not having to continue to go back to the hospital, or skilled nursing facility, it can be comfortable at home."]
+[-1.2550451755523682, -4.28617525100708, "And you please describe how assessable and adequate geriatric care in Orange County"]
+[-3.197219133377075, -0.2528863847255707, "how successful Geriatric Care is"]
+[0.9743097424507141, 2.516120672225952, "accessible and adequate or accessible. Yeah, yeah."]
+[-1.4647226333618164, -1.2053025960922241, "I mean, if you really look, there's a lot of options. I just pick us personally, I know a lot of the assisted livings. I know a lot of the senior centers and adult daycares, and a lot of the different nonprofits that support and surround the geriatric community, I think there's a lot there can always be more, there's never too much. There's plenty of seniors that are really struggling with not being able to eat or cook for themselves or not being able to drive, you know, to the doctor's office. And so that's one of the reasons this is we do primary care as we go to them. If they are not, don't have the ability to drive, we have our doctors and nurse practitioners, we go to their home, or the assisted living community. And so we're big believers in bringing in services to the senior instead of bringing them out. It is you know, if I have memory loss, and you're taking me out of my home, which is I'm all about my routine, it might mess up my day. Yeah, we have what's called a circadian rhythm. And if, if that's upsetting to take me out, and I'm in a waiting room, or there's other people around, and I go in and see the doctor. And, you know, it may or may not mess up my day. And so it's just really convenient to have our providers and our team who were on mobile, we have 56 providers today in three states to go to the seniors in there in the comfort of their own home. So I think more services that can provide that concierge style of medicine, and not just medicine, but services, to get people to have transportation to do the services that they need. There's a lot of nonprofits out there that have buddy programs where, you know, we need more volunteers and this industry to go say, Hey, we're gonna assign you three people, three seniors who are really struggling with blank you And, you know, this one doesn't drive. So if you take her out to lunch once a month, you know, or go bowling or, you know, just go for a picnic at a park, you know, go for a walk, it can be the smallest thing where you're playing, you know, running with someone. And it just, there's something that they get to look forward to all month long, or, you know, it doesn't have to be too much. I think there's a lot of different nonprofits and organizations that do a lot of amazing things that people aren't aware of. And the best way to learn about them is just to start touring these communities and starting with the ones that are closest to you, you know, whether it's the local senior center, or joining a support group, or you know, whatever it might be, and the nonprofits are amazing, Katie, the, you know, one of them that that a nonprofit that we're going to be starting at Guiss Med, or senior Doc is going to be for our hospice, where it's basically, it's similar to like, make a wish foundation for seniors. And we're not going to use that phrase, but just so you understand, what we're trying to do is we're trying to grant a wish for them to see a loved one they haven't seen that might live out of state, or to help pay for a move into a senior living community or pay for furniture or pay for the rent, to the loved horseback riding or go in a hot air balloon, like will create an experience in sometimes just putting a roof over their head or giving them some, some meals or you know, time together. And so we want to honor the seniors in our nonprofit that we'll be creating this year to have an amazing experience when they're on hospice. So that's one of the one of our goals this year."]
+[5.23994255065918, 7.059676170349121, "Yeah, that's amazing."]
+[-1.1209304332733154, -0.9290922284126282, "Yeah, most assisted livings, you know, I hate to give out any numbers or statistics, but most of this communities that serve seniors are not at capacity. So the they have really robust marketing teams to advocate educate seniors on what their options are, they don't, they're available for two or seven days a week, where, you know, someone could walk in and say, hey, I'm interested in options for myself or a loved one about how much it cost and the size of the apartment and your culinary experience and what activities are going on. And so the vast majority of communities, the vast, vast majority are not at 100% capacity. So it really just comes down to affordability, it comes down to you know where that person wants to live, if they want to live in your loved ones, or just stay close to home where they they know that that bank they've gone to for the last 20 to 30 years, they know that they have their hair stylists that they love, excuse me or barber and so that they feel comfortable and want to stay close to home. And that's an option. But again, I think it's it's it just comes down to educating them and for them to take the initiative to go to one of these places, and they don't have to be sold anything. It's just, hey, I'm here today, just looking at my options for the future. So I know what's available, and the time comes that I might consider senior living options. You know, I'd like a quick tour just to just to get an idea of what it costs and what services and amenities you guys offer in that in that marketing director. I'd be happy to take that person around. And you know, show them you know, tour of the community."]
+[4.006253242492676, 7.191599369049072, "I'm sorry, I missed part of that."]
+[3.7727606296539307, 15.534725189208984, "Yeah."]
+[-1.2179193496704102, -3.5646519660949707, "Yeah, there's another tough question. There's some Jerry Sykes or Jarrow Sykes where people go in, you know, they're struggling with with mental illness, whether it's long term or short term care. I think they do a good job with what they have. You know, a lot of it comes down to insurance. Most of these stay pretty full. Unfortunately, there's, there's a huge need for for more of them. You know, so um, It's a challenge and you know, I don't have an answer and I think it's it's a, we have to attack it from a lot of different angles. To do the best we can job, you know, is an industry is we can. I know one of them closed down recently in Orange County. From what I heard, it's called Newport Bay Hospital. They were one of the leaders in a big Gero Gero site that like Hoag Hospital and St. Joe and Saddleback would all refer to and it closed down during the pandemic. So there's some other really good ones that are that are out there. But, but from what I see an orange county there's, there's less not more I know Garden Grove hospitals bringing building a Jarrow, Psych. And I think there's one other hospital in Huntington, Huntington Hospital has has one as well. But yeah, I mean, that's, that's there can never be enough of support systems around the area. Yeah, yeah. And I think they get a bad rep for all the challenges, you know, that they experience. And, you know, I think they do a really good job and have a lot of people with big hearts and care. And I think going back to the respect pieces. I think as an industry, we want to call the people who the seniors who are in these places, I think we use the different verbiage and how we talk to seniors and around them. My preference, at least in the assisted living world, where I come from, as we always want to be called communities, not facilities. The people who live in them are residents, not patients, in the places that they live their apartments, not rooms. And so, you know, I think if we change our language, sometimes it makes it feel more resort, like more community, like, a little bit more of a positive spin, and very, everything's so clinical, where, you know, we don't want the linoleum floors, and this, you know, smell of bleach, you know, walking in these places, and everyone's in scrubs. And we want that feeling for the people who are who are living in them or staying there for a short time, even in skilled nursing to feel more comfortable and not feel like they're, you know, in a hospital, you know, with the hospital stigma, what their food is, and they create amazing experiences are beautiful in all sectors of the senior living. But I think if we can really educate ourselves, and sometimes we just don't know, right, like, if you're, if Katie, if you didn't know anything about Senior Living, and you're using those, what I call the F word is facility, not community, I would just say, hey, you know, this is this is how we call it, we call it community here. We call them residents, not patients, and you're like, Okay, we can I can switch my language. But I think the more people we tell to use different, it's our frame of reference, but to, to share better words on how we communicate with the seniors and talk about the places that we're supporting. Overall, it will improve our our industry. So I think, you know, coming up with all the different buzzwords and use this not this, it helps our industry grow."]
+[3.647508382797241, 15.54427719116211, "Yeah."]
+[0.6210454106330872, -2.906543254852295, "Yeah, I mean, there's always new development, there's new communities being built all the time. There's, I just think that the baby boomers are coming that we all know that that, you know, I hate this phrase, but we call it the silver tsunami you are, there's 1000s and 1000s, in Orange County alone that are going to be turning 65. And a lot of them don't have a plan. You know, and if they're diabetic, and you know, they're struggling with driving, because they can't see anymore. How did they get to the grocery store, and they don't want to live in a community. Maybe it's not severe. There's there's not I think there's for that middle market to higher market, I think we're okay. I think for the low income. I think Orange County is going to struggle and, you know, the more dollars we can add more grant dollars that we can try to try to get the better for, for this initiative."]
+[1.7828924655914307, 6.528629302978516, "In your opinion."]
+[-1.2760223150253296, -2.216771364212036, "Yeah, I mean, I think we have the right people in place everyone I network with and know From the industry has a huge heart and has a similar goal, you know, they're all in this in this industry for the right reason, the vast majority anyway, or it's not just a money grab. But you know, there needs to be more more nonprofits more support more of the service organizations, focusing more on seniors, you know, an example is, you know, everyone talks about, you know, teenager suicide, but what they don't know is more seniors, in my experience. There's more suicides with seniors, and there are teenagers, but no one talks about that. In my history, there's been three to four suicides in the communities that I've worked in, you know, all male, of course, you know, it's just tragic, you know, whether they lose a spouse, or, you know, they just have stuff going on in their life, you know, that they, but but no one talks about, you know, senior suicide. And so, the more service organizations like the Elks or the Rotary, or the lions, that spends more on more time and dollars and support for the seniors that, that they can be serving, as opposed to saying, Hey, we're gonna put in this new, you know, handball court at the school down the street or do something at this park, I think there's tons of opportunities that seniors can benefit from that people forget about, I think if, when the city does the, you know, the mayor does the state of the city. You know, I think there should be more emphasis on, you know, anything senior related, and not just, Hey, we're putting our deck together, I'm gonna go up, do my speech, we're going to talk a little bit, we'll spend one or two little bullet points on seniors, okay, we knock that out, let's talk about the Chick fil A, that's opening up, and they really just kind of skim over it. And there needs to be more emphasis on seniors. And so I attend a lot of the state of the cities, and there's just, it's just kind of high level, and it really doesn't, you know, for the vast majority of them anyways, they don't really spend a lot of time in this space."]
+[0.03408007696270943, -4.9232611656188965, "Thinking about are the older adult resident in Orange County, who is getting the least amount of attention."]
+[-1.6200852394104004, -1.5491667985916138, "I think, you know, loneliness is a big piece. And and I think it's that, hey, I just, you know, whether they just retired or, or they're in their 90s, you know, I think a lot of people experience loneliness. You know, there. You know, there's, there's a lot of relationships with family members that are not good. For whatever reason, you know, where, you know, even though there's a daughter that lives down the street, she hasn't talked to mom more than once a year or twice a year, she may get a call, because she's busy with her kids, or they're just relationships, not there for whatever reason, and the quality of life for someone to wake up and stay in their pajamas all day and not have a lot going on. You know, maybe there's some beautiful angel out there who used to be a neighbor of someone that's kind of looking after them, or a former colleague, you know, or an old college roommate, you know, that might help out with someone, but there's a lot of people who, who don't have anyone to rely on. And so they have to make a decision earlier in life to make decisions for themselves. So the State of the County doesn't have to make decisions. If they get dementia, or if they can't, they come to a place where they can't make decisions for themselves anymore. And so that's a challenge. But, you know, the, for me, the low income is, is an area where I'm a little bit more naive, and just not as is experienced with but I think that's going to be the area where, you know, advanced OC really needs to focus on."]
+[3.610685110092163, 5.498819828033447, "Yeah, I want to be mindful of the time but if you can spare me a few more minutes, because I just have one more question that I want to ask you."]
+[-2.6099207401275635, -1.0632226467132568, "Yeah, I mean, I don't I don't think I have another nother Good. Good point here. Katie. I think I've kind of covered it all. You know, I think there's a lot of other diseases that a lot of people have that they don't talk about, like something is, you know, you may think of as silly as incontinence, you know, but it may be embarrassing to me if I'm mean continent. And every time I get in a car, or I go to a doctor's office, right, you know, I have accidents or leaks, and I'm too embarrassed to go by depends. And now it affects my ability to go in and leave or, you know, there's not a lot of emphasis on, you know, Parkinson's, you know, there is a Parkinson's foundation, but they're relatively small. And when people go out and advocate and go on these walks, like the Alzheimer's walk, or walk, or you know, or or, you know, people that support cancer, or breast cancer or whatever, it is a Relay for Life. There's a lot of dollars that are being raised for advocacy for education for training, finding, finding a cure, but there's a lot of other things that affect seniors that people don't think about. Yeah. And so, you know, there's it not only do they not think about it, or aren't aware, they just, they don't even know it exist, you know, that incontinence is a reason why mom doesn't want to leave her house, but she's too embarrassed to tell me is the son. Yeah, and so they're there. I think, you know, we do a lot of Doc talks and education and in services for staff, or we're talking about, you know, a lot of these issues, that even the communities who, for the people that work in senior living, don't, aren't even aware of. Yeah, I think there's, there's a whole thing around, you know, you know, with sleep and a lot of different things that can affect a reason why someone's not living the best quality of life that they're overlooking. And so that's our job. As a provider, we look ourselves as like the quarterback of, of our new tagline here at SR Doc is called guiding you to better health, you want to be that point, person, that point the physician is to help with medication reconciliation, where we have all these different specialists recommending different medications, and some of them may not make sense, or they overlap. We want to help, you know, recommend different specialists or let's go get you know, our you know, whether it's blood or you know, a different type of specialist or, you know, there's a lot of different things that we can recommend or physical therapy that they don't even know is an option to build up their strength because they're slowing down. We want to be the point person because a lot of people think they're in control of the seniors lives, whether it's the adult child, if if mom starts to slow down or become more forgetful, there's a thing we call MCI, which is mild cognitive impairment, where they don't really have dementia yet, but they're starting to become a little forgetful. They're in that gray area. And so technically, they can still make decisions for themselves. But they're struggling to make good decisions. So we can help educate and share what their options are. To give them the best quality of life, but I wouldn't say there's one thing I if I were to say one thing, it's just a, all the little things that can add up to why someone's not living a good quality of life."]
+[4.789709568023682, 3.4807560443878174, "Yeah. So let's continue our interview. Thank you so much for your time, you can think to me, okay, thank you."]
+[-2.7016654014587402, -3.2876648902893066, "So the primary goal today, excuse me, is to identify what needs you think are most important to the older adult population you serve. Those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families, and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through this list. And let me know when you are ready to begin and I will follow up with some question."]
+[4.0506181716918945, 5.390397548675537, "Data screen oops"]
+[3.4272327423095703, 4.117025852203369, "that's a short list. Okay. Let me see."]
+[1.8909187316894531, 4.226796627044678, "Yeah, we tried to, you know, fit in into one. Yeah."]
+[3.430091381072998, 4.037164688110352, "I was joking. It's a pretty long list. Okay."]
+[3.2002596855163574, 6.344848155975342, "You're not the first person who says that. But anyway, if you've given it to me,"]
+[1.8529237508773804, 6.343425750732422, "I won't be biased."]
+[-2.2757649421691895, 0.336763858795166, "You are answering this as somebody we have identify as an expert in health care."]
+[-2.1793770790100098, 0.3457440435886383, "Okay, so just as a healthcare, Okay, gotcha. Right."]
+[2.2786498069763184, 4.918442726135254, "But then, of course, you know, we all bring our own personal experience and knowledge. So understood."]
+[3.5278687477111816, 4.245797157287598, "Let me just keep going through this list to work so hard for this man."]
+[-3.4268972873687744, -3.0054819583892822, "Okay, okay, so for our records, can you please tell us your role and how you interact or engage with older adults."]
+[-2.9244019985198975, -0.6001808643341064, "So in my profession, I am involved with cancer. And our health system is focused on treating, preventing, and helping people survive with cancer. So the population that is very common, who has cancer is the older populations. And so we see folks who come in who have early stage to late stage diagnoses who have other medical issues on top of their cancer, we also see people in a prevention setting who want to prevent their cancer. So that's the context of where at work, what we see folks"]
+[3.282243013381958, 4.077751636505127, "It's a pretty comprehensive list, though. Tell you that."]
+[-2.8440897464752197, -0.5688998103141785, "Think just with when you have cancer on they're going to start there. I don't see screening and prevention. Right. So even older folks need to be mindful if they haven't gotten cancer, that they still have a higher they have may, in fact may have a higher risk of that. So although it's a list of common issues that impact folks I think it'd be important to call out the prevention aspect of it screening"]
+[-0.4288393259048462, 0.7764864563941956, "Yeah, just I think that prevention is screening there."]
+[0.6238990426063538, 1.6066581010818481, "I saw someplace where you had sort of community activities and such. Just trying to look for where it was, you know, again, places where people can congregate, and, you know,"]
+[4.306265354156494, 4.672445774078369, "be together to do activities together. Yes, I don't know if I see that on here."]
+[-0.492419570684433, -1.2686505317687988, "Those are sort of like community centers that cater, there are some living living centers that have activities. But if you were just in a community, for instance, is there a civic or community center, and it can be culturally, you know, sort of tailored to what neighborhood it is, as well. So I think understanding that there's a cultural barrier, as were around it is important. And I'm not seeing that so much per se on here. So just knowing that we have different segments of population, and especially as you get older, and you have this insecurity, being around people, and having activities structured around your culture, I think also helps engagement"]
+[-1.4067516326904297, 1.4787603616714478, "will be under the broader umbrella of emotional well being. We give you some examples."]
+[0.3400658071041107, 0.03781052678823471, "Yeah. family, church neighborhoods. Yeah, exactly."]
+[2.4721806049346924, 3.7722737789154053, "Okay, well, of the needs on this list, including the ones that you just mentioned, please rent the top three that you feel are the most important."]
+[-1.3022103309631348, 1.3102190494537354, "Think behavioral and mental health is really important. I think the digital divide is very important. I think behavioral and emotional well being kind of linked together, frankly, those categories, but then I think the other one that I would put on there is is the economic security."]
+[-1.6664155721664429, 1.1725456714630127, "Yeah, I mean, you can use the first you can, you know, I mean, you the you can use behavioral, because I mean, they all find fall under health. Because it's the same thing, you have to have access there. And availability. So there's a Venn diagram that pretty much covers it. So you know, I don't want to marginalize one thing versus another there. But I do think in one bucket, it is a, you know, health, mental health and well being so All right, if you're making me pick three, then I would go health care access and delivery, behavioral mental health and digital divide."]
+[-1.6847660541534424, 0.6398085951805115, "I now want to repeat your choices. I don't want to double count. Okay, so, all right, got your top three. Now I'm going to ask you a set of questions of each of the three that you just mentioned. So the first question is, when you mentioned that we see the health care access and delivery."]
+[-1.9101274013519287, -0.07430542260408401, "Yes. Yeah, I think I think one is is I mean, it's multifactorial. Some of it is the cost. Some of it is the insurances. It's listed on there. Some of the just so many barriers for them to make an appointment and actually get to the appointment. Right. So that, you know, overlaps with transportation or the digital divide. So I think all those things have very much again, crossing relationships."]
+[1.5080212354660034, 7.459288120269775, "I"]
+[0.6098540425300598, -3.0493452548980713, "think one of the barriers here is a is cultural. I think we there's some cultural sensitivity, but I think there are folks who just stay very secluded in their communities or their neighborhoods. Oh, sorry. Public transportation is although there's so many great things about Irvine in Orange County, I don't think public transportation is that good here. And so I think that that's something that makes it harder for folks and"]
+[-4.041595935821533, -1.9001752138137817, "now aren't they are different experiences for different groups of older adults from different backgrounds, for example, where they live, disability status, income, education level, etc."]
+[1.983575701713562, 6.795859336853027, "They're"]
+[3.310927629470825, 6.434947967529297, "just Yeah. Let me just repeat that."]
+[-0.5283418893814087, -0.6933227181434631, "Yeah, I do think that a couple things, one, people who are coming from more affluent backgrounds or families or neighborhoods may have an easier time accessing some of these things. I also do think that people who have strong family support would also be, are also very good. But I think when you have lost that sort of family support that generational sort of living together, it creates that gap."]
+[-1.8851337432861328, -2.1078896522521973, "Yeah, I think that's where I came up with that digital divide aspect of marriage. Because if, you know, if I wasn't there, my wife or my kids weren't there to help my mother, learn how to use an iPhone, you know, or the, you know, internet on the computer, I'm not sure how she would ever do that. And she would still be writing checks and using stamps. I think there has to be, you know, proactive education around this. So that we can, you know, it's a different type of teaching someone who's 70 75 years old, than it is someone teaching who's 20 or 30 years old. So I think we need to be tailored in how we, you know, tailored to how we teach, but also tailored to how we develop programs. I mean, if you or I had trouble on a website, you can almost imagine that, you know, our parents have no chance to do anything. So that I think we don't make it easy for folks to access or enable themselves to get access."]
+[3.799941062927246, 15.4573335647583, "Yeah."]
+[-2.0342071056365967, -1.6170539855957031, "I don't think it's necessarily unique to the older population. I think it really speaks to the lack of resources that exist for mental health in general. And, you know, we see the same issues in the younger folks, the middle age folks and the older folks. Again, and even if people wanted to try to seek the services, they're sorely lacking in many communities, mental health professionals, whether you're an MD or not, I mean, those are, those are just hard to find quality, quality providers. And so I think it's not unique to the older population, I think, what again, leaves them isolated is that if they can't find something proactively, or they don't know how to, then it just kind of gets left along to the side."]
+[-2.230625867843628, -1.2450437545776367, "I think we need to, you know, increase the number of mental health workers or facilities that we have. Be, I think, again, if we have this digital divide, which, you know, can now have been shown post pandemic to connect a lot of people where they didn't have local access, you know, our elderly population is going to struggle the most with learning that. So again, education and simple platforms to connect them."]
+[-1.7326983213424683, -1.9443557262420654, "Yeah, I think that does affect it, as well. But these days, everyone, everyone has a cell phone, and they're connected. And so you know, think it's a matter of how we are sending the messages and how we're building trust with folks. And you know, and then how will making it easy for them to do it. But I think one of those three things always fails. And that's why you don't allow people to have the access that they need."]
+[1.185744047164917, 1.2510510683059692, "Again, I think it's going to require a proactive approach of, you know, believing that we have to improve some outcome. Maybe it's number of appointments or number of people who click on the sites, and again, build an educational and access tool that connects people to those services. I think until we're actually sincere about stuff like that, it's gonna be hard to show demonstrate the fact."]
+[-1.9004130363464355, -2.1019692420959473, "Yeah, technology is tough. As you get older, and we're all experiencing that as far as ourselves. And you know, the screens are getting smaller, and the buttons are getting smaller. There are physical limitations that older folks have that younger folks don't. There are, you know, in technology like that is not intuitive to older folks. There are a few things that are intuitive without headin training. And we know, you know, there are certainly some but I think there's there's a hesitation to change or shift. Again, if you're not used to the fact that you can send checks to your bank by texting a picture of it, there's going to be a suspicion that someone's going to steal your information and such. So I've seen this a lot. My mom had the hardest time doing that stuff. At least one there's a digital tracking and the other one, it's like, it's just you know, it was fate. So you know that that change management aspect is tough, but then when we will if you just convince people to change, but don't give them the tools that actually help them do it."]
+[-0.9455260634422302, 1.4295196533203125, "Again, we're talking about digital divide,"]
+[-1.917402982711792, -2.2713069915771484, "I think, again, tailoring a lot of the programs websites, you know, we always talk about in health about, you know, creating documents that can be read at an eighth grade level. Right. That's, that's what we do. I think it's equally important that we create tools that can be utilized that 75 year old level, right. That's the actual dexterity and the understanding of a page. I don't think we ever really consider that aspect of it. In the older population."]
+[-1.143975853919983, -0.2826255261898041, "Again, I think if you have family support, it helps a lot, it obviously gets frustrating, but I think that's those are good things. So"]
+[-1.9408382177352905, -2.1715197563171387, "Think, you know, again, it's gonna require structured education, and an actual sight that a 75 year old can navigate. So it needs to be pretty simple, big visual, big buttons. You know, understand that people will double click like crazy, my mom used to keep clicking two or three times on things and then you don't even know what page you're on. And so you know, that's, that's, that's unfortunately, the facts."]
+[-3.1509454250335693, -0.012394766323268414, "Okay, we're gonna move on to the next set of questions. The first one is geriatric care."]
+[-1.0094218254089355, -4.2347636222839355, "Again, having lived in Orange County only a couple of years and geriatric care being a very broad term, but I am impressed with the number of sort of elderly assisted living facilities or communities around. I think it's, it's good, that despite the high cost of living around here, that there are communities like this. So I was I was surprised to see as many as I did. I'm not saying that makes it adequate. I was just, you know, you just assume, you know, you're in downtown Manhattan, you would not see many, you know, older assisted living places. And, you know, this type of real estate is just as just as pricey. He is downtown Manhattan. So"]
+[-2.6126341819763184, 0.28317970037460327, "Again, I know those exist around here. I think I think folks who have means have choices with long term care. And I think that's where it can sort of fall off quickly."]
+[-2.145087957382202, 1.348490595817566, "And the next one is mental slash behavior, health or substance use treatment."]
+[-1.3206943273544312, -3.5682501792907715, "I think, again, reflective of the rest of the country, it's underserved here. And it's, it's not unique to Orange County. In the meeting recently, I, I asked someone I said, Well, everybody thinks it says it's really important to have mental health facilities. My question then was put agree in Orange County, where to locate that mental health facility and build it, because then nobody wants to live next to a mental health facility. Right. Everybody's been supportive of it, but not in my neighborhood. And so I watched this happen in Charlotte, and, you know, our center built a mental health facility, but it was out in the country out in the near the cornfields. I mean, it was not in downtown Charlotte, you know, where the people needed to. So again, you're creating, again, transportation barriers and other other geographic barriers. But that's just the reality of, of putting in services and, you know, people wanting certain things in the neighborhood."]
+[3.64676833152771, 15.555322647094727, "Yeah."]
+[-1.7898284196853638, -2.424595355987549, "I've seen that be well program, it's not to say older adults, it's more of a, you know, takes the program to you situation, which I think is pretty novel. I haven't seen that in many cities. I think it's hard to expand that. Because it requires a lot of personal capital. But I think from an idea standpoint, and you know, no, you're not going to have a huge facility, then, you know, that's a way to think that's better than a hotline."]
+[3.1155755519866943, 5.775378704071045, "This, so this, next is the last of the series."]
+[1.2933791875839233, 3.0012459754943848, "My impression is they're they're decent, but I don't know if I can answer that fully informed."]
+[3.876838207244873, 7.833737850189209, "Enough, right."]
+[-2.411639928817749, -0.975712776184082, "Older adults in the next 10 years, multiple health issues that will require more care and more attention."]
+[0.3786836564540863, 0.2211298644542694, "The next is going to be the cost of living. And then third, is the technology divide will continue to get further and further."]
+[0.6581427454948425, -2.2004566192626953, "Yeah, I think, you know, there's always a role for government, whether it's state local, to, to really prioritize some of these things. I think it's hard for local entities to do that. So if the broader governments prioritize these things, and put incentives in for, you know, or RFAs for people to, you know, do these things. I think it's a good thing. I think that's the responsibility of lawmakers. I know they have tons of competing projects and other things. So yeah."]
+[0.052402470260858536, -4.899652481079102, "So thinking about all the older adult residents in Orange County, who is getting the least amount of attention"]
+[-2.4327216148376465, -1.844762921333313, "the least amount of attention among older adults, is the question. Yes. I think it's the the mentally ill standpoint"]
+[1.4844456911087036, -1.4222116470336914, "I think one of the big things is the homeless in this aspect, the housing sort of insecurity."]
+[-0.6201640367507935, -4.096285820007324, "Right. Last set of question, we're almost there. So in addition to what we have already talked about, just like to dig a little deeper into your area of expertise, so thinking about your area, which is well, actually under our, I guess, are based on the master plan for aging, puts you under the Health Care reimagined or healthcare as we age. And then, of course, as a cancer specialist, what are some ways that your area is working or not working for older adults in Orange County"]
+[-1.807874321937561, -1.9059048891067505, "we're really focusing on prevention and screening. We also are working to to treat people holistically. So to have a different alternative routes of treatment, like acupuncture, traditional Chinese medicine, aromatherapy, and these other things that are less pharmacologic, and more holistic. I think, you know, it's hard for older older folks to just take drugs for everything. So this is, this is an area we've hit it to, to offer those services that are particularly cater to older folks. And some of the struggles they might have. We know that neuropsych testing and those types of things are very important. And that is, those are all things that at least at City Hall are really focusing on."]
+[2.368805170059204, 4.839676380157471, "That's my working perhaps."]
+[1.1798423528671265, 1.3306115865707397, "I think we still have trouble engaging folks. Right, making sure that we're where we really focusing on access. People who are, you know, who can leverage these services, I think it's hard to engage them and get them into the building or onto our website."]
+[3.0128014087677, 0.06535916030406952, "When network revise policies are needed."]
+[-0.47120341658592224, -1.8669618368148804, "I think there needs to be more incentives or grants out there that focus on an older population. I think again, they kind of is you start getting to those older folks, it just kind of starts homogenizing with someone who's, you know, 60 versus 75, then we know that there are real challenges between those ages. So, yeah, I think that is, that's an area where we can be better."]
+[1.539052128791809, 7.447014331817627, "I"]
+[0.843696653842926, -2.1846628189086914, "think you have to, it's not going to be a single area. I think, again, you have to think of the the government's right, municipalities. And it really needs to be something that you know, elevates all of the stakeholders together"]
+[1.8855863809585571, 0.9055951237678528, "what sources of data do you find most relevant to your way in"]
+[1.9636138677597046, 1.017496943473816, "data is"]
+[1.7447757720947266, 0.67386794090271, "You know, in our day to day work, we we use data of you know, number of patients coming in how the outcomes are how the the perception is of our ervices we rely on, you know, patient or family based councils that can provide us opinions. And pieces of data that we use, it helps us predict out, you know, from the county census, about aging and other things, incidences of cancers and helps us predict out where we need to focus more of our effort per se."]
+[1.8901089429855347, 1.262265682220459, "A lot of people you could talk to so but you have to gather data."]
+[4.537981986999512, 3.089041233062744, "Well, with this current phase, which really the first of many phases are doing, what we call the state photo interview, which you are a part of, we only have until the end of this month, we have a span of six weeks. So we started this process, the middle of April. So next phase, we're moving on to your provider survey, which was going to ask you, after we complete this interview, whether you know, may be able to perhaps future assistance to distribute a survey. Reach out to Nancy again, later on the time comes. Definitely."]
+[-1.7141278982162476, -1.4957146644592285, "I think you could talk to, you know, people who are on the front lines around this. So talk to the nurses who work at an emergency room that are seeing these people come through up to paramedics or police force, who get called for, you know, sort of crimes or incidences with elderly whether it's they hurt themselves at home or whether they've been a victim of some something. I mean, I think those are those are raised in different issues from different perspectives."]
+[4.71384334564209, 3.1501691341400146, "All right. Last question, when we follow up with you if necessary. Yeah, of course. Oh, here we go. So this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research. If you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website, www dot att soc.com and you can leave an anonymous voicemail on our phone line at any time. And of course you can also reach out to me personally. Yeah, great."]
+[3.8902885913848877, 6.910884857177734, "Here we go."]
+[-2.7024319171905518, -4.81166410446167, "Okay, good afternoon. My name is Tohron Barnes, and I'm a member of the Advance OC team, the research team specifically and we're a local nonprofit conducting the counties. The county of Orange is older adults needs assessment. Thank you for your willingness to take part in the interview. And the purpose of this interview is to identify the needs of older adults and to gather insights from your expertise and experience. The information you provide will be used for the development of Orange County's master plan for aging. So this interview will last approximately an hour and with your permission or discussion will be recorded only for transcription for transcription purposes. The recording will be deleted after transcription. Okay, if you do not feel comfortable being recorded, turn off your camera and change your name attached to the picture. And fine, your responses are confidential, meaning that your identifying information will be removed from the report. Please note that your participation is voluntary. And you may choose to answer all questions in part full or not at all. You may also withdraw from the interview at any point in time. Okay. So if you are unfamiliar with any terms are used during this interview, please let me know. And I'll give you definitions or examples. Okay. Sure. Yes, you do. Thank you."]
+[2.208923578262329, 6.198357105255127, "No, I do not. Okay."]
+[-0.419740229845047, -3.527590274810791, "So the primary goal of today to identify the needs that you think are most important to older adults, older adults in Orange County, and this is 60 years and older. And we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families, and the community. Okay, I'm going to share my screen. All right, it's gonna be a list of common issues and concerns impacting older adults. Want you to take a look and let me know when you're ready to move forward."]
+[4.628175735473633, 5.451535224914551, "Okay. Oh, Lord have mercy. Or do I have to make it bigger"]
+[3.986276388168335, 4.750883102416992, "Let me I have to scroll up and down for you. So yeah, okay. Okay. Yeah. Then I'll scroll down. So you can see the complete list. Just let me know when."]
+[0.5278012752532959, 1.2081929445266724, "You know, the only thing that I can probably give you information on his transportation. Okay. So that that would be it for me. Okay. Yeah, transportation and mobility. Yes, absolutely. That would be mine. Right. That's it."]
+[5.567532539367676, 8.78705883026123, "Okay."]
+[-0.6472326517105103, -2.806432008743286, "Sure. My name is Joanne Jacobson. I am the senior community transportation coordinator. For Octa, I manage several programs for seniors and disabled. One being the senior mobility program. That is a program that is funded primarily through measure M two cities are given by monthly funding based on sales tax revenue, and their population of 60 years and older. And each city designs a transportation program for their senior residents based on the needs of their community. So I manage all of the cities, there's 32 out of 34 cities that participate. So I manage that program working with the cities. And sometimes the seniors because my name is on the s&p web page for on the octa side. So I get a lot of calls from seniors. I also manage another grant. It's enhanced mobility for seniors and disabled. And it's a program where government agencies and nonprofits can apply to receive vehicles and operating money and capital money. And we put a call for projects out every couple of years. So I manage that program. And then I manage an adult day we do a transportation subsidy for six nonprofits that transport their participants to and from the facility. Those though aren't always senior, some are, but it's disabled, a lot of mental disabilities but dementia to Alzheimer's. That kind of describes it."]
+[0.10770727694034576, -4.184065341949463, "Thank you. So thinking about Orange County, and all the older adults in Orange County, and looking at this list of common issues impacting older adults."]
+[2.3641443252563477, 4.8637614250183105, "I don't think so. I don't see anything that I would think is missing. Okay."]
+[0.08500625193119049, -4.24186897277832, "And of the means and listed, Please rank the top three that you feel are the most important for older adults in Orange County."]
+[0.5313610434532166, 1.196319818496704, "Um I would say transportation is number one"]
+[-1.019923448562622, 0.9878506064414978, "economics security, and then I can only see down to health care and while you can put health care and delivery, okay, health care access and delivery."]
+[5.576058864593506, 8.79644775390625, "Okay."]
+[0.2742939591407776, -2.4280171394348145, "um aging, and they don't losing their driver's license or they decided not to drive or they no longer have a car or a vehicle. They can't get to places they can't get to doctor's appointments, they can't get to grocery stores, they can't see their friends. So transportation is a big issue when you start getting older and you're coming on losing your driver's license."]
+[-0.32940444350242615, -2.519184112548828, "Um, I say that because I get a lot of calls from seniors and they can't afford the transportation, even our access, our paratransit service is $3.60. Some of them are hesitant that that's that they're on a fixed income. That's a lot of money. So I get this a fair amount that cost for transportation is an issue for them."]
+[-2.690462350845337, -1.804377794265747, "Why are older adults older adults struggling with that issue, because they"]
+[-0.35090184211730957, -2.4624903202056885, "can't get to their doctors, a lot of times, our paratransit service was just on strike, they just resolved their strike, they were on strike for a couple of weeks, I can't tell you the calls I got with people crying because their their elderly mother could not get to her doctor who one of them was a radiation or chemo appointment, because she's in a wheelchair, and they don't have a vehicle to take her in a wheelchair. So I was getting a lot of calls like that, that. That missing appointments, because they don't have the transportation or they don't even know about it. They don't know that there's low cost transportation, they think that the only thing out there is Uber. So they have no idea that there's these low cost transportation programs for seniors."]
+[-1.33855402469635, -2.7438299655914307, "I'm getting the word out. The word needs to get out that there are a senior non emergency medical, there's my program. There's 211, they have resources there, people just don't know. So I think I think you need to get the word out. And another good resource for people is 211, because we work with 211 and providing transportation information, but there's a lot of transportation resources with them and people would know to call 211 Orange County"]
+[-0.8016499280929565, -2.337686538696289, "Yeah, I just see these the seniors that are on fixed incomes, and the rents high, everything's high. So it's hard for them sometimes to afford food afford transportation. And when we were in the pandemic, there were a lot of senior centers that had a nutrition program for lunch for seniors and they would take the s&p transportation from their home to the Senior Center, have their lunch and do their lunch program. But when they all shut down for COVID We actually had to go to our board of directors and got approval to deliver these meals to seniors homes, because we don't normally allow that for the SMP program. But we asked our board of directors if we could give it and allow the cities to deliver meals because these people weren't getting food"]
+[-0.9260262846946716, 1.979781150817871, "and what barriers exist to see an improvement in the area of health care, access and delivery"]
+[-2.206425189971924, -0.5153328776359558, "that I can't speak on that Well, I just know that they have a hard time getting to facility sometimes. And that's really, that's really all I know about is their transportation to these medical appointments, that they miss them often. And I have caseworkers call me because they're looking for transportation because some of their senior patients can't make it. They're not coming to their appointments because they don't have transportation, or they can't afford the transportation."]
+[3.226093292236328, 8.629034996032715, "Oh, yeah, if"]
+[-0.43714839220046997, -1.3726692199707031, "you're, if you're getting, it's more difficult if your primary language is not English, it's harder to get around. You know, people in Newport Beach, they don't have the same issues as somebody living in Santa Ana or Garden Grove, they do not have the same transportation issues for the most part. So yeah, I see it in the language spoken. If you're able to speak in English, it's easier for them. But also the socio economic, it's definitely when you when you when you're a little bit below, you know, your income is lower than, or you're at the poverty level, which I get a lot of calls from, from seniors that are at the poverty level. And it's hard, it's really hard for them. And they oftentimes don't know where to go. And especially then, when you're talking immigrants, or even just people that don't speak the language very well, they're lost a lot of times you hate to see that."]
+[-0.4468003511428833, -2.6511216163635254, "You need to get the word we need to get the word out there more. I mean, even if we put ads on our buses, our buses are rolling billboards. You know, did you know that there's a senior mobility program and or, you know, just just advertising, letting people know that there is. And I had one city that actually ran ads an ad in the movie theater in Yorba Linda about their senior mobility program. That was huge. They got so much publicity from that. And so many people signed up and finally found out and even their family members found out Oh, look at there's this transportation, and it's $1 for a taxi, you can go anyplace in the county. So it's, you know, thinking out of the box and being creative, like the city was, and they they contracted with a movie theater, and it had before the movie was shown they had big ad on the screen letting people know so it's, it's just really getting the word out in creative ways."]
+[0.5406014323234558, 1.1830132007598877, "Do you have any other innovative ideas for addressing mobility and transportation issues,"]
+[-0.660357654094696, -2.494335889816284, "um, that one is a really good one. We could, you could put, put an ad on on our buses. But like with the senior mobility program, each city has their own program. And if you live in Garden Grove, you can only use the program that is for Garden Grove. So I don't see that really as you know, it would be hard to put that on a on a bus and advertisement on a bus. But any any type of advertising, even cable ads, each city should have a cable ad I think a lot of seniors look at cable TV, like the city like Santa Ana has cable channel, they should put stuff up on their, on their channel, their cable channel, because a lot of seniors will use that. I find that a lot of seniors and it's starting to change but they don't use social media that much, or they don't know how to use it. But you know, people are getting older so it's they're starting to, but as of now I don't think social media is the best place for that. It's more like you gotta its just gotta be out there. Even, you know, if you put a flier up in a grocery store. You live in Laguna Woods, and you go to the Vons and Laguna Woods and they have a bulletin board up, put your fly around, you know, just in your community, but just get that advertising out there."]
+[0.6307796835899353, -3.065103769302368, "Oh, no, no, no, no, no, no. No, no, that'll never happen. Never happen, because each city gets a different amount of money. So Newport Beach has a huge program, Villa Park, not so big, each city and it depends on the funding they get, and the residents and what the needs are no, no, we would never have that. Everybody's different."]
+[0.9713568091392517, -1.9696266651153564, "No, no, no, no. No, because each city knows what what works for their residents. They're all they're all a little bit different. So"]
+[1.0616116523742676, -0.9253290295600891, "well, I hear what you're saying. But I'm talking about, like, if you can change it for the future, and it could be more equity, you know, across cities and improving"]
+[0.6085461974143982, -2.8746836185455322, "would be that would be nice. That would be nice. If everybody could offer everything be great. Let's have a taxi program, you can go anyplace in the county for $1. You know, I think that would be great."]
+[2.9622912406921387, 8.309771537780762, "That's the word."]
+[2.8419039249420166, 5.863013744354248, "I guess I don't quite understand what you what you're what you're kind of looking for."]
+[0.4983387589454651, -3.236422300338745, "The number one issue is we need interconnectivity between counties. We need I had a lady that called me the other day mad, mad mad because she could not get somebody to a medical appointment at UCLA, and they live like in San Juan Capistrano. There is no connectivity between counties. That's a huge issue. And that's that's everybody's issue. It's not just Orange County. But when you have these people in Orange County that need to get to USC, UCLA, Cedars Sinai, they can't get there on on any type of transportation, that's not going to cost them $500 One way and literally $500. So so that's a really that that's a big issue, that I think that's all the counties coming to it well, especially orange in LA, because I do get people that are calling me wanting to get to a doctor at UCLA, how are they going to get there, they're in a wheelchair, and the family can't take them. So that that's a really, really big issue right now."]
+[-1.2613065242767334, -2.686580181121826, "Um, I think it's just, it's just letting people know that there's 211 out there that can help them find transportation, that there's senior, non emergency medical, that there's the senior mobility programs, there's our access program, our paratransit program, it's just getting the word out, I think that's the biggest thing is to get the word out educate people. And we do go out and sometimes do presentations at different senior living facilities, senior centers, etc. to kind of let people give people an idea of the things that are out there. And I think even more of that just to educate the community."]
+[-3.1675164699554443, -1.2468234300613403, "All right, so this next question is going to be about different services for seniors."]
+[-0.38783958554267883, -2.6453654766082764, "I don't know. I honestly I don't know all I do is have grants that I'm responsible for. We do have transportation programs for several dementia Alzheimer's facilities, and we work with the facility Alzheimer's, Orange County and Alzheimer's Family Services where We provide a subsidy and they, they transport their participants to and from, and we pay for a portion of those trips. So that would be it like what I'm doing, I don't really deal with like medical, besides the transportation end of it."]
+[2.5418219566345215, 5.147247791290283, "I know nothing about that. Zero."]
+[-2.0566351413726807, 1.2906196117401123, "Mental health, behavioral health and substance use treatment."]
+[2.145692825317383, 5.880028247833252, "I don't, I don't really do anything with those either."]
+[-0.2928410768508911, 0.5346292853355408, "And then social or human and social services."]
+[-0.39412105083465576, -2.6483163833618164, "Again, we have some nonprofits, my day counts, community senior serve, there's like five of them, that we provide transportation subsidy. So it would just be the transportation to and from these facilities that we would provide. And it would be for most of them are seniors, not all of them. But when you're talking Alzheimer's facilities, it seniors, but all we do is provide the transportation."]
+[-0.4706982374191284, -2.410651206970215, "Again, my perspective comes from transportation. Or are we prepared to make sure that they know about their cities program that there's many there's age well, and avisar that are going to take them to the doctor, it's we need to, again, my big thing is the market, you've got to get that that information out there to family, to the seniors, to let them know or people that aren't even a senior yet, but are going to be in 10 years, and they might need this service. So just so that people know about it, because so many people I get calls had no idea that there was low cost transportation for seniors. No idea."]
+[1.2277874946594238, -0.12103785574436188, "funding. We need to we need it needs funding."]
+[0.4393099844455719, -2.8919599056243896, "Yeah. That that would be great. That's a huge one. Yeah. Yeah, that would be that that that's important. That's really important. And when you talk to these people that have no way to get their loved ones to UCLA, without it costing $500, one way. I mean, that's it's huge for these people."]
+[-2.507690906524658, -0.22612088918685913, "I don't get them that frequently. I do get them. Maybe 10 a year. Okay. So it's not super frequent. But I do get, I guess it's on my mind, because I just got one yesterday."]
+[1.5937657356262207, -2.772230386734009, "I guess I would say homeless seniors."]
+[-0.03517669439315796, -2.566145420074463, "Again, I think as homeless seniors and people 60 years and older, that are living in their cars living on the streets, and sometimes we don't even have account for those people. We don't even know who's out there sometimes. So I think my personal opinion is just it would be seniors that are living on the streets or in you know, for the senior mobility program, they have to prove that there are to use a transportation that they live in that city. If they live they say they live in Costa Mesa because they live on the street and they're staying in Costa Mesa but they don't have an address. So they can't use a program because they don't have an address. So I just see that it's kind of unfortunate, you know, they fall through the cracks"]
+[0.5340290665626526, 1.1912274360656738, "related to transportation and mobility that,"]
+[0.4921415448188782, 1.1439495086669922, "you know, I'm sorry, I don't know more for you. But, you know, all I do is transportation. So I don't, you know, I don't, I don't really get involved with anything else. I just see things on the periphery. But everything is really just transportation related."]
+[4.686275482177734, 3.181044340133667, "Okay. Well, this concludes the interview. Thank you so much for your time. incredibly helpful to our research, and if you find that you have more information to share in the future, please feel to reach out to me. You can go to our website events oc.com Or call our anonymous voicemail at 949-415-6898 at anytime. Okay. Thanks for keeping you abreast of you know, with the project and then also you'll get our monthly newsletter about So, yeah, that'd be perfect. Thanks again so"]
+[4.842022895812988, 5.148994445800781, "much. Okay, take care. Bye bye."]
+[3.6766059398651123, 15.524834632873535, "Yeah."]
+[-2.6675989627838135, -3.176931142807007, "The primary goal today is to identify what needs you think are the most important to the older adult population you serve. Those who are 60 and older. We want you to think as broadly as possible, take it into consideration of the older adult caregiver, family and their community. I'm going to share my screen so you can see a list of common issue and concern impacting older adults. Please take a few minute to read through this list and let me know when you are ready to begin"]
+[4.281540393829346, 5.335063457489014, "and when you want me to scroll, then let me know because there are a few more items on the bottom"]
+[4.120578765869141, 6.369213581085205, "okay, go ahead"]
+[4.0699005126953125, 6.464242935180664, "yeah. Yeah, go ahead."]
+[5.593173503875732, 8.834375381469727, "Okay."]
+[-2.4239304065704346, 0.04338831081986427, "Okay, my name is Kennedy. I am. I'm a I'm a registered nurse. I'm a supervisor in LTSS. I've been in the department for over"]
+[0.3874049186706543, 3.058627128601074, "seven years. So when it comes to LTSS, we have different programs. We have CPS, we have"]
+[-2.1815598011016846, 0.1941504329442978, "MSSP, and the new introduced CalM. And LTC, which is a long term care where we have older adults that stays in a nursing home as their residents. And I'm I'm supervising the L LTC. Which is the nursing home or we call it long term care facilities where"]
+[-0.07329155504703522, -1.1201350688934326, "we are CalOptima has members residing there for you know, depending on the medical needs, social and whatever the need may be, yeah."]
+[-1.9221718311309814, 1.246400237083435, "Would have career behavioral mental health some Let me see."]
+[-2.5862784385681152, 0.04115479439496994, "I think pretty much is not a natural is is is missing is all all the factors we have, you know, you can define them. And know you have some chronic chronic problems there like at attack and yeah, or diabetes. I think we can add in dialysis, you know, dialysis centers where they can get dialysis centers where they can get dialysis, you know, yeah, sometimes is a big problem. Yeah."]
+[2.482750654220581, 3.803898334503174, "Up there, on the list, including the one that you suggested, Please rank the top three that you feel are the most important."]
+[-2.6062371730804443, -3.021907329559326, "Pretty much the most important. I mean, depending on the I can write, you say you have a lot of the chronic issues. You know, you have so many chronic diseases, which is all over the place. I think homeless homelessness, behavioral and mental health you know, chronic chronic health problems. Yeah, combine all of them together. And most importantly, we can cope. We can talk about the economic, economic security, you know, because most of the older adults are retiring without with not enough money to take care of their financial needs. Yeah."]
+[-2.7009971141815186, -1.3019145727157593, "When you think about chronic diseases or chronic health, how or why older adults struggling with this issue,"]
+[-2.0415353775024414, -1.2070460319519043, "you know, that they're struggling with issues is is a combination of many stuff, you know, most of the way they struggle with it, you know, they're, they're chronic in nature. It starts long time ago, and that's what they call polypharmacy. Because they have the text, so many medications that say you see an older adult with diabetes, and hypertension, and some other chronic issues, you will see most of them might have up to six or seven different medications they're taking. So in the older adults, it might be quite difficult or kind of challenging for them to remember what to take or what not to take in. And most of the older adults are non compliance with their medication. That is, how many years do I have to live, I don't want to be bothered with a whole lot of medication and, you know, this medication, they have a lot of side effects, that affects you know, their day to day activities, you know, some of them might experience some side effects related to most of those medications, and they're going to stop taking it, you know, so,"]
+[-0.7778788208961487, 2.2937188148498535, "yeah, then what barriers exist to see improvement in this area."]
+[-1.895310640335083, -1.2026171684265137, "barriers to exist is more of providing in service, you know, there have been people out there to, you know, to educate the importance of taking those maintenance medications, because these medications are like, they're gonna take you for rest of their life. It's not like, like, if you're, if you have hypertension or diabetes, we are expected to take your medication daily, you know, so most of the older adults may not be able to comprehend what you're trying to tell them to do, so they won't take it so education in services is number one. Number two is most of the older adults though they don't have access they do not have access to caregivers who can come to their house and help them most of them actually prefer to be independent but their mental and physical capacity don't actually you know, give them what it takes to be independent so they might say I want to live in my house that then who helps them to reminds them when to take their medication you know, who comes there to help them to cook if you look at the county and state program most of the time they don't cover a lot of hours for the for the older adult and you know not but not everybody has you know walked to gain like insurance or whatever to provide those services. Most of the most of the earlier though they don't even have health. Some of them qualifies for health insurance, but most of them are limited you know, you know how Medicare medical use codes and Part A Part B so it kind of affects how they I mean, how they get access to the medication and how they get caregivers most of the elderly adult they're qualified to get a caregiver as they don't have it. And cost of living in California is another problem because even if they have they're gonna get caregivers they're qualified is so difficult for for for employers, employers to find caregivers to provide care because whatever the state or the Fed or the private individuals are paying these people are not enough for them to live and provide those there is a multiple factors. That's you know, yeah, but more more often I can I can see having assets because of you know, limited insurance or limited financial capacity of the older adults some of them retired poor because of the kind of job they did, you know, so you have to have a lot of money to something to supplement whatever you're getting from government so it becomes a challenge. Yeah."]
+[-0.7007358074188232, -0.8935407400131226, "you know, you know how sometimes you know how chronic chronic health is more is selected to they'll tell you due to research and what I'm gonna be more rational on this. They're gonna if you read a lot of literature it's gonna tell you Oh, high blood pressure is more of you knoq this ethnic group, or cancer of this is more of this ethnic group. You know, you see, you look at a limited, I'm a black man limited. My black folks are an example. The study that says, oh, high blood pressure, diabetes is more of black people. I don't see that genetics. I see that's more of a standard of living. because if you don't have enough finance to eat good food to eat, maybe won't be dining on salad and things if you're if you belong to the poor and well, I call it um If you belong to the poor society, you end up as an older adult as a young or middle adult eating junk food, because that's where you can afford, you can only afford McDonald's three times a day. So when you eat it, every time you develop, diabetes will develop high blood pressure. So if that particular ethnic group, don't have access to the finance, to live better, they're going to tend to develop diseases related to what they're eating. Finally, a lot of literature has said, Oh, we have, you know, these people, if this ethnic group is more of this, and this ethnic group is more of that. My own experience, I don't think is more of a ethnic group, I will see it as a social social structure where the economic put you where, where you belong, due to your will I call it the economic power to live a better day, don't don't get me wrong, there are still some genetics problems that predispose you to to get in a disease in our birth, you know, yeah, you see, if you belong to lower class, US, the percentage of you having chronic illness is higher. So I'm not I'm not, I'm not going to classify based on race, I will classify based on economic power and social belonging. That's how I say it."]
+[7.179767608642578, 6.153903007507324, "What do you suggest is the best way to address this issue."]
+[-2.019359588623047, -1.2637490034103394, "Um, you know, it's more of what I said before is, is, the best way to address it is not like a common, like, there's no silver bullet, you should or need to get get a salt, you know, is going to be kind of providing education, trying to make sure that people are prepared, when they're still in their 40s or 50s. For them to know, now I have diabetes, and I'm going to be taking these medications, if I stopped taking it, because see, all these chronic diseases, that's why they become chronic, because our bodies tend to compensate a lot. As I have a high blood pressure, when I'm young, in my 20s, I might still be running the very high blood pressure, but my body's compensating, that is 40s, my body's trying to make sure I adjust to whatever I'm getting, but when I'm start getting old, the body's getting weak. When you're when the body gets wakes, you know, you get very weak, that's when the these these chronic problems tend to, you know, come out, you know, so is starting to educate people, you know, this social class, is there's a lot of factors there. You know, there's no, I'm not getting into that. How can we make sure they have access to financial support, because what we have now is majority of elderly adults, there all the time, that report and the economic things are not getting better financially, you know, prices are going higher because of inflation. They're getting little money paid, they can even go to grocery shop and buy the healthy stuff they should be getting. So the government has to do a lot in the financial part of their life. You know, not that they don't work hard. Most of them work hard because of the kind of educational exposure they had in life. They are they are they are not the top class. They won't. They are not the middle class, they walked in the lower class, they retire with a very low Dane, you know, pension, or some of them don't even have patience. Most of the elderly people basins, they'll base their retirement on Social Security, which in California is not going to buy you anything. You know, you know, most of the programs so badly people might not have even financial, when they spend what they have their money on. They might not even be they won't even have enough money to do this more pain. There are drugs that are going to get it as I need to eat, I don't need that drug. So the social factor on the financial part of it is is really really, really affecting them a lot. You know,"]
+[1.3711644411087036, -2.4655513763427734, "You know, what you see a majority of homelessness has to do do with. If somebody put this house for rent and put it at $2,000 a month, that's what he's gonna be whether you're 20, or you're 90 doesn't really I know, state has some program that helps the elderly, but it;s not it's not it's not. It's not broad. He's not. He's not all I see is not good enough. To supplement for them to, to have, you know, somewhere to live. And as I said, majority of the homeless people more have behavioral issues, some of them have some mental problems. How can we most of them, actually, they finally they gave up in life, I don't care I've been in the streets, the money I'm getting is not even enough to put the roof on. So put a roof over my head. So when they live in streets, they they get they get accustomed to live in the streets. And most of them takes, you know, most of them are drug abusers. The only way they can get this drug is to be in the streets. So we had the education out there, you know, where is the the anti drug abuse efforts geared towards the elderly don't think is only young people, you know, that let people get they get, they get distracted, they get kind of confused, or they get they get depressed, most of most of them are related to their financial or social social status in the community. So you see them practicing or trying to try out some different drugs. So drug drug problems is not is not exclusively for young adults or young guys, no, it affects most of the guys that are homeless or their homeless is a big problem. Homelessness does not discriminate, or the young. If you go to homeless, I mean, any of that comes you look at the number of people there, you see that the older adults are more in number than younger people. You know, it's because of how the the society how the society structured, the older adults are not actually being taken care of the way they should. This Social Security and other things, there is not good enough. There has to be more programs geared towards protecting the elderly. But I bet you not everybody has a pension. Not everybody walked to end benefits. Majority of athletes depends on this social security they get from the federal government, and cost of living in California, security cannot help them maybe that's why they are homeless. So when you guys do this program, the state or the Fed has to develop more, more programs that gets into financial incentives, how can we give this elderly has actually worked for us, you know, the adjustment in the Social Security or cost of living is now really it doesn't help a lot. You know, you don't go to grocery shop you want to buy when you buy something from let's say, Ralph's, or average. Oh, so this is for elderly people. This is for young people, we all pay the same price, you know. So most of those good stuff, their financial standard cannot make them get cannot let them get it because most of their lives they live in, in a budget. They live in a limited income that they get monthly. So the state should get I'm not saying it's going to be easy, but instead to get towards a program they're going to be providing, you know, for elderly having food banks. You know, that's what they did. Do we forget that we still have the elderly people going around, you know, COVID went away, those programs went away with COVID. So the elderly people then give back to the society and start struggling, you're doing."]
+[0.03734569624066353, -3.011796236038208, "So is really is really is going to take a lot to change it better. I think I think the state is trying to move towards kind of figuring out"]
+[0.46413761377334595, -2.1006650924682617, "programs to help but if we don't hit the major part of it is the financial and economic class. Yeah, that's what I say go to homeless camps. And look how 50 is, I mean, 60, 70 people, I mean, year old people are homeless there, you know, it pains me when I got there better. It is what it is."]
+[-0.6600576043128967, 2.4180524349212646, "Yeah, what barrier exist to see improvement in this area."]
+[1.2317534685134888, -2.4546456336975098, "There's another thing I've kind of noticed last time I went out, because I volunteer one time to go, if you don't believe you have a problem, you there's no way to take care of it. You know, so this homeless people or homeless and lay out homeless adults or whatever there, they used to live in on the streets at a time they don't see it as a problem is a limitation. Or how can I do this so that life can have a carefree life takes over their day to day, the way they live day to day. Sometimes they don't, because they, the one of my guys said they get used to the get used to the streets. You know, so is acceptance is a limitation. But every limitation, you know, if people don't accept they have problem, there's no way you can take them out of it. That's where education in servicing, talking to people, you know, going into, you know, it's like, all these things. We don't wait to people get to that age, or people get to that stage to start bringing in telling them I know, beginning services them telling them educating them, you know, if we can get towards all the adults, from 50 to 60, we try to change a lot of things about their life, the way they live, the way they see chronic problem, the way they see homelessness, the way they see everything, you touch it you get them young before they get to that stage, because once they get in there is like they don't care any longer. That's what they're gonna ask you, I don't care that your medications will helpl, I'm not taking it. I don't want it. But if if if you're trying to start taking your medication when your 40s and 50s that you know the importance of missing missing a dose, that if you don't take them when you're 50, 60 Nobody cares when you get somebody who is going to convince me to take my medication, I don't care any longer. You know, that's exactly what's going on out there. So here's the limitation. You know, and I think um, I don't know why I keep talking about finance. And economics is a big deal as far as California is concerned. Whatever you like you do you provide, you go to the community, you provide them whatever they need that the minute you go, he goes away. In I remember I went on some one time to to visit some homeless people. They have all these chronic wounds, all everything. So I saw the LVN doing the dressing change. I asked them I know it's good. The nurse told me I don't I'm trying to do the best I can. There is no program to link them up. We can't link these people in any program, because when the only time emergency room will take them is when it becomes so obvious when they are in a critical condition. If you send them they don't even have a doctor, though they don't even have anyone they follow. You know, you say, I will tell you honestly, we think, or the adult has some has access to health care. I don't think they do. Most of those older adults in the homeless population. They don't even they don't, they don't have any doctor that follows them. What can I give you, even the doctors nah, their hands are tied. They have partisan what they call defensive medicine, they do the little minimum bets they can do to prevent loss. That's all they do. So it's really it's a really, it's a big problem in our society, though, you know, it's not what we can solve in a minute. But we're making, we're making a move and the earlier we study, the better if you start letting people understand what let's say I have high blood pressure. Now, as I'm walking, maybe I didn't save enough money in my retirement to to be able to continue taking the fancy form medication I take, once I go to Medicare or medical now I start getting medication that is not actually what I'm taking when I have private insurance. Utilize a limitation there is a problem because now they're giving me medication that is different from what I'm picking when I'm a young when I'm still walking when I have all these HMOs are these blue shield's. Now I have Medicare and Medicare, so we're not going to authorize you with we're not going to give you general meds, we're going to give you a metaphor, and that's how you're gonna get. That's what you're gonna get. You know, maybe, actually, maybe I'm going off. I'm going off the point where"]
+[1.643706202507019, -2.650118350982666, "you have a lot of knowledge to share different experiences for different group of older adults from different backgrounds when it comes come to homelessness."]
+[-0.8264596462249756, -1.1985317468643188, "Yeah, yeah, I think there's different experience based on based on ethnic background, because you know, some people I will use myself, I'm a foreigner, I'm not an I'm not I wasn't born here. I just I migrated here a long time ago. So I asked me, I cannot see my parents become homeless. Yeah, that's my upbringing. You know, all my friends, my parents can raise the homeless themselves, that they believe in life. But when you have a society where their upbringing, some some cultures are there, let me go, let me talk about let me use I don't know, if you're Vietnamese, or that population, they into extended family, they'll it's like a unit, you know, they cannot see, yeah, or the adult go on the street. That sector, that's a group of, you know, ethnic group protects their elderly population, then it goes to my, my own African American brothers that everybody's on his own. You know, they don't have that. And nuclear. No, I don't mean as a foreign I cannot see my parents become homeless, even if it's what I have, I'm going to make sure I prevent them from being homeless, even if they are not getting any government support. So that being my own support that some other cultures do not see that way, you know, culturally, if they believe that if if their parents didn't plan, to to have a garden, you know, startups when they're young, that's their own problem. If they find yourself in the state that let it be what it is they keep living not with their lives. So cultural upbringing norms and what you believe what the particular race believe affects how people see idli you know,"]
+[0.16430598497390747, -1.208245038986206, "Ah, the best way to address the issue is still what I'm still saying before. Because the American society we're in culturally, you're on your own, you know, is, is still letting people understand when they are young, that hey, I need to, I need to save for, for the rainy days, in and you know, not everybody, because of the kind of jobs and kind of class we belong is able to actually save any money. So some people say, Oh, I'm gonna get social security when I retire. But when you retire in this security may not even be enough to pay your rent. You know, so is the only way we can do is still help have programs which you're trying, you guys are trying to develop programs are geared towards helping the elderly. Now that they had them, some of them not that they didn't plan, some of them, they did plan that where ever they found themselves when they get old, messes everything up. Due to the the society you live in, you know, the the inflation right now is very high. You know, whatever they pay you as a social security money is not going to do it, it's not going to pay your rent, it's not going to do anything for you. You know, so all those stuff is is really is problematic. You know, yeah, the city, the county, the state should do more financially. I don't know how they're gonna do that, you know, not everybody has a roboust pension system, or not everybody saves money. Not everybody do have houses, most of the most of that leadership that become homeless is not their choice, because they don't have a place to live. Okay, then you go to nursing home, you live there a couple of times, Oh, you don't qualify any longer. Do you know that nursing home, discharges people to a motel. If a nursing home discharge you to a motel with a seven days voucher. As an adult, as I know that after seven days, the motel kicks you out. If you don't believe me was going on in this society to them, that's what they feel they get to be everybody's everybody's trying to practice defense, they're gonna say, Oh, he's she want to leave or he want to leave, he doesn't have a place to go, then the only possible place we can give him or her vouchers to go into a motel. Okay, the person you're discharging into, to go to live in a motel for seven days voucher, we don't even there's no, you haven't linked or connect this person to a medical doctor who are going to continue taking care of their chronic problem, that when they were in your facility, you were giving them medications for high blood pressure for diabetes for everything. Now you put them in a motel. He's got to see him on this, you're gonna see him on the street after seven days without any medication. So you see the cycle, and then he becomes sick again, he goes to the emergency room that made him they put them in a nursing home nursing home, put him out again, and society. Because everything is well defined, you have to have this to get this, you have to be you have to have this, like everything has a class, you know, if you don't have this medical problem, you're not gonna get this. If you don't have this, you're not gonna get this. So it kind of put limitations on even the nursing homes, even the assisted living facilities. They have their for profits, you know, they're gonna make money to return wherever, wherever they are. I know there's a program out there or they call it assisted living whatever it is, you're gonna have so much money coming in as a retirement for them for you to for you to be in those homes. Not everybody got any money coming in. You know, some people some people don't even walk, they don't even donate what they get is a very small money from the minimum they can get from Social Security. And because of most of our elderly population, are hooked up with drugs and most of them alcoholic, you know, whatever money they get. Before actually, that's something I noticed in the society. Most of these liquor shops, give them credit. You know, all these young adults, they go there, they get all the drinks they want. Once they get that Social Security, the first thing they do is to go pay all the liquor shops they Oh, oh, give them like three or four. Bring them like three or four days the money is finished nowadays in society, then those liquor shops at the time start giving them credit, again, based on what they're going to get, if you go to downtown Los Angeles, you know, that's what's going on are those small, small shops you see there that sells alcohol, they have a book, they bring the book out, you're gonna see the list of people are in harmony there. Because those people are not, if I don't pay, I'm not going to get next month. So what they do once they get that small check, they get, they go spend alcohol shop their own, they don't talk about food. So there's a lot of social stuff going on out there. Because I've been exposed a lot in the community. That's why I'm able to tell you what's going on, you know, will all this problem be solved in a minute, know that let's see a movement towards addressing those issues. And as I say, most of these are older adults, they're used to the street. Yeah, you know, they need to accept that they need help for you to convince them, you know, yeah, tell me what's going on, you know, if a facility can discharge someone who doesn't have a home gym or motel and is accepted in the society we live, that's the problem though."]
+[-1.8680369853973389, -1.3674083948135376, "Who are going to diagnose them, they don't even have a doctor who are going to tell them they are bipolar. Or they will have a doctor, they say they're going to tell them they have anxiety, I'm going to put you on this medication. Or you're depressed, they put they put a social worker that follows you around to tell you what to do. Because nothing is there's no incentive for them to go. Nobody cares. Nobody talks to them about them, even if you talk to them. Let's say like, all these non for profit goes to them, talk to them in a day, talk to them, they're not going to come back for the next six months is like you do you do some say, as I said, continuity is a problem we have in all the programs that's been developed by the state, you put up a program, you have someone go out there one day you talk to them, you're done. None."]
+[-1.8854572772979736, -1.4429585933685303, "What barriers exist to see improvement in behavioral and mental health for older adults. we have to get we have to get some teams out there. We have to they need to have access to mental health programs. You know, dedication needs to be there. Even if it's through sending them even if let's say when they're getting those their social security checks, we're going to put up a pamphlet there we got to put down like some in service with their check for them to read. If I'm depressed this way I go if I have anxiety this way I'm go you know, the question becomes, you see some doctors this they say oh, we don't take medical we don't take Medicare we don't take this I've said you see now there have been some doctors now that believed that passionately. They don't even take insurance. Yeah, they have security in there again, if they see homeless guy they kick them out. You know, so So the education having access to these programs and the program having continuity not one not one day program, you know, you develop this there has to be way to monitor it. There has to be a way to monitor the effectiveness of what you're developing. What I've seen that there's so many programs out there that nobody monitors they just get it out there handed over to private people to run for state those private people out there for profit. still sell without we're not going to monitor it. We have given it to one this private agency to take care of is is a big problem. Yeah."]
+[3.5678834915161133, 8.900870323181152, "Yeah. Yes."]
+[-1.8318766355514526, -1.4040595293045044, "Yeah. Yeah, most of you know what I said before, ethnically, you know, most people don't have because socially, ethnically and financially It defines it divides the group. Socially, let's say financially, if you don't make enough money, you're not going to have access to mental health programs. Because your insurance, most of the doctors, or most of the providers will tell you, we do not take your insurance. Ethnically, most people do not have access to education. When they are old, nobody's talking to them, nobody's coming to them, nobody. They don't get the in surveys, that hey, if I'm depressed, if I have anxiety, if I have this, this what I do, and nobody that don't even have money, even if you tell them that, oh, this is the medication for depression, you should get to the Do they even have a doctor to go to to get those medications. Now, when they become when they become chronic, or when they become when they're in their manic stage, you call 911. They put them in a hospital, then after the hospital is again, for profit, wherever they are, they will say non for profit, or for profit, you know, the hospital have you for a couple of days. Now they discharge you you go, what they do, they give you, they give you some pills, they give you maybe 30 days worth of this depression pills. Those when you decide to the community, you're taking these pills for 30 days, after 30 days, you don't have access to it any longer. You don't even have insurance. Don't even have a doctor who will prescribe it. The hospital has done the minimum best thing they can do. We're trying to defend ourselves from lawsuit. That's why we assess you. That's why we discharge you. Now we follow them. Yeah, for the older adults. We were reactive so we react to their problems we're not proactive. Yeah, so I said"]
+[-0.5644636750221252, -2.3469085693359375, "Governments cities counties got to do more. They need to do more they need to develop so many programs you know they need to develop so many programs geared towards older adults. Yeah."]
+[-1.2531909942626953, -4.2722063064575195, "Can you please describe how assessable and adequate geriatric care is in Orange County"]
+[-1.8901207447052002, -1.346880316734314, "Yeah, it is accessible to to operate this way is accessible to to people. But I will tell you most of the time is when they are in the in the in the manic or when they are in the lets say now, I have high blood pressures than older adults, you know I have a prescription let's I hope everything is okay. I determine if I take it. I'm talking about me who has all those insurance what have some other older adults does that have doesn't have anything they use I know I know in Orange County has no county hospital but they're still you use yeah and everything. They're using all these public hospitals to get few weeks of their medication where they are in either in their manic or in their active or where they are in the uncontrollable. Let's say you Oh, I saw someone who fell over there. I call 911 They're measuring his blood pressure. Their blood pressure is like 140 over 200 that that came to UCI. Oh, that. He goes to UCI, the doctor was run labs and everything. He has this attack. Maybe he's homeless, okay. They took care of stabilize him. Okay. Now he said they're not looking How can we let him to this to the communities certain programs where they can get medication Their goal is to, or how many people did I discharge. If the case manager didn't discharge them, they go to their wherever stand up, they do every month. We got to find a way to get them out, get them out to where we can get him out to get him out, he's gonna come back because there is no, there is no continuity in the society for them. Yeah, there is no way to get whatever you give them in the hospital, they can get it you send them home with one week or two weeks worth of their medication. Because of because they have private care doctor, maybe you link them up to a doctor while he's still in the hospital. When this member or when this guy goes home. He's that doctor is not going to follow him up any longer. Yeah, no way. Because as I'm still saying there is no continuity in the society to help this older adults is not actually, sometimes it's not. It's not all government folks. Some of the older adults have their own blame, because they don't want to, they get used to the street, you know, they don't see life worth living. They just whatever comes out of there comes out of there. They don't care what you tell them. Tell them don't don't drink, you're wasting your time that drink. That's only where the the the thing that drinking or using drugs is the only way to get out of their mental mental health or behavioral problem. So they keep drinking there. It's not happening even in even as rich as Orange Counties. Let's talk about that. Well, LA is quite different problem, you know. You see now you see how the homelessness population is exploding all over the county. He's not just happened. And because those elderly people that becomes homeless. Just tell me where somebody can get an apartment in Orange County for less than $1,000. There's no place. Some of them don't get 1000, maybe $1,200 a month for Social Security."]
+[-1.2138571739196777, -0.8475947976112366, "Yeah. Older adults, okay, you know, long term care is still using most of the long term care programs are medical benefits. You know, let's start with long term care, like going into a nursing home is not a Medicare benefits is a medical benefits. And most of all, the adults might not qualify for Medi cal. The because of they have homes. They live, they live in their houses. So if they have any reason to go to a nursing home, they better be out of pocket, or no nursing home. I mean, if they're going to stay there for a long time, but if it's like a quick visit, like scaled made, yeah, the insurance or Medicare will cover it once it turns into cost. So there are services in a nursing home like states classifies it. Level A, B and subacute. Once at once somebody's care turns into that and you don't have medical, you're not going to get it there's been no there'll be no nursing home that will admit you then if you think you're okay. You should have private Long Term Care Insurance. How many people 100 People have it's not a lot because it's a very expensive insurance. So you see this na are moving away from the people in the lower part of the society financially to them middle, middle, middle, late colleague working class or the adults that is retiring, because they have property or whatever they have, they do not. They are not qualified for Medicare. If you don't qualify for Medicare, you don't have a lot you don't have if you have any need for staying in a nursing home for long time, staying in LTC facility for long term, because you don't have Medicare, so you don't have medical, you don't have that benefit. You shouldn't have, you should have private long term care insurance, which is expensive, you know, you see these groups in between being poor and rich, that's where it's affecting them. But the people with made the people with medical, which is the people were talking all along the middle, I mean, the lower class level financially, they're qualified to qualify for Medi Cal because they do not have enough income, or they don't have any property nothing. So those people, they have access to long term care services that has been approved by Medicare, they have access to that. But um, I don't know is how they is how the health insurance works. You know, how the Medicare medical, you know, combination, you know, so, I've seen people I've seen some, some older adults, who was they were discharged from a nursing home because they do not have medical and they cannot get medical because of the financial status maybe because they go to county to apply. The county looks the county around the record, they might be seen houses or home there's okay with them the matter them okay, we give you medic car. That's what they call Sheriff costs. Yeah, if you give us 2000 a month, we give you medical maybe the person do not have 2000 A month maybe the house the county sin is where they live."]
+[3.7467896938323975, 5.306160926818848, "Michael to but we have around a six more questions. extra time"]
+[1.7350001335144043, 2.206491470336914, "to I think we use a lot. You know, I can be I can be I can be a resource for you anytime. But"]
+[4.108394622802734, 4.46658182144165, "he's not. He's a lot of problems. If I start talking I don't mean for six hours will be enough for me."]
+[3.9577088356018066, 5.572227478027344, "Yeah. Do you have a little, maybe 15 more minutes so we can. Thank you."]
+[-1.8053436279296875, -1.6380820274353027, "Pretty much the same for older adults is the same. There is no much education there to convince them that they need it. Yeah, yeah. Because you're not telling them you know that they've been living like that for many years or whatever. I tell them, Oh, you're depressed or you have an alcoholic problem or, or you have anxiety or you have memory loss, forget forgetfulness. They don't even believe what you're saying. Because they've been living like that for such a long time. Yeah, it's accessible. They need more education. They need more people out there. They need interaction with social workers, nurses, you know, yeah."]
+[-0.07037186622619629, -3.7307119369506836, "Upper East different, you know, to compare with, say, I'm comparing Orange County with other counties is different in Orange County, you know, they have access to that. Yeah. Is this you know, given maybe 49 50%."]
+[1.7842854261398315, -2.377793550491333, "Homeless homelessness will explode."]
+[3.692842483520508, 7.046665668487549, "Hello, yes, I'm here."]
+[-0.8248997926712036, -1.7682832479476929, "They go forward. Government. Oh, the goal for government should be enough to be improving access to care. You know, trying to try to make it accessible. I'm trying to I'm trying to get more often services out there education, trying to make sure that there's a continuity in services. If you have a program, that program needs to be followed up, you know, if if older adult goes to the hospital, there has to be a program that link them up. I know there is but you see the being done is not going to send somebody in the street, you don't want to live in a county that their nursing home can discharge an order to a motel for seven days, with a voucher, after seven days, it becomes homeless. Because there is no continuity, there is no you know, there's no checks and balances. Yeah, so government should do more in providing care and making sure those cares, there is continuity of care, which is apt to be honest with you, there is none. Everybody, Non non, there is some there, but most of the establishment is practicing what's called defensive, whatever they are doing, they want to defend themselves from lawsuits. So they do the minimum, the basic thing they have to do not to get involved in any legal action, you know, so the continuity is more kind of zero, you know, so got to do more."]
+[0.005993833765387535, -4.88909912109375, "Thinking about all the older adult residents in Orange County, who is getting the least amount of attention"]
+[2.1778531074523926, 8.39324951171875, "Or"]
+[3.4742772579193115, 6.907407760620117, "Yeah. However you want to take this question"]
+[-0.6178107857704163, -1.571681261062622, "the difference is not racial, there's no racial limits, I will take it by the list people getting exposed, or people that are people that are educated. What I mean, education is people that get in surveys, that the people that actually know how to follow up, people that actually understand the system, they know the system very well what to do. When most of the older adults, some of them don't have the knowledge of what is out there. Because they don't know nobody has told them. Yeah, so we got to get in, we got to engage community we live in, we got to gauge community services, you know, churches, whatever it is, those steps to educate, to provide the service the government should get involved in. So that we they're going to be a way to send the information out so that people will understand. We have this program. So if you have something that you don't know, what you don't know, is greater than what you see, if you don't know that you can get this you cannot get it because there's no education. And it's not your fault that you don't know because nobody told you. Yeah, you're not exposed that I can get. Maybe there is a social group I can go to, to to take care of my drinking problem. As a social group out there, I can go to take care of my drug or there's some social services I can have that will talk about my depression, my anxiety, you know, can recommend, Doctor Who are going to give me a medication for my depression. So that my moods I will be happy most of the time. People don't know that there is some there. When they end up in the hospital, they're going to get maybe 20, 20 pills of antidepressant, antidepressant to go home. Even if it's up to 20 they go home and they finish it. They are back to zero. There is no continuity."]
+[0.08925743401050568, -4.063214302062988, "Think about all the issues facing older adults in Orange County."]
+[-1.405538558959961, 0.0396539531648159, "Yeah, financial need. Yeah. On their behavioral health, you know, he's been overlooked."]
+[0.1646047979593277, -0.6981880068778992, "So, I want to dig a little deeper in the economic economic security that you mentioned earlier. That is that is working and not working for older adults in Orange County when it comes to economic security."]
+[0.05778536573052406, -2.043311834335327, "I think economic wise actually is not what state is now what's that alone can do another been adjustment in their social security payment and those what I think that can walk more is for the state county and non for profit and people that has money to develop more, more ways to put To help us financially, yeah, more ways to develop some programs, people, people, you know, donate some stuff, donates, whatever they can donate to make sure that the society is gaining from it in less a lot of foundations to get towards providing services, you know, employing social workers, employee nurses employing whoever they can get out there that can provide education to homeless let's get to the I mean, they can provide education to elderly adults. Let's get out there and let's get to the society let's get to the homeless, let's get to the churches. Let's go to the communities. Let's put up tents everywhere you see how do you see Do you see what we did to to make COVID vaccine available to people you know, put in tent will come here get vaccine. Let's put let's make other programs like that. Let's be more aggressive. Yeah, yeah. Not only when they have a pandemic, like you know, they want them to get vaccine that's when you go to homeless camps and set up a temp of camps for them to come give us in no let's go there and educate them let's put some social workers out there. Let's put some nurses out there to take care of their chronic problem. You put them in a dress and you slap a dress and then you let him up with a doctor who are going to follow up with it. That's what we should be doing for them."]
+[1.242637038230896, -2.8621134757995605, "He's I don't know. I say okay. If this man is diabetic, whatever you're doing in the simple dressing you're doing is not going to happen you need to control his diabetes for the wound to heal. Yeah, so the out there they're gonna there are some you know, those small small societies I think their name is mental health of Orange County or I don't know what they're that they are in some we're in Santa Ana is one of the groups you can you know, if you get towards all the adults that are homeless, that's a good that's a good agency there to talk to. Yeah."]
+[4.982879638671875, 3.4502580165863037, "So thank you. And this concludes our interview. And if you have anything more to share, please feel free to reach out to me or anybody at events will say I'm gonna stop the recording. All right."]
+[-2.6573569774627686, -3.3780722618103027, "The primary goal today is to identify what needs you think are the most important to the older adult population you serve. Those who are 60 and older. We want you to think as broadly as possible, take it into consideration of the older adults, caregiver, family and their community. I'm going to share my screen so you can see a list of common issues and concerning impacting older adults, please take a few minutes to read through this list and let me know when you are ready. And when you want me to scroll, just let me know your long list"]
+[4.293208122253418, 5.385678291320801, "okay, you can scroll down"]
+[3.2363481521606445, 5.620031356811523, "Okay, so this will be our last item. Okay. Yes."]
+[5.572998523712158, 8.790461540222168, "Okay."]
+[-0.9389122724533081, -3.3206982612609863, "Sure. My role here with the city's Community Services Department is Community Services Manager. Prior to that, I was solely the Senior Program Coordinator. And so we interact with the seniors here at the community center on a daily basis Monday through Friday."]
+[2.428274393081665, 4.8825273513793945, "Scroll down. Scroll down again. One more. I just want to make sure. Yes. No, you have you have you have it on there. I must have missed that one. So yes, everything's there."]
+[2.4293038845062256, 3.8125014305114746, "up their needs on the list, including those that you have suggested. Rank the top three that you feel are the most important."]
+[-1.0498576164245605, 1.0330917835235596, "Okay, so the top three for our city. How three would be housing, economic security, and transportation."]
+[1.0175262689590454, -1.3649011850357056, "When you think of housing, how or why older adults struggling with this issue."]
+[1.1308953762054443, -1.4567314386367798, "Um, you know, there just probably isn't enough affordable housing, as most cities have, we have a few affordable apartments that are in our city. But you know, the availability of apartments is small. So if we had to, to comment on that, it would be just the lack of affordable housing for seniors."]
+[-0.7166486382484436, 2.269256114959717, "Um, I imagine it's all about development. I will say this, though, that it is going to our city is improving. We are actually just going under a really very unique program with jamboree housing for a substantive housing project. So that will be another apartment complex available. So that is I think the biggest barrier is property and, you know, available develop developers coming in and being able to develop that land for affordable housing."]
+[-4.2023420333862305, -1.9781920909881592, "Are there different experiences for different group of older adults from different backgrounds. Oh, yeah, I"]
+[0.668555498123169, -1.432554841041565, "imagine. So I mean, we see that every city has a population of seniors that are wealthier and don't have the same struggles. But over the years, we've seen many seniors that have come to our center, indicating that they are being asked to leave their current housing complex. Next, and you know, they're worried and afraid that they're going to have to live in their car. These are seniors that are, you know, older and from 70 to 80. So, for us, yes. So you can definitely see a difference in affordability and those that have money and can afford their homes and stay in their homes, as opposed to those that that can't and what some of these apartment complexes do raise their rents. And when that occurs, if that's annually or biannually, that really has a significant impact on those that are living in those complexes."]
+[1.3948954343795776, -1.0391064882278442, "Oh, goodness, that's a very good question. I would imagine maybe a little more oversight with these apartment developments, you know, where perhaps there's a nonprofit or the government is having some oversight in how maybe a little more rent control for for their apartments, and they are all on fixed incomes. And that's why they're in those apartment complexes. So I think a little bit more oversight would be a solution and or rent control."]
+[0.10760639607906342, -0.7725567817687988, "When you think about economic security, how or why older adults struggling with this issue,"]
+[0.3058255910873413, -0.9223652482032776, "um, probably for the very same reason that, you know, when they get an increase in their social social security, oftentimes, it's not significant enough of an increase and or they get an increase, but then they get dropped, if they if they have social security and SSI. Oftentimes, if social security goes up, then they'll receive a letter that says, because that went up. They're reducing the amount that they receive in SSI. So I would say that they're just not we're not they're not able to keep up with the growth. And with recessionary times,"]
+[0.329332172870636, -0.9804438948631287, "Boy, again, I think it all goes back to if they're solely reliant on Social Security. And they they have they don't have a pension. They have no investments. It's those folks that need additional assistance."]
+[-4.214619159698486, -1.9048675298690796, "Are there different experiences for different groups of older adults from different backgrounds."]
+[-4.145981311798096, -1.912274718284607, "Well, that would be a difficult one. I mean, I would hate to I would hate to think that there are differences. But there I know they exist. So yes, I mean, you probably have many seniors who had careers, or were executives. And so their experience is different than someone who had a blue collar position and not as highly educated and didn't have a savings over time, and they don't have investments and or a pension to rely on."]
+[0.9679182171821594, -1.097765564918518, "Both back to again, you know, having perhaps more additional programs that are available to them to provide maybe a little bit more of an increase in Social Security or food food programs, you know, utility programs, utility costs continue to go up. And while our utilities do have some low income programs available to them, I think that would would help as well. And you just have to It's not any one answer. I think this is a multi prong approach that would be necessary."]
+[3.7317566871643066, 14.990480422973633, "Sure."]
+[-0.000804802926722914, -2.6497726440429688, "I think, you know, as our seniors age, they losing their ability to drive is difficult. And while Orange County does have you know, transportation programs that and even our center we we take part in the octa senior mobility program. But oftentimes that you know, there's there's not Have enough, or there might be limits to transportation, there is Octa access. But again, maybe there are not enough options for seniors. Perhaps, you know, the taxi service or something like Uber, but Uber for seniors some something that's easier for them to be able to use. I have heard, I actually just heard a report recently that Uber is going to a call system whereby I think they're modeling it, or they're targeting probably teens. But really, it could be used for seniors to where much easier for our seniors to call a phone number to schedule, transportation and a ride than it is to get into some type of an app that they're not, you know, not all of our seniors are, are tech savvy. So I think that would be helpful. So those are the issues that we're experiencing is they want the freedom to be able to go grocery shopping whenever they want, or to go to the mall and whatnot. And unless they're an access member, or they qualify for the access program, they are still somewhat limited. Even in our grant program that we have. It doesn't, it doesn't take them out of our city. Our grant keeps them within our city boundaries."]
+[0.8268048763275146, 1.4240447282791138, "Mm. I am very interested to hear about tranportation services that you have at your city. Sure,"]
+[-0.3041897416114807, -2.6526310443878174, "sure. So what we offer here we have the octa senior mobility grant. And we then contract out for AGEWELL Senior Services to provide our transportation needs. However, it is limited to just serving the boundaries in San Juan Capistrano. So our program provides free transportation from their home, they can go grocery shopping a few times a week, we, we limit the number of stores that they're able to go to. And then we also provide service here to the community centers so they can arrange for transportation to come to the center for programs, like our meal program, or legal aid, tax program exercise classes. So right now, that's what it's limited to here. If they have a doctor's appointment in another city, then they have to rely on either access or age wells, their own program, which is for non emergency medical transportation. And a lot of the times they think the seniors too, it's like you can't a lot of them require advance notice, as do we, and sometimes seniors, you know, don't have that ability. And sure, like same day service would be helpful for some as well. We've heard those comments over the years."]
+[-0.6511816382408142, 2.251474142074585, "What the area is just to see improvement in transportation,"]
+[0.09342505037784576, -2.6221048831939697, "goodness gracious, for that would probably, you know, really funding funding sources and transportation companies like who, you know, what other businesses or companies are out there competing with Octa or, you know, California Yellow Cab for instance. So, I think that is a barrier, that there may not be enough options for seniors for transportation,"]
+[-4.179962158203125, -1.9018113613128662, "are there different experiences for different group of older adults who have different backgrounds."]
+[-1.426532506942749, -2.4884653091430664, "I don't think so. I think you know, Octa and AGEWELL have done a great job with all seniors from all backgrounds, you know, and all ethnicities, so I don't really see that as much as an issue."]
+[1.425002098083496, 1.1505177021026611, "Probably, again, having meetings or interviews like what we're doing today is helpful and going back to Octa or organizations similar and discussing the needs of each community and how it how services can be expanded. is a good start."]
+[-1.1143511533737183, -2.7744550704956055, "You know, I think, I think the county does a very good job. Of and and and as do cities, local cities and senior centers, providing as many services and resources, leisure activities that engage the seniors and keep them healthy and vital. So I think, I think they're doing a great job with with in general terms, I think they're doing a great job."]
+[-1.4393274784088135, -0.6740170121192932, "Now, long term care is an interesting topic too, for the mere fact that again, it kind of goes back to a senior who may not have had a big career, and they didn't invest in long term care. So they don't have that available to them. And then, if they don't, and something occurs that requires long term care, families are being asked to step in. And oftentimes, I've heard over the years as well, that a lot of our seniors, they don't want to be reliant on their loved ones for their long term care. You know, it is a big financial burden. So honestly, that that, for me is is an issue."]
+[-1.6351823806762695, -2.070215940475464, "Not, yes, not the public, in general. So for seniors, I would imagine this has been an area where there hasn't been as much not research, but availability, or talk to the senior community, making sure that they understand that there are services available, however, I think, or I can only can speak to our city, in trying to encourage programs that will support them through things like grief support, or art for healing. That happens to be a program that we have that does touch on mental health, but in such a way that it's done through art. Programs like that programs that are really cutting edge are great, because there's such a stigma, I think still attached to mental health with seniors. Right, not wanting to think that there's something wrong with them, or being fearful to ask for assistance. You know, they some are and but many more aren't. So I think, yes, there could be a little bit more done in that area."]
+[-2.931905508041382, -0.5340176224708557, "Well, I know that they're, you know, I think some of our local hospitals. I know that let's see your St. Josephs in Mission Viejo. I learned recently that they they have a program and I don't know that it's necessarily targeted for older adults. I think it's just broad in general. But those are the only ones that the only one that I'm aware of. Most recently. I'm not aware of any others."]
+[-0.6151751279830933, -3.249570846557617, "You know, I think human i think it's accessible I think also having social services, especially in Orange County, right. So there was only one office that folks could go to or call and that was in Santa Ana. However now for the South Orange County area, there is a another office in Laguna Hills. So I think having some satellite offices spread around that are closer and easier for seniors to get to. It is great."]
+[0.7202350497245789, -1.23789644241333, "I still believe that housing is going to be a challenge In economic security, not knowing within the next few years if there if we are looking at recessionary times. I think, also long, long term care or in the home caregiving, you know, having a husband and wife where one is ill, or has Alzheimer's or dementia, and the spouse is staying in the home, and they're their primary caregiver, I think that is a problem. And I don't know that that will be getting better anytime soon."]
+[-1.3787928819656372, -2.0106241703033447, "A, you know, I think just offering more programs designed for health, I mean, seniors are living our society as a whole. You know, we're living longer lives. And I think, you know, there needs to be more work done in making sure that we can also meet those needs, and we can treat the senior as a whole, as you said earlier, just not only their physical well being their mental well being in a caregiving to, to help them go through those golden years."]
+[0.03162422403693199, -4.8203911781311035, "Thinking about all the older adults resident in Orange County, who is getting the least amount of attention."]
+[0.16937853395938873, -3.5040082931518555, "Okay, Orange County. Now, this is a tough one too, because our the economic makeup of our city, obviously, I would then tend to say, and I'm just looking at our city alone, we're different from, let's say, Westminster, who might have a diverse resident population, we are we do have a large contingency of Latin community. So for for that community. That's, that's tough. We've been working very diligently at programs and services and going into the community and informing that community what programs and services are available at our, our Senior Center. So yes, there there is definitely a difference they're"]
+[2.3025546073913574, 2.8402974605560303, "You know, I, I don't know that there really is an issue at the moment that is being overlooked. I mean, honestly, the basics are obviously what, what the most important, the most critical need is, and looks like from the list that we've been discussing. You know, we we have that completely. So it'd be hard for me to say if we're, if we're missing something, if I do think of something, and that may just happen. I definitely want to follow up with you on that."]
+[-1.709926724433899, -2.619335174560547, "I would like to dig a little deeper in your area of expertise of providing a community space on all ages, including older adults, right."]
+[-1.4098315238952637, -2.7331624031066895, "Or you're talking about our facility and what we have available to the seniors."]
+[-1.7208771705627441, -2.6309258937835693, "You can draw from that expertise. But I think just in general, in the capacity that you've providing a community space that all people could come but including, you know, the older adults too,"]
+[-1.1193877458572388, -2.631694793701172, "right. Right. Okay, so for us, I think our program has grown over the years. And since we happen to be a community center, combination, senior center space is definitely an issue for us. So it would be so nice to be able to have either a standalone Senior Center, or more space that we would allow us to broaden programs here in San Juan. Exercise happens to be one of the highlighted programs that many of the seniors enjoy, so possibly having an area of space for them to have a have gym equipment or more socializing space within our center would be beneficial. And and that's what we're we're kind of lacking at the moment."]
+[-0.6649351716041565, -2.8884963989257812, "You know, I do. I would imagine. So since I touched a little bit about our Latino population, there are several organizations within our city that that work with the Latino population, but as a whole, so everyone from youth teens and and seniors, so yes, if I had to say that you probably would want to engage organizations like Creer, or even Unidos. Those are two nonprofit organizations in San Juan, I think that would have a voice and the Latino population as it relates to senior issues."]
+[1.5068359375, 6.130275726318359, "Yes. Clear is spelled C,"]
+[4.970542907714844, 3.4296345710754395, "R. E. E. R. Okay. Thank you. Yeah, thank you so much. You're welcome. That concludes our interview. I'm gonna stop sharing and stop the recording now. All right."]
+[-2.7133963108062744, -4.816703796386719, "Good afternoon. So my name is Tohron Barnes and I'm a part of the research team at Advance OC. And we're a local nonprofit, conducting, excuse me the county. Older Adults needs assessment. Thank you for your willingness to take part in this interview. And the purpose is to identify the needs of older adults, and to gather insights from your expertise and experience. So the information you provide will be used for the development of Orange County Master Plan for aging. This interview will last approximately an hour. And with your permission, our discussion will be recorded for transcription for transcription and note taking purposes. After transcription, the recording will be deleted. If you do not feel comfortable being recorded, turn off your camera and quote and change your name attached to your picture. Your responses are confidential, meaning that we will remove identifying information in the report. Please note that your participation is also voluntary. And you may also choose to answer any question in part full or not at all. You may also withdraw from the interview at any time. If you're unfamiliar with any terms I use, please let me know and I'll provide an explanation or examples."]
+[2.2350690364837646, 6.327885627746582, "Yes, you do."]
+[-2.6666669845581055, -3.1103124618530273, "Thank you. Nope. Okay. So again, the primary goal of today's assignment to identify the needs of older adults and to for you to let us know what is most important to older adults. And those that again, those are folks 60 and older. And we want you to think as broadly as possible, taking into consideration the older adult, their caregivers, families and the community. So I'm going to share my screen so you can see a list of common issues impacting older adults."]
+[3.6706979274749756, 15.292847633361816, "Yep."]
+[3.831554889678955, 4.772955417633057, "The whole list, okay. So let me know when you're ready to move forward."]
+[3.8758368492126465, 5.123312950134277, "Let me just go through these really quick."]
+[2.496840238571167, 3.9622321128845215, "No, not at all. We just put them in alphabetical order, not any order of, you know, rank or anything like that."]
+[3.5929834842681885, 7.138168811798096, "Sure. Okay."]
+[-1.0229321718215942, -3.3947174549102783, "Sure. So my name is TJ McGovern. I'm a deputy chief of emergency op your operations Bureau for Orange County Fire Authority. And right now, as far as emergency responses, I typically don't respond to older adults right now in the emergency scene. But I did spend many, many years coming up to the firefighter ranks being a paramedic and ng captain. And going on a lot of these calls throughout my career. The engagement I have now is basically when we see him at community events or council meetings are kind of out in public. And they obviously come up and we have conversations about that, but not really an emergency scene anymore. But I do oversee, and I am responsible for all the crews that do go out on those."]
+[5.471117973327637, 6.400951862335205, "Okay, thank you."]
+[-1.5470499992370605, -1.2488629817962646, ", no, you kind of hit it, because one of the biggest things that I've seen through my career is when when some of these older adults don't have family to look after them, and we, and either their spouse or themselves or medical alert company calls us and we go out there, and we get a sense that they struggled or take care of themselves, we can see that with the home status that their their home is in cluttered. No food in the house, kind of just dishoveled if you will, and you know just not able to take care of themselves. And most of the time when we go in these situations, it's a godsend that we do because we're the ones that will reach out and start getting some help for them. Our first question we normally ask is, you know, do you have any family we can call and and when we see houses and some of the status we see um, if the answer is usually no. So I would say out of all these big ones is where they need help is kind of just their well being in their day to day operations of living,"]
+[-2.3565595149993896, 0.39585232734680176, "like personal care management."]
+[0.7640500664710999, -1.9107770919799805, "Absolutely, yeah, that's that really, you know, I don't want to say, a hoarding conditions, but their opportunity to take care of themselves has been significantly diminished by what we experienced and visualize in their dwelling, whether it's a residential house they've owned for many, many years, or an apartment that they live in."]
+[0.08125150948762894, -4.210115432739258, "Okay. So these needs listed. Now, I'd like you to rank the top three that you feel that are most important for older adults in Orange County."]
+[2.261871099472046, 4.129608154296875, "would 3 do you see as the most important"]
+[-0.36875244975090027, 1.2619584798812866, "economic security would definitely be one that kind of ties into that"]
+[-2.351865291595459, 0.3838469684123993, "you did connote personal care management that's on the list here for highest"]
+[-1.8354952335357666, -0.6357282996177673, "I would say, Yeah, I'm just kind of going down. Absolutely. Personal Care Management is definitely probably the top of when we respond and we reach out to where we need some additional assistance. I'm at so yeah, personal care management. You know, economic security and medical, now, if we're talking just medical conditions, and they're, they're well off their family, are you looking for kind of medical conditions to because of medical conditions, we'll go on cardiac events, shortness of breath, that sort of stuff. But we go on those quite frequently, I would say the biggest ones, but they don't need help. But obviously, they need advanced life support carries cardiac and breathing problems, as far as that goes."]
+[3.4837279319763184, 4.124797821044922, "Okay, so I'll add that to your list. Because I don't see that here."]
+[-2.2779805660247803, 0.46049004793167114, "Yeah, cuz we typically get a lot of our calls for cardiac related and difficulty breathing, which includes, I thought I did see like asthma like respiratory conditions is in there. He literally Add Card cardiac events. And, you know, a lot of mechanical falls, whether it's being they got dizzy and fell, or they tripped over something because of their mobility. piece of carpet or something, their their mobility is hampered later on in life."]
+[2.5739150047302246, 3.9959516525268555, "Okay. So now, when you think about the top three, that you Whoa, I don't have your third one from this list. I'm sorry, I need one more from this list."]
+[-2.258483648300171, 0.5085878968238831, "So let's go economic security. Yep. Personal Care Management. And then use the other one, I would say by cardiac and respiratory conditions. Kind of ongoing, or to summarize those out use ongoing medical conditions."]
+[3.4770703315734863, 4.130011558532715, "Okay. And so would that's the one that I added to where it's not on the list. Because related to that,"]
+[2.1077191829681396, 4.661243915557861, "I would say that's probably the third one. Okay."]
+[-1.1519132852554321, 1.0811527967453003, "All right. Well, so you do I'm looking at the list, you do have heart disease and stroke. So that is on there. That's a cardiac event. So you can scratch cardiac because I do see heart disease and stroke. That's a very, very common 911 Call we go to, you also have respiratory conditions or another very common emergency response that we go to also, so actually a four up there, so. Okay. And, you know, the economics of security. It's, you know, we have, we're not one city so we have a lot of different diversity in a lot of our cities that we do, you know, we have 23 cities and two unincorporated area. So we're, we're kind of all over the spectrum,"]
+[-2.21512770652771, 0.4180721640586853, "Yep. So now when you think about all the lists economic security Personal Care Management, you know, your heart disease and cardiovascular, you know, your respiratory conditions and you said shortness of breath, and then also the mechanical falls."]
+[-2.434880256652832, -0.22686029970645905, "You develop heart disease, your lungs don't work as well as they used to. So it's kind of just a deterioration of your whole health. It's just part of life. growing older, the mechanical Falls is, you know, that could be part of dementia, coming into play, and those sorts of things."]
+[-0.8564292192459106, 2.1374897956848145, "Now, what barriers exist to improving in any of these areas, this is the medical area of the mind intentional injuries."]
+[-1.8926875591278076, -0.9070049524307251, "Yeah, so the medical areas that's, you know, proper health care, having a proper designated physician, routine checkups by their health care providers, making sure they have enough and the proper medication at their houses, is something else we do see is they might get a medical or a prescription, and whether maybe they don't have the means to get to the store to get those prescription prescriptions filled. Or they don't have the means to pay for them to get them filled, when they might have to choose between food or medication, those sorts of things. And then also, family. When we get older in life, you have to have family support your kids, as you're getting older, you need that support to help you get through those sorts of things."]
+[0.4530602693557739, -1.7732646465301514, "Yeah, absolutely. In more, in a more fluent, I guess, are fiscally stability cities that we do serve, you know, you're probably going to see some more health care, they get to their doctor's appointments more, they were able to be under a physician's care, they don't have to worry about the finance piece for prescriptions getting those filled. And then some of the other lower lower fiscal areas. You might not see that not all of them, but you probably have more tendency to see that and, and some of the areas I've worked throughout my 29 years in the fire service, you can kind of tell when you arrive to their house or something that isn't maintained. And that's kind of something we can notice pretty quick on that."]
+[-2.4003748893737793, 0.024683823809027672, "Now, what do you suggest, so I'm gonna go one by one, what do you suggests is the best way to address issues surrounding the medical"]
+[-1.914480209350586, -1.148606777191162, "you know, okay, I spoke to those, it's just under, under doctor's care, routine appointments, routine checkups, making sure that they have their prescriptions on hand, and making sure that active staying active is accused of very acute thing that, you know, we definitely need to get them out walking social events really helps them get out of their residence, and interacting with the public or their friends or public services that they have, you know, getting active and you know, exercise, those are definitely going to help all the medical conditions that are associated with getting older in life."]
+[-2.1837704181671143, 0.0017819828353822231, "Now, what would you suggest is the best way to address the issues surrounding improvements with personal care."]
+[-1.280500054359436, -1.4705959558486938, "So that's where we need help. We need help there. They need help from county services. Reaching out making sure they have an avenue and they're aware of the avenue that they can call or reach out to to get those services and assistance. It should be very easy. They all know everyone knows if you have a accident medical emergency, there's a 911 number that you can call and we will come we We definitely need to get to the point where maybe it's like a two on one call, that they can call and just ask for help, because they are unable to sustain or they're in assistance, that maybe not isn't a medical, a life threatening situation, but they just need that day to day assistance, giving them direction of where they can go to find those essential needs to sustain, you know, their life."]
+[-0.4084380567073822, 1.284995198249817, "What do you suggest is the best way to address issues surrounding economic security,"]
+[-1.7829622030258179, -2.1264400482177734, "kind of the same thing, having an avenue in a venue for these older adult communities, to have somewhere where they can reach out to, you know, the technology gets more difficult for them, it's moving so quick. So having something easy to go to, and kind of a one stop shop, of who they can call who they can reach out to, to assist them in directions to find these essential services. As we're all going to need when we get older, that's not readily available to us today. How do we get there. But as you grow older, technology moves so quick, it's hard for even myself, keeping up with the technology. So it has to be easy to find those essential functions that they could use."]
+[-2.4601449966430664, -1.1306501626968384, "You know that that really goes back to help from the county health. That is back to doctor's care. Having support these people are going to need support. Because when you get in that Alzheimer's and dementia, you don't know where to go, you're scared, you're probably by your self, if you're not at a assisted nursing facility or assisted living facility. It's all about those essential services that they need help for. Once you have Alzheimer's and dementia, you need that support mechanism. And that's where we got to get for these people. That is very, very large right now, when they get in that Alzheimer's dementia phase is they need assistance because they are no longer to sustain by themselves. And without family or friends or children. They need someone where they can go to to assist."]
+[-1.0624490976333618, -4.046085357666016, "Okay, now could you please describe how accessible and adequate the following care services are in Orange County and I for services, one geriatric care to long term care, three mental health, behavioral health and substance use treatment and for human and social services. So with one geriatric care how accessible and adequate is that service in in Orange County."]
+[-1.454172134399414, -1.5969581604003906, "So on all those services, um, you know, through all our big health care providers here, I know that we do have those services available. But in order to get those services, you have to be proactive to reach out to get those services and to keep going to those services. But if there's older community is unaware of how to reach out to those services, that hence the problem, they cannot access those us as 911 providers, we have routinely back when I was in the field as a paramedic, firefighter, and even a fire captain, we knew that we can contact Social Services with name info, and that's where we would reach out to them to provide because when some of these older adults when, you know, they don't have Alzheimer's or dementia, and we recommend it, we're not sure that they're going to follow up because it's hard when when you need to reach out to these services, mental health, that sort of stuff. It's a tough conversation. Because you know, you're kind of addressing that, you know, you have a need, and it's hard to come in there and admit to that, at times, not everyone can just say that I have a mental health problem I need, I need help. So what really helps is having clinicians kind of aware and kind of reaching out to them as well."]
+[-0.9782599210739136, -3.7518422603607178, "Now the you know, of any services or programs in Orange County that you know, specifically some provide support for older adults on any of these services."]
+[-1.2142945528030396, -3.9118945598602295, "Offhand, no I could I could, I'm able to research through the internet I could. But what we typically would do, we'd reach out to Orange County Public not public health I just said, social services agency social services. Yeah, we would reach out to them make contact, advise them of the situation we found, and then kind of let them take over. But I don't know like what hospitals have what but I would be able to research it online and, and I think in this county, we do have all those services available, but it's about getting that message out and making it readily available for them. And that can be done, you know, through there, they're able to go get routine checkups. Maybe there's something that all the doctor's offices, the hospitals that clinics they go to, for the elderly community with brochures or something just so they can, you know, you give them one or they're able to take one and bring it home and maybe read it at a later later time. But at least it's it's it's another resource that's available to them."]
+[-2.366271734237671, -1.2178245782852173, "You know, that was hard for me to understand, because I've never had to use those. I would assume not knowing in depth, it would be like a doctor's appointment, I know, I go see a cardiologist, I'm gonna go I'm gonna tell him my signs and symptoms, what I'm experiencing, and that cardiologists would say, run some tests on me, give me some medications, have a follow up appointment, get some routine schedule is going, but I don't know, the depth of what those services provide the you know, mental health, I know, we do have a couple of facilities where, you know, private and public where they can go get those help. So they can be admitted, depending on the nature of that. But as far as in depth, I'm not sure I know. My dad had Alzheimer's dementia as I went through that. So it's just kind of a waiting game. Those are tough, there's no answer for those. So it's kind of a, it's a long drawn out very painful situation for for not only my dad that I went through, for the family, too. So that brings me to the next point. When these older adults are going through these, I think the family, you know, it's part of the family, their caretakers need some assistance to what to expect and kind of closing the loop with the family members that are going through this too."]
+[-1.676224708557129, -0.5714462995529175, "Well, you always gotta put fiscal responsibility or fiscal elements into this, because you know, with inflation, everything's getting more expensive. Healthcare is getting more expensive, prescriptions are getting more expensive. And typically, most of them are on a fixed income income. So, you know, the health care system, hopefully, it just doesn't run past them with the inflation of health care with prescriptions and costs going in there. That's one of the biggest things that I see, I think medical treatment, they're learning every day with all the research that they do. So you know, we're making huge strides in cancer prevention awareness treatments, so we're definitely moving forward with that. As far as that goes."]
+[5.591413497924805, 8.813599586486816, "Okay."]
+[-2.2944610118865967, -2.6301980018615723, "I think that has to be a priority, because it's not, you know, we're gonna get to a point where we don't have any more older adults. This is an ongoing continuous concern that we all need to have. And we need to be proactive, and have services and plans for these older adults for perpetuity. It's not going away. Everyone's getting older, day by day, minute by minute. So we definitely need to be proactive and look for new innovative ways to make sure that the older community is is a priority for us moving forward."]
+[0.08470458537340164, -4.975710868835449, "Now thinking about all the older adult residents in Orange County, who was getting the least amount of attention"]
+[1.7137266397476196, 8.069643020629883, "as far as what"]
+[1.4208265542984009, 3.6124284267425537, "just them getting their needs met."]
+[-1.070539116859436, -1.0517363548278809, "I would say people who are unable or unwilling to reach out and ask for help. I don't know but I would say probably the people with lower income They probably, you know, they have priorities or priorities put food on their table and shelter over them first. There, some of these individuals are just in survival mode. And there might be a mindset where if I'm reaching out, and it's gonna cost me 20 3040 $50 To go to the clinic, I'm gonna stay here, save that money and hopefully wait it out, in some situations, waiting it out, cost them their lives or deteriorate their lifestyle. Moving forward also."]
+[-1.9789679050445557, 1.3063839673995972, "offhand maybe a substance abuse, mental health, those would probably be and the third ones are so maybe substance abuse, you know, alcoholism, I'm sure they're not doing recreational drugs. Maybe they've been alcoholic for their entire life, and it's definitely waning on them. What asked me that question one more time,"]
+[1.5626869201660156, 6.057282447814941, "I would say that is probably the big one."]
+[3.0061612129211426, 5.141718864440918, "Right. After all the questions and you know, thinking about what I'm asking you only thing"]
+[-1.5218582153320312, -1.2908941507339478, "now that the ones you know, I've been doing this a long time. And the ones that really are bothersome, if you will, is going to a residence going to an whether it's a house or apartment, and they're not able to care for themselves. Typically, it's no family is there and they're just they're surviving trying to survive day by day. And having services to come in and help them. That's that's probably the toughest one to go through. You know, they spent their whole life getting through and now they're just struggling because maybe they have some early signs of dementia going on, and they don't know what to do. They're afraid they're alone. So I think the bolstering of services for these individuals would be a key."]
+[4.645941734313965, 3.1962618827819824, "Well, this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research. And if you find that you have anything else to share, please feel free to contact me. You can also contact with us through our website events, or c.com. Or you can also call our anom our anonymous voicemail at 949-415-6898 at any time. Okay. Well, thanks again, she. And yeah, I'll be in touch or, you know, information about the about the next further stages of the project. And also, I'll just keep doing a loop of like where we're at. Perfect. I"]
+[10.658443450927734, 8.433863639831543, "appreciate that."]
+[-1.4254412651062012, -2.844785451889038, "I'm sure we're going to be collaborating on the events to outreach to the seniors themselves, because we need to know from them, you know what their needs are. All right, that means a lot. Alright, thanks again. Take care"]
+[2.024915933609009, 7.002285003662109, "is"]
+[-2.6385390758514404, -2.775996446609497, "Those who are 60 and older. We want this thing as broadly as possible taken into the consideration of the older adults caregiver, family and their community. I'm going to share my screen so you can see a list of common issue concern impacting older adults."]
+[3.917578935623169, 5.099793434143066, "Please take a few minutes to read through this lesson. Let me know when you are ready to begin."]
+[4.018739700317383, 5.955798149108887, "Okay, I'm ready."]
+[-0.8759587407112122, -3.436617851257324, "Yes, my name is Griselda. And I work for Orange County Parks. And I am a park division manager. And I oversee 1/3 of the open space"]
+[0.4624755084514618, 1.7389142513275146, "which includes an outdoor space including"]
+[0.5623303055763245, 1.6092981100082397, "regional parks"]
+[4.007906436920166, 6.545190334320068, "Really go yes."]
+[2.1047682762145996, 5.962271690368652, "Do you have anything with"]
+[-1.820969581604004, -2.4593846797943115, "like programming to keep, like older adults engaged, for example, opportunities for interpretive programs where adults can go on"]
+[0.5599750876426697, 1.5601096153259277, "can learn about local history through our OC Park has several historical sites have we actually provide tours of our historical sites, and we actually provide"]
+[0.6144546270370483, 1.406684398651123, "information about our local history. I don't see anything that"]
+[2.9252099990844727, 3.9749882221221924, "I don't see any of these categories where where"]
+[-1.9602726697921753, 1.170225977897644, "maybe it will fall under mental health or mental well being."]
+[-0.441001296043396, 1.334822177886963, "I don't know what it would fall into, but more like education or like long,"]
+[1.9663584232330322, 7.923803329467773, "more like"]
+[2.444509506225586, 3.74434232711792, "long life education, anything that has to do with like, older adults either taking courses in classes, that kind of things. I don't see that in this list. And we can dive a little deeper into that later on. Thank you for sharing that. So of the list that you saw, including the one that you suggest that can you bring the top three that you feel are the most important or the most important in my role as working with parks. Yes, of course. I would say the top one would be diet, fitness and nutrition."]
+[0.3107781708240509, 1.6545543670654297, "It would be a safe place to exercise"]
+[1.6662840843200684, 4.94170618057251, "number one"]
+[5.57151985168457, 8.81201171875, "Okay."]
+[0.0270331222563982, 1.4636369943618774, "Also behavioral and mental health by using by older adults using outdoor space or or visiting parks, or as park users, that would probably be a good thing for mental health that would be two."]
+[1.4688047170639038, 8.844952583312988, "And"]
+[-1.439217209815979, 1.5411170721054077, "And also emotional well being would be one as well. I think those three would be my top three. Thank you."]
+[-1.2818078994750977, 0.7637357115745544, "So when you think of diet, fitness and nutrition,"]
+[3.2676069736480713, 6.262940406799316, "Okay, repeat the question."]
+[0.25736162066459656, 1.543188214302063, "Of safe places to exercise, being able to, to find a place close by where they live, where they can either go for a walk or exercise"]
+[0.26709821820259094, -2.315786361694336, "That may be a challenge for some people, the older they get, they may not have transportation, or have anything close to their homes."]
+[0.4729708433151245, 1.6683218479156494, "Yes, like I said, perhaps you live in an area where they don't have the open space and outdoor space available to them so they cannot enjoy the outdoors."]
+[-4.108560562133789, -1.936571717262268, "Are there different experiences for different groups of older adults from different backgrounds. When it comes to this issue."]
+[1.65806245803833, 6.618905544281006, "I would think so because depending on on"]
+[0.28806573152542114, 1.5960443019866943, "where people live, there's some areas in the county where there's a many outdoor spaces to exercise. And there's other other places in that in the county where a park may not be or a park or an outdoor space may not be close to their homes. And some people may not have vehicles to to either either get to a local park or maybe even walk to a park. Those probably will be the the things preventing people from accessing a place a safe place to exercise."]
+[1.2294352054595947, 7.72217321395874, "Well,"]
+[2.304795503616333, 4.789341926574707, "one, I would probably let people know that these outdoor spaces are available"]
+[1.4672068357467651, 8.848690032958984, "and"]
+[0.5373254418373108, 1.5820765495300293, "provide them with information and locations of the parks and perhaps provide them with information about"]
+[0.5342180132865906, 1.1793915033340454, "transportation, public transportation, they may be able to get a home and vehicle"]
+[0.48177915811538696, 1.54932701587677, "transportation so they can get to these outdoor spaces."]
+[7.144746780395508, 4.64775276184082, "Okay, thank you for sharing. So moving on to the second"]
+[-2.719052314758301, -1.6235451698303223, "issue or things that you feel that are important that is the behavioral health. When you think of behavioral health how or why older adults are struggling with this issue. Can you go up, I want to kind of see the definition again. Yes."]
+[0.0002334245655220002, 1.465147852897644, "I guess research has shown that, that having exercise and being outdoors can really help with mental health. We saw it during COVID Where were where people"]
+[0.0043552168644964695, 1.3923406600952148, "were stressed with you know, not being able to like see their boundaries or their or go to work. We saw an increase in in attendance and our parks and we've been told that it helps with anxiety and depression. So it's a good way to once people are outside it really helps with mental health, overall mental health."]
+[0.05733262747526169, 1.9803366661071777, "With barriers I think again is being able to one realize, identify the local outdoor spaces are available public spaces"]
+[0.4955866038799286, 1.5836960077285767, "I don't, I don't really know how to address that. All I can say is the the outdoor spaces that OC parks provide us we, most of our spaces are ad accessible. And a lot of our signage is in different languages. So we try to in parks we try to provide with"]
+[0.4932393729686737, 1.6786253452301025, "all our park users with like, we try to provide them with the same experience when it comes to our outdoor spaces."]
+[-2.070453405380249, 1.0746521949768066, "What do you think, what do you suggest is the best way to address this behavioral health needs."]
+[0.12371304631233215, 1.4269280433654785, "Like I said, I'm letting people know that these outdoor spaces are available, and where they can exercise they can go for walks. A lot of our our products provide programming, where you can take a class, you can go on a hike with a park ranger, you just there's a lot of programming opportunities that OC parks provides. I think letting the older community or making them aware that these this that we have these programs is probably probably helped people with anxiety and depression and memory loss issues."]
+[3.000901699066162, 6.17915678024292, "Thank you. So when we think when you think of the last"]
+[-1.391384243965149, 1.5512845516204834, "need that you identify is the emotional well being"]
+[-2.7126474380493164, -1.737383246421814, "how or why are older adults struggling with this issue."]
+[0.5009533762931824, 2.414243221282959, "Limits inclusion quite a bit of mindset we can use."]
+[1.660008430480957, 6.322678565979004, "I think I guess it all goes back to"]
+[0.696619987487793, 1.911843180656433, "having a place where perhaps you can you can"]
+[0.24884112179279327, 1.4598509073257446, "take a walk with a friend, you can maybe have a picnic with, with family."]
+[1.7942687273025513, 4.449034214019775, "I think getting people out there"]
+[0.04622279852628708, 1.371135950088501, "perhaps bringing your family or your church to together at a at one of the campgrounds for example, or going on a hike or or like I said just walk. And I think that's that will probably contribute to emotional well being providing spaces where people can meet and bond and and spend time together."]
+[-0.7782832384109497, 2.257120370864868, "What barriers exist to see improvement in this area."]
+[3.143178939819336, 6.2808661460876465, "Like I said, it goes back to"]
+[0.4553299844264984, 1.7320994138717651, "letting people know that we actually have these outdoor spaces we have"]
+[0.41979944705963135, 1.621720790863037, "we have picnic areas,"]
+[0.6837711930274963, 1.6796668767929077, "programming that is open to all all park users searching just letting them know that we actually have these resources for them."]
+[-4.141813278198242, -1.9497445821762085, "Are there any different experiences for different group of older adults from different backgrounds."]
+[0.47817716002464294, 1.5721509456634521, "Not that I could think of I think I said that it kind of goes back to like where they live and how many parks are are close by. And if if probably the"]
+[-0.5194958448410034, 2.4978272914886475, "the biggest barrier would be accessibility like how far these parks are or outdoor spaces are is getting getting them either transportation to these to these these open spaces."]
+[0.4065435528755188, 1.8359320163726807, "As far as are getting people out to the outdoor space."]
+[1.2482950687408447, 6.555660247802734, "Probably"]
+[0.3899502456188202, -2.6739342212677, "improving like public transportation, working with maybe with local public transportation organizations like maybe OCTA maybe"]
+[0.35374119877815247, -2.654707193374634, "working together with OCTA to provide better routes to the parks and open space. That would probably be"]
+[-0.23514671623706818, -2.5109612941741943, "one way to get more people out or perhaps if there's a nonprofit that can provide shuttle service or"]
+[-3.1284406185150146, -2.2354657649993896, "especially with, with older,"]
+[0.19074846804141998, -2.41882586479187, "older park users that may not be driving anymore, or that they may be limited. They have limited mobility and maybe having heavy shuttles. Or I think I think there's there's ways of getting getting transportation"]
+[-1.698241114616394, -2.658205986022949, "opportunities for our older communities. Yeah. Thank you for sharing."]
+[2.043198823928833, 5.893243789672852, "I don't work with that particular"]
+[1.421483039855957, 5.241469383239746, "group."]
+[2.787116289138794, 5.805290699005127, "And so I don't think I can speak on that. I don't think I can answer that."]
+[2.425128221511841, 6.8222246170043945, "I'm not, I'm not in the in the health"]
+[-1.663904070854187, 0.6140955090522766, "public health"]
+[2.737410068511963, 5.835343360900879, "arena. So I don't I wouldn't be able to answer that. That's not. That's not what I don't know anything about that. I'm sorry. Yeah, no worries. Yes, I understand. Yeah."]
+[2.6908533573150635, 5.9071879386901855, "Yeah, I don't have an answer for that."]
+[3.2602453231811523, 5.93436861038208, "Okay, so last would be if you know,"]
+[-0.6874425411224365, -3.9860730171203613, "any human shelter services services are accessible and adequate in Orange County."]
+[2.6934053897857666, 5.844961166381836, "I wouldn't be able to answer them. Unfortunately. I don't. are not familiar. Yeah."]
+[-1.063284158706665, 0.35626769065856934, "I would probably have to say the cost of health care."]
+[0.550878643989563, 3.5810508728027344, "But I'd think that would be probably the most challenging."]
+[7.083308696746826, 4.687207221984863, "Yeah, yeah. Thank you for sharing."]
+[-0.011028993874788284, -3.4862444400787354, "I think the county should be able to provide"]
+[0.4578428268432617, 1.7353546619415283, "outdoor space where"]
+[-3.38529896736145, -2.0331406593322754, "both older or older adults can get access."]
+[-1.7348994016647339, -2.6020078659057617, "I think letting letting the older community now that these resources are available, probably key would be really important."]
+[-0.003477035090327263, -4.858410358428955, "Thinking of all the older adult residents in Orange County, who is getting the least amount of attention"]
+[1.6141449213027954, 5.453855037689209, "Oh, I don't I I don't work with that. Or that group of"]
+[2.668362617492676, 5.937097072601318, "I don't know. I don't know that answer. Yeah."]
+[2.3701889514923096, 6.215675354003906, "I don't know."]
+[3.7120885848999023, 15.454635620117188, "Yeah."]
+[2.2962896823883057, 5.446468353271484, "Ah, I don't know of any. No, I don't. Yeah."]
+[4.72656774520874, 3.240521192550659, "So this concludes our interview. Thank you so much for your time. Incredibly helpful. Whatever research, you find out what to share the self okay to reach out to Okay. I will think you have a good one. Thank you."]
+[3.289362907409668, 5.467402458190918, "We start them."]
+[-2.605729818344116, -3.2316410541534424, "Okay, great. So the primary goal today is to really identify what needs you think are most important to the older adult populations that you serve. And for our conversation, the definition of an older adult, or those who are 60 years and older, says following California's definition for an older adult, but we want you to think as broadly as possible, taking into consideration the older adult, their families, their caregivers, and the community that serve them, but also the community that"]
+[-2.4836673736572266, -3.5110504627227783, "they engage with, right. So, right now I'm going to show you my screen and it has a list of common issues and concerns impacting older adults. Just take your time and read it through. You don't have to memorize it'll stay up for the duration of our interview. And I just want you to just kind of read through it and take it all in, and then I'll ask you some questions about it."]
+[5.561447620391846, 8.852543830871582, "Okay."]
+[5.578627586364746, 8.800714492797852, "Okay."]
+[2.955997943878174, 4.847784996032715, "Oh, yeah. You don't have to remember any of them."]
+[3.8047382831573486, 4.934663772583008, "I just want you to read them through once. So yes, there. Yeah. So you can reference it Because it's gonna stay on the screen. Oh, wonderful. Wonderful. Okay, that's helpful."]
+[-1.2185323238372803, -3.116745948791504, "Okay, all right. Sure, my role at WisePlace is the CEO. And the way that my organization and myself interact with older adults is that we provide shelter and basic needs and wraparound services"]
+[1.6422407627105713, -2.518669605255127, "with the ultimate goal of ending homelessness and helping older adults, secure housing, and then retaining housing."]
+[1.2795391082763672, 1.1358238458633423, "So actually, I've been I've been leading the organization for five years and believe it or not the first three and a half years, I was almost doing direct service just out of necessity."]
+[3.754655599594116, 4.363212585449219, "And so I'm a bit removed now, but obviously, I know the participants"]
+[-0.05223194882273674, -3.9554362297058105, "and very still very involved in the services. Great, thank you. So thinking about Orange County and looking at the list here that's right in front of you. First of all, I'd like to ask is there anything missing from this list"]
+[3.1895904541015625, 4.326501846313477, "it seemed very comprehensive. Okay, so nothing comes to mind now."]
+[4.820096492767334, 7.844860553741455, "Okay, and you can always add ad it later"]
+[-2.698910713195801, -2.809100389480591, "if it comes up in conversation. So given all of these issues that you see here, I would love it if you could rank for me just based on your perspective and opinion rank for me the top three issues for older adults in your opinion, okay."]
+[2.3994569778442383, 4.027216911315918, "Gosh, these are all very meaningful and important"]
+[1.5578174591064453, -0.6851054430007935, "you know, just from just from our perspective, using our lens, I would say housing"]
+[1.7555248737335205, -2.716486692428589, "being the number one and I say that because obviously when I meet the older adults, these women are all experiencing homelessness."]
+[1.433579921722412, -0.6282705068588257, "So I would say housing"]
+[1.7297929525375366, 4.903375148773193, "as number one."]
+[-1.2942559719085693, 0.6057582497596741, "And then I would probably pull out health care"]
+[1.7023515701293945, 4.907043933868408, "as number two"]
+[-0.4454330801963806, 1.1302398443222046, "I would probably as number three economic"]
+[2.2325024604797363, 4.442971706390381, "I think those are the three. Kind of very, very"]
+[3.1188161373138428, 4.474045276641846, "kind of critical that we're seeing at WisePlace. Okay, great. Great. So I'm going to ask you the following questions on those three things, we're going to take them one at a time."]
+[1.1225985288619995, -0.7657625079154968, "You know, limited income, their market rents, not enough assisted living, not enough affordable housing."]
+[0.3463466763496399, -1.1477960348129272, "You know, I see it every day, I see women who have sometimes work their whole lives and have a pension, and it's just not enough."]
+[1.1942387819290161, -1.2171069383621216, "And it's not the right housing, right, going into fair market housing, you need support, you need assistance, you need services. And so housing alone is not enough, isn't even the answer, I would say for older adults or most vulnerable populations, frankly."]
+[1.242132544517517, -1.1768897771835327, "So it's just you know, it's a it's a fordable. issue. It's a lack of housing period. I think that's where it starts from, right, because I think there's not enough housing, and then you stack on the affordability of it. And then it's not the right housing period."]
+[3.6835203170776367, 15.568778991699219, "Yeah."]
+[1.2802350521087646, -0.9713982343673706, "I mean, having been through our first affordable housing"]
+[0.29422688484191895, 3.0258829593658447, "than my first five years, bureaucracy"]
+[0.4381389617919922, -1.9295967817306519, "I mean, I hate to say it, but it just does seem like a lot of red tape. It also seems like and I think it's tied to bureaucracy that, and I don't think this is specific to California, I think this is federally, but I mean, building"]
+[1.0022515058517456, -0.5781725645065308, "support service type housing, affordable housing, it's, you know, you're paying like $750,000 per unit."]
+[0.8555750846862793, 0.25911352038383484, "And so it's just, it seems to be just buried in red tape. And that red tape comes with a lot of fees."]
+[0.9243946671485901, -1.2844899892807007, "Just astronomical prices. The bills, affordable housing are something that older adults so desperately need."]
+[3.4165842533111572, 9.076601028442383, "Yeah, yeah."]
+[1.3506865501403809, -1.130162239074707, "Definitely. And I think that's why, you know, regardless of what type of affordable housing, it should always have services."]
+[-0.8826200366020203, 0.4212424159049988, "I think that would best meet everybody's needs, from health care, to accessibility to socialization that breaks up isolation."]
+[-0.3371695876121521, 0.42658746242523193, "You know, a social worker, case manager health care, I think it's important to have services at everyone's disposal."]
+[-0.5035767555236816, -0.19688962399959564, "Cultural services."]
+[1.2865352630615234, -1.1764582395553589, "I think housing alone without services is not the same. And I think, you know, housing should tailor its services for various populations, just like a restaurant, you know, you wouldn't feed your clients, one thing, you would have an array of services that meet their needs, and includes that. Yeah. Yeah."]
+[2.6439170837402344, 7.939074993133545, "Gosh, I mean,"]
+[0.3148473799228668, -1.7633147239685059, "it's hard because I've never been in a sector that is swimming in money. It seems like homeless and housing is, you know, you constantly see, and maybe because we're in California, and it's maybe, you know, you see every article saying, you know, and it's with, sometimes with billions of dollars, not even millions of dollars, so, so that's why I tend to think like, gosh, this is still really expensive. And then the bureaucracy all of the holdups and it seems to be that that money is is just going back to bureaucracy."]
+[7.027279853820801, 6.205667495727539, "So that's a shame. So I don't know how you counteract that. I guess you would lobby."]
+[2.2897450923919678, 7.2584710121154785, "You know, you would you would,"]
+[2.1817197799682617, 7.14727258682251, "you would lobby,"]
+[0.8995120525360107, -1.9222090244293213, "we would get cities and counties the funding that they need so that they could release it. And you I think from a state level, federal level, you have to support cities and counties being able to do this faster."]
+[3.443276882171631, 9.09335708618164, "Yeah, yeah."]
+[3.3404200077056885, 5.473587512969971, "Okay, so now we're gonna switch"]
+[-1.5468015670776367, 0.5949586629867554, "gears and go to your number two, which is healthcare access and delivery."]
+[-2.6429343223571777, -1.890848994255066, "So you see it right in front of you all the sub categories there, and all the examples, how and why are older adults struggling with this issue."]
+[-1.3122462034225464, -1.266059398651123, "I mean, healthcare is just so complicated. And I know myself, you know, I'm, I'm an immigrant from the Middle East, but the rest of my family are refugees from the Middle East. And I know growing up, we didn't have access to services, or if I think of my grandparents, or if I even think of my mom, and my aunts now that are in the older adults category, you know, they need a lot of assistance, they have language barriers, and they need a lot of assistance."]
+[-0.09454450756311417, -1.7013353109359741, "Just navigating healthcare and at WisePlace. I mean, we see so many women who should be, you know, connected to Cal Optima, but they are not."]
+[-1.6912574768066406, 0.20165087282657623, "And we get them connected to health care, which is really,"]
+[-2.8912746906280518, -0.5812048316001892, "you know, really tragic that somebody 60, 70, sometimes 80 is literally lacking health care."]
+[-3.078744888305664, 0.02719452977180481, "And then I do think the, like, this looks like the last few things you have on here, kind of like specialized care for lack of a better word, you know, nursing home availability, geriatric care for"]
+[0.9642336964607239, 1.7322545051574707, "Gosh, I don't know. But I think in how in home services, I think that would be really important to take services to"]
+[-3.141671657562256, -2.210705518722534, "older adults."]
+[0.8267815113067627, 0.6403120756149292, "And obviously, the cost"]
+[-1.8339895009994507, -0.5117920637130737, "is really prohibitive of somebody feeling empowered to take care of themselves."]
+[-2.462409734725952, -0.010163345374166965, "And when you feel sick, you feel sick today, not four weeks later, when you can get an appointment."]
+[1.78803288936615, -2.728025436401367, "You know, that's what we're seeing a lot when we would get on the phone for women at WisePlace, and really, really advocate and sometimes just show up, you know, we didn't have any fear of like, we're going to show"]
+[-2.329998016357422, -0.18566207587718964, "we're just going to invite ourselves to this doctor's office, we're going to lightly but here we are. And, you know, just it's just hard. It's just"]
+[3.7557389736175537, 15.511507987976074, "Yeah."]
+[3.677882194519043, 15.540135383605957, "Yeah."]
+[1.6269607543945312, 1.1038296222686768, "You know, I don't know how you do this, but I think you need to take it into communities."]
+[-2.7055599689483643, -2.074995279312134, "You know, if he if I feel like that's like a more proactive approach with older adults, if you are,"]
+[-2.591463327407837, -0.0017360164783895016, "you know, if our health care system for older adults is reactive, so we call you when someone is not feeling well, or sick. It's almost too late. Right. And so"]
+[-1.377575159072876, 0.060999784618616104, "I don't know how health care systems do that. But they have to find a way to take it into communities."]
+[1.0742406845092773, 1.7952265739440918, "Because if you if you take, you know, your service into your"]
+[1.2475703954696655, -0.5055928826332092, "housing, communities, whatever it is,"]
+[2.281944990158081, 6.319361686706543, "I think you'll get a better response."]
+[-4.091832637786865, -1.8449510335922241, "Yeah, you know, and then once again, with regards to health care, access and delivery, are there different experiences for different groups of older adults."]
+[-2.100910186767578, 1.0021568536758423, "Yes, and I mean, for me, I do believe it is separate here. Yes, behavioral mental health. But if you think of health care access, and delivery is also you know, part of your health care is your mental health,"]
+[-0.4637316167354584, -0.3120826780796051, "or culturally."]
+[0.7298343181610107, 1.202101707458496, "You know, I just think everything has to be specialized."]
+[7.098219871520996, 6.123189449310303, "So I know this is a big question, but how do you suggest what is what do you suggest is the best way to address"]
+[1.896204948425293, 1.4135419130325317, "I mean, it seems so simplistic and I'm sorry if you know it is simplistic answer, but I do think you have to take it to the people."]
+[-2.014101505279541, 0.6160906553268433, "Because I think you have to bridge that relationship prior to someone feeling so ill."]
+[-2.167387008666992, 0.9134545922279358, "And unwell. You know, I think you have to somehow make it a proactive and not reactive"]
+[-1.1193745136260986, 0.34949156641960144, "kind of delivery model on a service model. And I think there's"]
+[0.7956182360649109, -0.2928914427757263, "easy ways to do that that are culturally relevant that are sensitive to communities."]
+[-2.0168564319610596, -0.2929103672504425, "You know, but it is a bit, you know, out of the box, right. And so that takes a level of trust. And if you want continuous reliable health care, you know, you do have to kind of build relationships in the community. Don't think you can sit in an office and hope that people are going to, you know, come to you. Yeah, yeah, yeah."]
+[-0.417876273393631, 1.341193437576294, "Okay, so now we're going to visit the third thing that you mentioned, which is economic security."]
+[1.1335902214050293, -1.304268717765808, "I mean, I think housing is such a big issue for older adults, that the cost of housing is just unbearable."]
+[0.34767696261405945, -0.6689128279685974, "So you're, you know, often living on a fixed income. And so, by the time you pay your rent, there's usually nothing much left. And so, you know, when you have to pay a little bit for medicine, or whatever it is, your basic needs. Food."]
+[-0.815945029258728, -2.2700228691101074, "I just think that what we've experienced is older adults, I mean, even when we have women with vouchers, and all the support systems, it's still an issue, it's still very much an issue, until you're really wrapping services around you're saying like, okay, you know, let's make sure you have a, a nutritious food supply, because they're not going to be able to achieve that on their own."]
+[2.0365517139434814, 5.472995281219482, "So, you know, unfortunately, we see that a lot."]
+[2.096762180328369, 5.172637462615967, "I mean, for us specifically, we also see, you know, a lot of"]
+[0.5066654086112976, 0.36120060086250305, "debts that, like we come in and help pay off."]
+[2.2998759746551514, 7.74849271774292, "And so obviously, that can be just so overwhelming."]
+[-3.01845383644104, -2.241063356399536, "I mean, let me think of older adults, specifically."]
+[1.223475694656372, 6.570422649383545, "Probably"]
+[-2.608799934387207, -2.740527868270874, "five to 15, I would say for women 60. And I mean, my first year, we serve somebody who was 92 years old, who was in our shelter, and that just broke my heart that a 92 year old woman was on a cot in a 1950s building, not even a room and a gymnasium. That's where she slept."]
+[0.7485043406486511, 3.199876070022583, "But I would say outside of 2018 2019."]
+[-2.5208680629730225, -2.888509511947632, "Probably 87 is like on average, the kind of most senior, older adult that we're serving. So if I think of 60 to 82, probably the highest bill I have paid for is around 25,000. But I would say if five to 20 in that range for women 60. And up. Yeah. Wow."]
+[1.3619790077209473, 3.3170664310455322, "Because they pile on, right."]
+[3.822746753692627, 15.436927795410156, "Yeah."]
+[2.361881971359253, 4.176664352416992, "No, I would I would definitely say from my lens at wiseplace. Those three"]
+[1.7472659349441528, 5.63291597366333, "seem to come up the most."]
+[-0.3983055055141449, 1.2788689136505127, "And then once again, you were mentioning for economic security."]
+[2.730783224105835, 7.107178211212158, "Yes, yeah, I would say you know."]
+[1.64730966091156, -2.573723316192627, "It's interesting, because if you're a chronically homeless, older adult woman, then you are eligible for live permits supportive housing, but again, you know,"]
+[2.029107093811035, 5.379459381103516, "there's not enough of that."]
+[1.7922371625900269, 8.417898178100586, "And so even in those situations like"]
+[2.4710123538970947, 2.892503023147583, "these, these are still these are still issues"]
+[-2.763979911804199, -2.1402885913848877, "and our phone rings off the hook for older adults."]
+[2.6662700176239014, 6.804528713226318, "And I would say you know, people are asking"]
+[3.684420347213745, 15.504429817199707, "Yeah."]
+[2.350053548812866, 7.746252536773682, "And then obviously,"]
+[-2.012019634246826, 1.1190725564956665, "you know, mental health wellness as well. Yeah, yeah. So I mean, as you know, no two people, no two people are alike."]
+[7.0716705322265625, 6.1067962646484375, "Yeah, yeah. And then what do you suggest is the best way to address"]
+[1.4757508039474487, 3.676290273666382, "I mean, I, at least from my lens, and my lens could have, you know, a total skew just because of the service that we provide for the community."]
+[2.5408594608306885, 7.306376934051514, "You know, through WisePlace."]
+[1.071255087852478, -0.669776439666748, "After housing, there is little to no money at all,"]
+[-1.1887413263320923, -0.5050713419914246, "even when we have somebody in a subsidized assisted living situation."]
+[2.3957619667053223, 2.862239122390747, "So I think that, you know, unfortunately, all of these will be issues to varying degrees if"]
+[0.9659920930862427, -0.6342166066169739, "the housing and the health care is not taken care of."]
+[5.580599784851074, 8.799123764038086, "Okay."]
+[-1.1617774963378906, 1.027864694595337, "Great, great. Well, we covered all three things. I don't know if you want to mention anything else. With regards to those three things housing, health care access and delivery and economic security."]
+[2.7073798179626465, 4.058225631713867, "I don't think I have anything to add. I mean, everything else is really relevant on this list, too. Yeah."]
+[3.550931215286255, 7.414125442504883, "Yeah. Okay, so now we're done with this."]
+[3.398064613342285, 4.03615140914917, "This list."]
+[3.4160401821136475, 5.813266754150391, "We're going to now go on to other questions, I wanted to ask you,"]
+[-2.8342318534851074, -0.11358775198459625, "the following areas of care, I'm going to ask you for you to judge how accessible and how adequate"]
+[-3.3672244548797607, -0.3272950351238251, "the following services of care are. And the first one is geriatric care. And the way we define geriatric care, it is very similar to pediatric care care for children's specifically geriatric care would be care for older adults specifically."]
+[0.9931613206863403, 2.5316109657287598, "And so the question was, how accessible and adequate and adequate"]
+[2.2621288299560547, 6.533205509185791, "Um, I think once you find somebody,"]
+[1.0236170291900635, 2.326681613922119, "it is good. But it has been tricky for us to like make the right connections, make sure it's a good fit, help get the person to appointments."]
+[1.2028554677963257, 1.2953439950942993, "So I think that, at least for us, it's difficult. And that could be just because we're a more grassroots organization. And maybe it's a WisePlace issue, like we don't have enough bandwidth."]
+[-2.5558576583862305, -2.0050435066223145, "But I think once we are able to kind of really help and advocate for the older adult, then usually the connections that we make, then usually they're pretty pleased with their care."]
+[-2.541160821914673, -0.4434104859828949, "Great, what about long term care, and this is care for older adults as they age. So you know, you may see them at 50, we may see them at 80. Yeah, so I, I would say our organization has kind of only, at least with me, kind of"]
+[0.3402114510536194, 3.0466434955596924, "experienced that for the last five years, so can't really speak to more than five years."]
+[1.4511195421218872, 8.865046501159668, "And"]
+[7.059023857116699, 6.11818265914917, "I don't know how to kind of phrase this. But"]
+[-2.6844708919525146, -3.1533000469207764, "in the beginning, I would say like the first three years, the older adults that we were serving were overwhelmingly"]
+[1.69917893409729, -2.624338388442993, "had experienced chronic homelessness."]
+[-2.0954272747039795, 1.1972339153289795, "And usually had were, you know, living with mental illness had a physical disability, and then oftentimes also have we're dealing with recovery in substance. So"]
+[0.7401384115219116, 3.5842151641845703, "for us, that was very difficult. And I find that that is very difficult to find like the proper care for when somebody is kind of checking off all those boxes, if you will."]
+[-1.789493441581726, -0.10145125538110733, "And I think that if we as an organization are not the proactive ones, their level of care is not great."]
+[1.5913742780685425, 6.478098392486572, "So I think it really does."]
+[1.79911208152771, 5.916365146636963, "Kind of, at least what I've the majority"]
+[0.3166030943393707, 3.0327329635620117, "of what i've experienced the last five years, If our team is not on it,"]
+[-2.7664310932159424, -2.0706522464752197, "then older adults are incredibly vulnerable."]
+[3.685208320617676, 15.503588676452637, "Yeah."]
+[-1.1860394477844238, -0.3852131962776184, "Especially when someone is housed. Most people, most organizations will not follow up in the way that we do. Because there's no funding for it."]
+[0.07686663419008255, -1.743579387664795, "Which I'm thankful to Cal Optima, they're kind of changing that conversation a bit. So"]
+[1.159425139427185, 1.2733798027038574, "it's kind of just an interesting place to be because we tend to be one of the smaller organizations."]
+[-1.26707124710083, -0.6119292378425598, "But maybe, because it's like, I'm still in the weeds that I'm no, go, go check on this person, go check on this person, go check on this person. Right. Yeah. Especially because the majority are not necessarily placed in the ideal assisted living 24/7 care. Right. And so that"]
+[3.3934783935546875, 8.569622993469238, "Yeah, yeah. Yeah."]
+[1.0147711038589478, 2.3179612159729004, "You know, that's tough. I would say accessibility is okay. Because there are providers, but I think the quality is not."]
+[2.448540210723877, 7.487980842590332, "You know, unfortunately, it's just been kind of"]
+[2.1318328380584717, 5.107302665710449, "our experience."]
+[2.524691104888916, 7.377103805541992, "You know, again, it is very hard to find"]
+[1.6836494207382202, -2.7059569358825684, "a person who can really understand somebody who has experienced homelessness, five to 10 years."]
+[-2.4967668056488037, -0.3999648094177246, "has dual diagnosis, I just have,"]
+[-2.2255258560180664, -0.26692989468574524, "I just haven't been unfortunately, super impressed by the level of care that I have seen firsthand in the last five years, because again, the first three years, I was taking people to appointments myself, because I was trying to figure out what the hell is going on at my organization and in the county. And so I saw it firsthand."]
+[0.800717830657959, 1.7009960412979126, "And I don't think it was for ill intent. I think the intent to do good was there. But I just, I don't know, if it's like, you know, providers are overwhelmed."]
+[2.386425018310547, 4.847045421600342, "But there was something missing. There is some there was care missing. And I saw it over and over and over again, unfortunately. Yeah. Yeah."]
+[1.0543688535690308, 1.9047006368637085, "No, I can't actually I can, you know, like, county have certain. So they're like providers. But"]
+[3.69171404838562, 8.877130508422852, "no, yeah."]
+[1.9180099964141846, 5.929594039916992, "I would imagine that you engage with that quite a bit."]
+[2.529021739959717, 7.44040060043335, "You know, I don't know if my expectations are"]
+[1.0032737255096436, 2.4872043132781982, "accessible. Sure. I'm adequate. No."]
+[-1.6658819913864136, -2.7690112590789795, "I think you know, what I don't like is if you'd like just roll the dice. And you just happen to have a really passionate person on the other end, that really, really cares, then you feel like you've hit the jackpot for, you know, the older adult, but that isn't always the case. Yeah. Right. And so I feel like it's not adequate. It shouldn't be structural, it should be just a value set in the organization. It shouldn't just be like, Oh, because Michelle was there Tuesday, and she's great. But Jim not so great. And so don't make appointments on Wednesday. Like that shouldn't be the case."]
+[-2.3449230194091797, 0.2346479445695877, "There isn't just this like, standard of care. I don't know what to call it. But you know, what have I experienced is accessible. Sure."]
+[4.226310729980469, 8.978676795959473, "No."]
+[3.8004097938537598, 15.433324813842773, "Yeah."]
+[0.49113747477531433, 3.176503896713257, "So if we were talking in 10 years time,"]
+[0.20363116264343262, 3.5137939453125, "and I'm asking you now to think about it in 10 years time, what would you think you say, I would say is the biggest challenge facing older adults."]
+[1.0686042308807373, -1.2317126989364624, "I would really say it's the three things that we talked about. I can't, I can only imagine it just getting worse, unfortunately. Because you know, there's aging populations and the housing is not getting."]
+[1.816603183746338, 3.681199550628662, "It's not catching up to the need."]
+[1.483740210533142, -2.36751651763916, "There's been like, even just in the five years I've been in this space, there's been so much good headway. But when I got here in 2018, and I've been in nonprofits for 20 years, but I've never kind of led a shelter. I've never been in this sector."]
+[1.4054957628250122, -1.0405631065368652, "And in 2018, the county was talking about we are going to build, you know, whatever it was 3500 units of affordable housing."]
+[0.37342390418052673, 3.0764167308807373, "It was five years ago."]
+[3.7542014122009277, 7.939852714538574, "Right."]
+[-0.6357892751693726, -2.1813275814056396, "So that's why I went back to the like, I don't know if it's lobbying, if it's more money, if it's, you know, get rid of some of the red tape make this easier, because you're gonna have so many older adults who are going to, and what we've seen in the last two years,"]
+[1.797010898590088, -2.794520378112793, "is that like, we're experiencing women 60 And above who are experiencing homelessness for the very first time."]
+[0.8386267423629761, -0.9485506415367126, "Because of, you know, mainly the three reasons that we talked about, right, it starts with housing, and then the health care, and then all the other bills start to pile up. And then it snowballs."]
+[3.6593618392944336, 15.540019989013672, "Yeah."]
+[0.29489395022392273, -2.219573736190796, "Oh, gosh, I really think government needs to lead the way. Because I feel like that's, that's not the only way, right. And I firmly believe in public private partnerships."]
+[0.6888771057128906, -2.4188179969787598, "But it does seem like the counties and the cities and the states and right, they really have the power to say, here's the money, use it for this. And we're gonna get rid of, you know, these three or four things. It took me two years to get through the Historical Commission of Santa Ana, for my housing project, two years."]
+[1.374593734741211, -0.9182597398757935, "And then it took another like year and a half to get to construction. Right, which I think that was like, relatively good. But"]
+[2.4083027839660645, 7.52182674407959, "you know, like, it just"]
+[2.3278961181640625, 5.985265731811523, "I don't know. It just it doesn't make sense. And I know, this was my first project. But maybe it's a good thing. It's my first project."]
+[0.6401636600494385, -0.03595655784010887, "Some people are making a lot of money."]
+[2.3710641860961914, 6.223207473754883, "I don't know."]
+[-0.20080675184726715, -2.6295175552368164, "It's just weird. And it does seem like government has, you know, the power. It's not the nonprofit, the nonprofit can't come in and say, Oh, we're not going to pay this permit, or we're not going to go through this commission or this council. Right. So I do think government should be the leader."]
+[5.467764377593994, 6.3935112953186035, "Okay, thank you."]
+[0.6672388315200806, -0.20173878967761993, "Yeah, that's a great question. Because I actually think the population, you know that we get to walk alongside of it. wiseplace is getting a lot of attention. So I actually don't, I don't think this could be naive, but I don't think it's the population that we serve. Actually, I think"]
+[1.766640305519104, -2.7496490478515625, "that women are experiencing homelessness and older adults experiencing homelessness are getting a lot of attention."]
+[1.979777455329895, 5.720354080200195, "So I'm not sure you know, who else would be"]
+[1.8185027837753296, 6.829069137573242, "Would it be,"]
+[2.646676778793335, 5.951806545257568, "I'm not sure that's a really good question. And I would love to know that."]
+[0.6191321611404419, -0.15678727626800537, "Well, populations just generally, I'm not sure."]
+[2.2836947441101074, 2.7765846252441406, "issues being overlooked"]
+[2.4244892597198486, 6.84632682800293, "I'm not"]
+[3.3232996463775635, 6.340872287750244, "kind of speaking out of both sides of my mouth, but um, but I'll do it."]
+[1.4632291793823242, 6.438311576843262, "You know, I think"]
+[1.391129493713379, -1.035836100578308, "like health care, and housing. I actually think they are being overlooked even though they have a lot of attention. And I know that that's weird to say, but I"]
+[1.8978298902511597, 6.540007591247559, "think they're being"]
+[2.2733378410339355, 2.734363317489624, "overlooked because there's not real solutions."]
+[2.300168514251709, 2.757369041442871, "And so I think that is why I'm saying those issues are being overlooked. Yeah."]
+[1.7078864574432373, 3.0420236587524414, "Because there's a lot of like press opportunities and press releases."]
+[1.8021016120910645, 8.518932342529297, "But the kind of"]
+[-1.9693938493728638, -2.1727805137634277, "You know, the really the disrupting of systems that we know don't work, I think, I think real solutions that have like long lasting impact for deserving, you know, older adults, I think that that is not necessarily happening. Or maybe it's just not happening as fast as someone like me who is impatient for action,"]
+[2.143078565597534, 2.8973686695098877, "for action. And so that's why I'm saying even though there's a lot of attention, they're still overlooked, because everyone's on autopilot."]
+[1.0408604145050049, -2.96059513092041, "Okay, so now I want to dig a little bit deeper into your service in the community, and wiseplace. So we were thinking about, you know, housing and homelessness, especially for vulnerable women in Orange County. That's working really well."]
+[1.3030316829681396, -0.7139609456062317, "I would say the first even though it's in construction, I think the biggest shift and programming is that we want to add to the affordable housing, with wraparound services in the community."]
+[1.8019872903823853, 1.8839023113250732, "Because we know that that is like a solution. And I do agree with all the red tape and politics and the cost of units know that I don't control that. Right. So."]
+[1.675216794013977, 4.952913284301758, "But so I would say that, like, that's number one."]
+[1.4316232204437256, -2.0870296955108643, "We haven't done it in 100 years, we've never done it before. This was our first attempt. Yeah, about near killed me. But you know, we didn't just say, We're gonna stay a safety net shelter. We said, we want to do that. And housing with wraparound services, and we fought really hard with our partner to say no, we will be the wraparound service provider, not you. Even though 100 pound gorilla jamboree housing, right. Because we know that our quality is good. So I think, you know the that really evolving our own organization, and really putting pressure on ourselves to do a $30 million project when we, at the time were like a $600,000 organization."]
+[1.4836622476577759, -0.8624517321586609, "So I would say that's number one, like we have to add affordable housing units"]
+[-0.018051298335194588, -4.0366997718811035, "in the city, and ours specifically will focus on older adults with dual diagnosis disabilities."]
+[2.024122476577759, 2.339480400085449, "So I see that as a solution. And so I think that's something that we are doing well."]
+[1.9651527404785156, 4.634568691253662, "And I think once we get one under our belt, then you know, our ability to do more of that"]
+[2.8522963523864746, 0.2008703202009201, "will continue and is the strategic plan. Sure, sure."]
+[3.657219409942627, 11.002326011657715, "Um,"]
+[0.5474717617034912, 1.842097282409668, "Because I was, you know, like I said, you know, my first day, I walked into a 92 year old woman who was sleeping on a cot in a gymnasium."]
+[0.9683583378791809, -1.5901702642440796, "And that's how we operated. You know, for the last five years, we didn't have an elevator, we didn't have the right infrastructure."]
+[1.7405253648757935, 1.2189842462539673, "So, although we are going to do that, well, it's one project with 47 units, and it's a start, but it can't be the end. So that's what we need to do better. We need to continue to do more."]
+[2.593656301498413, 6.950654983520508, "And also, you know, I'm really mindful of"]
+[-0.9727982878684998, -1.4845631122589111, "Clinical Services, outside of counseling and therapy, I think we do that well. But like the medical clinical services, we don't do that well, and it's not within our wheelhouse. But if we are putting a stake in the ground and saying, we care about older adults, and we want to build affordable housing for older adults,"]
+[1.5743721723556519, 1.5680946111679077, "we have to integrate that into our services. So I'm very mindful of that. I don't have any of the solutions yet. I think the solutions will be through partnership, strategic partnerships."]
+[-1.24412202835083, -0.0933741107583046, "But you know, like, I can envision like a clinic at another affordable housing, we needed to get one done right."]
+[1.2997959852218628, -1.0350980758666992, "The $30 million for you know, a now $2 million organization is a huge stretch. So but when I think of creating affordable housing or"]
+[0.3547378182411194, -1.8352080583572388, "senior affordable housing in the future, I do think there has to be a clinic on site."]
+[2.053208112716675, 4.687340259552002, "And so I think that's what we could do better. Okay."]
+[-2.006525993347168, 0.2927051782608032, "Sounds like you're gonna go into the healthcare business. Oh, gosh."]
+[2.422048330307007, 7.673189163208008, "I mean, that's terrifying."]
+[4.515743732452393, 7.898385047912598, "Okay, so"]
+[3.345942974090576, 5.336986541748047, "tell talking. So after we discussed everything we discussed,"]
+[2.720463752746582, 1.8256657123565674, "all the issues that you brought up, who or what entity, or what kind of entity is best suited to address these issues."]
+[2.6970088481903076, 1.7141884565353394, "Don't think it's going to be one entity."]
+[2.150021553039551, 7.7649455070495605, "Like, even for me, like"]
+[-1.989250898361206, 0.2089131474494934, "I could see the next 10 years and continuing to help solve solutions. I don't want to be the health care provider."]
+[0.07538089156150818, -2.058997392654419, "But I want to find a damn good partner, who I know is going to be accountable to the people that we serve. Just like for me for housing and all the other wraparound services, I want to be accountable."]
+[1.7841792106628418, 6.36763858795166, "So I don't think and I could be totally wrong. But"]
+[0.7585524320602417, 3.479799747467041, "it's not like a stain your lane thing. But I think when you try to do all these really big problems and bring solutions to them, it is really hard to do all of that well."]
+[1.3036257028579712, 6.396964073181152, "So I think it is going to be"]
+[-0.866209864616394, -0.13923166692256927, "housing partner, like a therapy partner, you know, a health care partner,"]
+[0.41846105456352234, 0.766975462436676, "transportation partners, you know, economic financial literacy partners, I think all the partners have to break be at the table."]
+[2.5908915996551514, 1.6857739686965942, "So I think it's going to take multiple partners, because"]
+[3.7501254081726074, 5.983220100402832, "I just I don't see how it could be done. You know, otherwise."]
+[3.7892332077026367, 15.474091529846191, "Yeah."]
+[2.135413646697998, 7.2040181159973145, "I would take out rules for"]
+[1.0524359941482544, -1.5004693269729614, "unnecessary rules, I would say, an unnecessary bureaucracy that stops the building of various types of affordable housing that can be permanent supportive housing, that can be assisted living, that can be mixed use."]
+[0.4760180115699768, 3.0195202827453613, "But like, this is a crisis now. And in 5,10,15,20 years, it is going to get worse and worse and worse and worse."]
+[3.7671477794647217, 15.471558570861816, "Yeah."]
+[2.2775769233703613, 7.180246353149414, "So I mean, that's that's the fog, I would wave."]
+[1.141217827796936, 0.40166234970092773, "Yeah, I would also, like add accountability to everybody. I"]
+[1.200840950012207, 0.3667334020137787, "I just don't see accountability in systems."]
+[1.0405688285827637, 0.33956342935562134, "You know, I think I think it's the funder has ADD accountability. So like, if I get money from somebody, somebody"]
+[1.2299162149429321, 0.4047195315361023, "should be holding me accountable."]
+[4.744168758392334, 4.1406354904174805, "I mean, Katie, between you and I, like when I first started, we were doing our emergency shelter for the county. I got there and I was like, oh my goodness, this place is on fire. Like literally and figuratively. I was trying to pull data of course, we didn't have any known used computer at wisely, even in 2018. And I was terrified of my first meeting with the county"]
+[0.5431903004646301, 1.8330069780349731, "And I walked away going oh my god. Wow. Easy."]
+[-0.902797281742096, 1.1194370985031128, "You know, why were they just happy that it was keeping people alive and fed."]
+[1.2265228033065796, 6.466716289520264, "So I think"]
+[3.6482536792755127, 10.995220184326172, "um,"]
+[0.7291295528411865, 0.2353617548942566, "and I think the best person to do that as the person who's giving you the money"]
+[2.503962278366089, 7.353720188140869, "because as the you know,"]
+[0.3997108042240143, -0.12897664308547974, "you don't want to lose that money. You want to keep impacting lives, but it's"]
+[4.560481548309326, 4.185005187988281, "you know, I think and obviously, you're the expert in this and I listen, I love talking to Tracy the last couple years because it's like"]
+[-1.278120756149292, 1.7873090505599976, "there's a place for output but there's a bigger place for impact. It's like your heart and your mind meeting."]
+[1.0060205459594727, -1.3692649602890015, "Um, I think even if you throw away some very unnecessary red tape that I've personally experienced and on the road to building affordable housing for older adults,"]
+[1.2414937019348145, 0.3984379768371582, "there still has to be that accountability piece. Mm hmm. Ya know, for sure, for sure."]
+[0.6751905679702759, 1.691147804260254, "It's going to be both. So we have a museum in front"]
+[0.6038289666175842, 1.6518579721450806, "of of the building that is going to be public. We're going to display the community arts and things like that."]
+[1.8241991996765137, 4.124575614929199, "But this space is tight. And so that's kind of going to be it."]
+[1.8070284128189087, 4.0974650382995605, "And so I think we could probably dream a bit bigger for other spaces."]
+[-0.7852181792259216, -0.24804390966892242, "That we have like a little bit more room. Because like so for instance, like my crazy dream of having like a clinic on site, it's not a clinic just for the people that we serve. It would be a public clinic for whatever community we're in. I was talking to like Laval at South County outreach, because I was telling because they're, you know, they're doing a new strategic plan. And I was telling him, you know, this is the weirdest thing. We're serving chronically homeless people, and when they're an emergency shelter,"]
+[-0.8333649039268494, -2.0978896617889404, "you know, you feed folks, three nutritious meals a day plus snacks, everything accessible, then you take that same client, you pop them into their own apartment for the first time, and you provide no meals. And folks were like, happy that they would show me their monthly calendar. And once a month, someone would come in and bring fresh fruit. I was talking with Kyle was like,"]
+[1.2156367301940918, -1.2998316287994385, "you're missing an opportunity. Like, you know, go talk to the big gorillas, right mercy house illumination, foundation, Jamboree, housing, National Core, go talk to the counties in the cities, because this is a problem. People are malnutritioned, and permanent supportive housing."]
+[4.460697650909424, 4.755867004394531, "And so anyway, he so he and I were like, well, let's do it with you. And I was like, Okay, well, let's build a pantry."]
+[1.445046067237854, 0.3537020981311798, "And so, if and when we're able to do things like that, my hope the goal wouldn't be just for those that we serve, it would be like a public benefit. Yeah. Yeah. Makes sense. Makes sense."]
+[4.309980869293213, 7.329344272613525, "Okay, well, this has been wonderful."]
+[1.1331167221069336, 1.031175136566162, "I mean, I'm sure you are talking to, I'm sure, like illumination foundation, I have a lot of respect for them, because they are doing recuperative care. So I think conversation with them, you know, makes a lot of sense. And I'm sure you've already had one or two or five. Conversely, they're so big, but probably lots of people out there. We just spoke to them two days ago. Yeah. Oh, good. Yeah, I think they would have, you know, some really great insight that, you know, we cannot offer at this time, we don't provide the same service. I think that's the only person that comes to mind."]
+[1.778173804283142, -2.741349935531616, "You spoke earlier about older women being were homeless for the first time, you're seeing a lot like an uptick in that"]
+[3.62817120552063, 10.967402458190918, "Um,"]
+[0.028695818036794662, -3.355863571166992, "I mean, I just would want the county to know, and I know that they're aware, because I've been to, you know, I think that they're aware."]
+[2.539820671081543, 2.1994729042053223, "But I would want them to know that it's a it's a solvable issue now."]
+[1.1865978240966797, -0.8503116965293884, "But support systems and housing are not in place is going to be"]
+[0.049917981028556824, -3.2185873985290527, "you know, very hard to manage in the future. I think, you know, the, I would hope that the county understands like the time is now, not in five years, not in three years, because what we have seen the last two years is exactly kind of what I described. They they are it's a different profile just to overgeneralize just to make the conversation easier."]
+[-0.9664803147315979, -0.3813542127609253, "You know, it is women who are starting to have health issues, they have no support. They can't keep up"]
+[0.7790746092796326, -0.5539882183074951, "With rent, they have fixed income, healthcare bills are piling up."]
+[0.11990226805210114, -3.159038543701172, "It's just, it's just I'm seeing it the last two years, and it's starting to snowball. And I would just hope that the county knows that, you know, let's not make a big problem, an even bigger problem."]
+[1.5943557024002075, -2.4550793170928955, "Because if we could even eliminate shelter, if we could get housing and get the women and men like anybody tied to housing, then, you know, the goal should be to avoid shelter period."]
+[1.6957533359527588, -2.574286460876465, "Because these are women who have never been in a shelter. And that alone is incredibly traumatizing."]
+[1.3703100681304932, -2.324676275253296, "And so I would just hope that the county knows that, like, let's fix the problem. It's already a problem. But if you if you just put 1000s of people in a shelter system, you're making a bigger problem"]
+[1.4767950773239136, -2.2479984760284424, "You know, it's hard because you need both like for me, like, you know, even I think my board was surprised that my recommendation for our next five year strategic plan as we got affordable housing off was not to do a second affordable housing was to make sure that we have one shelter, so that we have affordable housing and shelter, then we'll come back to affordable housing and start to scale. So I'm a fan of shelter, I see the power of shelter."]
+[1.730048418045044, -2.7310311794281006, "But I hope that the county appreciates that these women who are these older adults who are experiencing homelessness for the first time that they are different than chronically homeless populations, what they need, generally are different."]
+[1.503749132156372, 8.804258346557617, "And so"]
+[1.3369033336639404, -1.1098408699035645, "like in namesake Yes, I feel like there's a lot more funding for affordable housing for sure."]
+[0.6347893476486206, -3.465939521789551, "Um, but I mean, if you even think of like jamboree housing, like, you know, they're our partner, and I was just like, how many units are you doing in Orange County, you know, and they had, you know, four projects in the last six years, 10 years in Orange County. This is a very capable, affordable housing provider."]
+[2.520174741744995, 7.455379009246826, "You know, so"]
+[1.549598217010498, -0.8916656970977783, "I think you need the right type of housing. And I think unfortunately, what I'm saying is,"]
+[1.4241669178009033, -2.2714107036590576, "a lot of the cities in the counties, they're taking over industrial spaces, and they're making them into shelters. I don't see how that helps anybody."]
+[0.5200325846672058, 1.845036268234253, "I mean, I walked into your shelter, and I like walked right out. It's beautiful. It's from the ground up, there's a beautiful mural. But it's like, you're in an office space."]
+[1.1045501232147217, -1.4167444705963135, "low ceilings, I mean, you know, and Fountain Valley Westminister garden grove, which is the area I've lived in for almost the last 10 years, they're doing the same thing."]
+[1.5570335388183594, -2.414715051651001, "So I don't think you can abandon shelter, because it's a safety net. But it's kind of like if you don't have the pipeline, like I would get a lot of heat my first two or three years because I would have women at the shelter for two or three years."]
+[0.555701732635498, 1.8783345222473145, "I can't place them in an unsafe situation. They can't live without services."]
+[1.9361287355422974, 4.0516180992126465, "Um, so I think you need both. I think you need both. I don't know, it's a little heartbreaking to me."]
+[1.4292702674865723, -2.553082227706909, "You know, yeah. It seems to me too, that older adults is a whole nother playbook for them. As homeless. Because oftentimes, you you think somebody's homeless, and maybe it's temporary, or maybe they are chronic. And you can place them in, you know, to get some services or mental health services or whatever, and maybe bring them back to being productive members of society. But if you have an eighty year old or a ninety year old, it's sort of like, No, this is about managing their care. Yeah. Right. Right. Exactly. Which is why, you know, I think your conversation with maybe illumination foundation would be very interesting because I feel like that's kind of what they're doing, or at least that's how I understand it. And that's how we've interacted."]
+[-1.9183921813964844, -0.004676545970141888, "Yeah. Well, they they're doing something really interesting, which is they're starting their own health plan. Oh, my good. Yeah. So that's why I said you're going to be a health care provider. They didn't think they were going to be an insurance plan. But here they are. You're kidding. I had no idea I need to reach out to Jack and have a coffee. It's been a while."]
+[1.168874979019165, 3.406796455383301, "Yeah, it is so difficult to manage. And they're taking an inside outside approach, you know, just being the one stop shop, because they need to be, or at least they need to be knowledgeable. Right. And they can I mean, they are, I mean, it's such an apples and oranges conversation, right."]
+[0.7622202634811401, 0.03764438256621361, "They're doing by the 1000s. And, you know, we got almost 400, you know, before we had to kind of 400 women a year, before we had to kind of scale things down for the next two years. But yeah, they are impressive. I mean, that's a machine."]
+[1.496834635734558, 1.646226406097412, "You know, that's definitely a machine. I'm very grateful that they're, you know, in the community, because, you know, they do things that you know, we do not."]
+[1.3953019380569458, 3.582223892211914, "Well, it's a sad state of affairs, when, you know, we have to have somebody like them scale in the way that they have. Yeah."]
+[3.784398078918457, 15.480669021606445, "Yeah."]
+[4.5948405265808105, 4.461336135864258, "Well, it has been such a pleasure, I really enjoyed our conversation. Thank you so much, if you can, if you think of any one else that you think I should talk to, or if you want to come back and say, Oh, my gosh, I totally forgot to tell you this, please feel free to reach out. Okay. And that insightful I think this is"]
+[1.5810363292694092, 1.2262800931930542, "this process, by the way is all year long, it's gonna take us a whole year to do, we're doing 100 stakeholder interviews, probably a lot more at the end of the day with different referrals. And then we're gonna do provider surveys, focus groups, community surveys, we're doing town halls, all of that, culminating into something we hope will be pretty cool and illuminative and then hopefully, move the needle. You know, for me, so. Well, this is great. Yeah, thank you for doing this work and doing the research and pulling data in and helping with the with a, you know, a good plan. I'm hopeful. I'm hopeful. I really am. I shouldn't seem hopeful. But I really"]
+[4.798605442047119, 4.760204792022705, "well, I can't wait to see what you guys unveil in two years time. Thank you. Please count us in as allies and supporters. However, we can help amplify the work that you're doing. We would be more than happy to thank you so much. Yeah, I really appreciate the work that you're doing. And you know, Ashley and Tracy, they're, they're good people. So I'm glad that you know you're with them, too. They're both so you're in good company. You're in good company. Yeah, I am. Well enjoy the rest of your day. I hope your husband gets well soon. Yes, an ankle. That's hard. That's hard. Yeah, he broke it in like three places and dislocated it. So it's"]
+[3.2150962352752686, 5.4881181716918945, "gonna get like he's gonna be bionic, he's gonna have the metal plates and all that good stuff. So Oh, boy. Yeah. I hope you I hope you have reinforcement for what's to come in your household."]
+[2.4316468238830566, 6.775700092315674, "I'm not. We have found out."]
+[-2.0595192909240723, 0.22247399389743805, "I am not helping the healthcare system."]
+[-2.4763388633728027, 0.09036868810653687, "be fired as a nurse. Oh, my goodness. Thanks again. Oh, yeah, you took it"]
+[3.7784264087677, 15.49849796295166, "yeah."]
+[-2.537095308303833, -3.4032928943634033, "All right. Thank you. No. Okay, wonderful. All right. So the primary goal today is to identify what needs you think are most important to the older adults population, especially the ones that you serve. And for this interview, we define older adults as those who are 60 or older in years, we want to think we want you to think as broadly as possible, taking into consideration the older adults, but also their caregivers, families and the community at large. I'm going to share my screen so you can see a list of common issues and concerns that impact older adults. Please take a few minutes to read through this list. And let me know when you're ready to begin."]
+[-0.8610076904296875, -0.9236137866973877, "Sir, so to clarify, and I know that you'll be speaking with January Johnson at the Orange County Housing Authority. But our main program to residents is rental assistance. So in that we know about their their housing needs. Don't serve seniors as just a population. So I'm not going to be as familiar. I'm clearly going to be familiar with their their housing and homeless needs, because that's the programs we run. But I'm not, you know, I would just be guessing whether caregiving exceeds their economic security versus their emotional wellbeing concerns."]
+[2.6846394538879395, 4.47970724105835, "It's perfectly fine if this is within your scope. And yeah, what you feel based on the work that you do are important factors."]
+[0.7223898768424988, -1.811145305633545, "Yeah. So housing is an important factor and being able to age in place. So on our rental assistance, the Housing Choice Voucher Program, or what people call the section eight Rental Assistance Program. The individuals have been out the the rental assistance, or we have affordable housing developments that are built, right. And so the rent is not as high because it's already subsidized. And then we also build permanent supportive housing. And that supportive housing does have built in supportive services for chronically homeless individuals. That, you know, basically, to assure that they can remain housed. The biggest thing in rental assistance, general rental assistance, and general affordable housing is the older adults needs as they increase, right. So their rent is taken care of that, should they need assistance with daily living activities. That's not part of you know, necessarily that's another component that has to be subsidized if this is a lower income senior so I know that there are a lot more resources out there especially with cow up to my health. But I think for the the older adult, definitely they have a static income. Generally, you know, SSI SSDI. Rental Assistance is key, or affordable housing is key for that, that population that finds them finds themselves to be low income in the county. So if you are looking at"]
+[1.5639781951904297, -2.0687625408172607, "So issues and concerns representative list of common issues impacting homeless homelessness housing. I think you've got personal care management, which I guess is daily living activities would that be"]
+[3.433320999145508, 9.081811904907227, "Yeah, yeah."]
+[-1.484062671661377, -0.001104495138861239, "caregiving. Yeah."]
+[1.5457179546356201, -1.4292384386062622, "And I'm guessing that housing and homelessness is up there."]
+[-0.27584442496299744, -1.6152514219284058, "Yeah. No, I mean, that's, you're talking to this. So yeah, we know that that's a critical need of this population. And I just put the other one as aging in place. And that could be a variety of these issues. It for it, because I'm essentially talking about low income, that's the population that we target all of our funding is for low income individuals. So when I'm talking about seniors, I'm talking about low income seniors. Right. Right. Got it. Okay."]
+[1.0596033334732056, -1.2822144031524658, "So when you think about housing, homelessness, aging in place, you know, I will start to ask you questions, the following questions about each of those specific things that you've listed. And I just, I'll just go in order based on the order that you had named, and we're going to ask you specific questions about the same set of questions, but specific questions about each of those. Right. So thinking about housing, specifically, how and why are older adults struggling with"]
+[1.2508598566055298, -1.1081045866012573, "Oh, there, we don't have enough affordable housing in the county. There's not"]
+[0.47991815209388733, -1.336456060409546, "I'm not making a general assumption that older adults, you know, can work, just generally. There's not much income growth. Alright, so what's more, you're living on a fixed income, there's not enough affordable housing,"]
+[0.2638826072216034, -3.7726409435272217, "in Orange County, and what barriers exists to seeing improvements in this area."]
+[0.8826339244842529, -1.8883732557296753, "So we have housing funding strategy for development of permanent supportive housing, so financial resources, if you're going to develop that kind of housing, you need the financial resources, for the Aging in Place piece, you need services that are paid for, that can accompany that housing, so that when the individual needs a higher level of care, they can access it, because they can't afford it. Otherwise, if they're a low income individual, senior, older adults. So I mean, the barriers to housing our land, available land, financial resources, zoning, not in my backyard. I mean, it's it's a thesis statement on, you know, the potential barriers to housing and it's general it's not just for closure. In fact, senior housing often affordable housing is sometimes easier to build from, from a community perspective, because people don't feel as threatened by older adults, or, or that grandma and grandpa need a place to live as opposed to, oh, that homeless individual, right. It's like veterans, veterans are also easier to everybody wants to, you know, house veterans and has a place for that. So. So it's just, I'm giving you the general background on barriers to, you know, you know, developing the housing. Yeah."]
+[-3.917079210281372, -2.0446934700012207, "What would be different older adults"]
+[0.07433772087097168, 0.05097195878624916, "meaning like maybe where they live, their disability status, maybe income or education levels"]
+[0.7239400744438171, -1.8336493968963623, "generally with affordable housing, it's just income qualification now on on disability or mental health, we're also building mental health M HSA funding is going into and they also So have a component right for the older adults. So there may be specific housing, right, that needs to be built. If you have, you know, mental health, substance, you know, use challenges. homeless housing. So if you're chronically homeless, that's where it's a different type of housing, is your your intervention is permanent supportive housing. If you're chronically homeless and severe, you know, severely and persistently, mentally ill. You and that population needs greater number of wraparound services. And that's how that housing is built. So yes, there are different needs. That's generally across the population, though. For seniors, the that key component is more the aging, so somebody who needs or has mental health or substance abuse issues, it may, it may be different for a child than it would be for an older adult, but the general adult population and that senior, you know, same interventions are needed. Yeah. What about,"]
+[0.3833765685558319, -1.607116460800171, "I mean, absolutely. I mean, each, each development that comes online has to look at their actual population. So if we're building senior affordable housing, that that property is going to look at the seniors that actually took the housing. And I'm not a gerontologist. But I mean, I am literally at my 94 year old mother's house today, telecommuting, which I do every Friday. And so I you know, have a unique insight on that, I mean, there's a lot of different needs, when you're 70 versus when you're 80. Versus when you're 90. They're, they're they're very different. I think, anything, your cultural background, where you live, I mean, I just noticed, because we grew up in Riverside, and thank God we can afford my mom's senior living here. Which in Orange County would be almost, it'd be tough. Yeah. So I think and then, I think it's the same. This is, you know, my, my general opinion, is that people project on homeless or low income, that somehow the needs are different than the general population, and they're not. If you come from a certain cultural background, you still have those ties, or things that you've just been raised, you know, doing that are important to you, that may be different than somebody else. If you're aging, it doesn't matter. You know, you're low income, you're rich, now you're rich, you've got more, you've got access to resources. But it doesn't mean that your choices are different. It doesn't color your choices. You still want to have a choice you still want to live in next to your family, or you want to live, you know where you've lived your whole life. Just because you're low income doesn't mean that choice went away for you. Or that it should be limited. Because that's in the Housing Choice Voucher Program. That is the choice of the individual. So I think that's important to keep, you know, in when we're building this out, is that that choice still exists."]
+[2.9356298446655273, 4.670083999633789, "Yeah, thank you for that. You've really important things to mention."]
+[1.1367552280426025, -1.6057721376419067, "Yes, if it's housing and homelessness, Good. Is it equal in every category is that 60 year olds, seven year olds, 80 year olds, and then you just ask the question, because those needs are different. And then finding for us, you know, we always say we need additional funding to fund more housing choice voucher, right. individuals that need rental assistance, if we had additional funding for that Rental Assistance Program, we'd be able to meet more needs. And then in the built environment, like when we're developing affordable housing, I think we just need the information. And then is, you know, I know, there are our funding, I know, Cal Optima has PACE program and other that looking to get, you know, a development that could combine that as the services right for the affordable housing. Company components. So that's my, that's my answer."]
+[1.7434463500976562, -1.1386770009994507, "Yeah. Those are all good points. I'm sure you can go on for another three hours on that issue. But let's go back and revisit I know you kind of combined housing and homelessness together in some parts. Um,"]
+[1.386059284210205, -2.380500555038452, "yeah, we, we need. I think we just need a different shelter environment. I don't know what age that starts. If that's 70, but an individual that's 70 year old that may be finding themselves in a transitional our emergency shelter, I don't think necessarily is getting what they need services wise, while they're there. Now, obviously, the ultimate goal is to transition them to housing as immediate as possible. But they're individuals that find themselves homeless and need daily living activities. That's going to be a different environment, it's not necessarily going to be at your bigger shelters. So it's one of the most heartbreaking things I've seen in my career because I was over homeless programs for a while, but it grew up so much needed to have its own department and rightfully so. But seeing 75 year old on a concrete floor, we've done much better, you know, over the years, but I think it's just looking at the you know, the those homeless needs and I think they're acute, right, because their access health care at the time if you find them street homeless, it's the way they're going to address their diabetes. There are other things that are out of control. Right, that is to get them into some sort of housing or shelter immediately. And then those that need that, like I said they need daily living activities, it's just something it's it's one of the hardest things to fund and wrap into that that shelter service. Yeah."]
+[-0.7817528247833252, -1.2745815515518188, "It is it seems to be more recuperative care when it comes to an older adults. And again, I'm not a geriatric specialist, but I don't think I have to be to know that the CO occurring conditions that aging brings on is, is, is different. And then that's on top of it, they have serious persistent mental illness and substance use, are just talking about somebody that's, you know, most of our homeless are going to find ourselves, they're gonna find themselves with those co occurring conditions, but there's also some that are going to not be seriously persistently, mentally ill they might be less than that. Or that might be just substance use, or extreme poverty. And but their aging, right, just the things that they're going through, is probably more you no recuperative care, like you said assisted living kind of non congregate shelter living situation. Yeah."]
+[-0.5076857209205627, -1.2405850887298584, "No, I think for this probably changing for for low income, because that's the population right that we serve for low income older adults that access to health care, right. That and access to transportation. I mean, if you've got to get to health care, if healthcare is not coming to you, then transportation is a key. And you know, having that person be able to age in place, right. And, I mean, your economic being low income is also in itself, just another pressure, another stressor, to, you know, that the conditions, you're already going through between you just getting older, you're getting, you know, higher blood pressure, your whatever is going on, you can't walk as well. And the access to healthcare is access to a walker, right, it's access to hearing a, it's access to all that. And that's more difficult for a low income individual on a fixing, deciding between the portion that you're paying for rent, right, and then you need to pay for food. And that, then you are needing, you know, other assistance for you to be able to age in place. And then if you need somebody to help you shower, that's extremely expensive. And as a different, you know, you have to get that subsidize, that's not something that a low income individual affords in the regular, like a senior living type environment. So when an older person"]
+[1.4137911796569824, -2.405240058898926, "That's a good question, because I think the shelter systems grown up a lot. I'm not as clear when we had sort of bigger shelters, and then when we were clearing the flood control channel, and there was an immediacy in older adults or just in a large shelter. That isn't, that isn't something that's that's there. I think the individuals try to exit them out to more appropriate board and care environments where they can get that kind of service. Wow,"]
+[0.9486846923828125, -1.3910298347473145, "that's a lot of coordination for an older adult with a variety of different challenges. Not just the housing factor. Yeah. Okay."]
+[0.20347237586975098, -1.9164475202560425, "Now it's knowing the needs of the low income seniors. Is it additional connections to mainstream benefits that we need to coordinate in the system better, such that, and we're working with the housing authorities, for instance, in Orange County are working with CalOptima, MOU to ensure that the people who are getting on our rental assistance, not just older adults, but a great portion of our, our housing authorities, voucher program, our older adults, that's it's a great portion of who we serve on our programs. But we're trying to work on that this individuals have received a voucher making sure that they're connected to Cal Optima, because generally, they're probably they're their client, they're probably Cal Optima eligible. So I think in the system, just coordinating that, right. So that the individuals may have access to a benefit. I'm low income, and I need this Walker. So yeah, this is who I can go to now I can tap into this benefit. And stay, you know, where I'm at."]
+[-1.189046025276184, -3.984545946121216, "Today, just being able to access, like you said, resources for all of the holistic needs that they might have. It may be through your program, but then it may be through account optima and other agencies. Yeah. Okay. So, I'm going to move into a whole nother tangent that has nothing to do with the list that you saw earlier. So now we're going to talk a little bit about the continuum of care. And if you don't have an opinion, you can just pass a you don't have to speak on something you don't feel comfortable speaking about. But we would like to get an opinion from a variety of people, not just, you know, purely experts in that area. So we just would love your opinion regardless. So can you please describe how accessible and how adequate the following care or services are in Orange County. So for geriatric care, very similar to we talk about pediatric care, so care for children, we're talking about geriatric care care specifically geared towards older adults."]
+[-3.069603443145752, -0.595525324344635, "As tough I haven't had, we don't have to, we don't help people get access to that. So the only thing that I noticed to speak I have personal experience in geriatric health care with my mom who's not low income. And I, I know for certain that the health care system needs geriatric specialists. Yeah, somebody who is 80 years old is completely different than somebody who's hit 90. Yeah, but I don't in Orange County, I don't have knowledge on that."]
+[0.907876193523407, -1.634424090385437, "Yeah. So that's what I'm talking about those, as the daily living activity needs increase, right, that spectrum is they they moved in, and they were perfectly capable at 70. And now at 80. Though, you know, somebody that can come visit or, or just do showering or something like that, that it's, it's needed, especially for low income individuals, because the housings paid for we have these subsidies, right. But there's, there's, you know, other than connecting to potentially like a Cal Optima benefit. Yeah. Yeah."]
+[-1.8653430938720703, -2.304115056991577, "Are you aware of any services or programs dedicated to serving the needs of older adults when it comes to"]
+[-1.6570627689361572, -2.4177722930908203, "We have been working with them for years they have you know, that when they built their plan, they also looked at the needs of that they have an older adult separate pot, right for CSS WAS IT support and services um, They have an adult population, which the the older adults are also part of, but they have a specific carve out for older adults specific card about for transitional age youth, for instance. But yeah, definitely on the mental health services, healthcare agency, the MHS a program. There are services. Great."]
+[4.150068283081055, 7.684574127197266, "Not as familiar. Okay. All right."]
+[0.49081966280937195, -1.488174557685852, "Okay. Yeah. And and did you see when I say housing, it's also housing for their caregivers, generally, those caregivers tend to be low income. So let me I worked a long time ago with SCAC Senior Citizens Advisory Council, and we would go to them and and we were talking about senior housing, and they made an entire statement on how housing for, you know, their caregivers was just as important as housing for themselves, because they, their caregivers were coming out of county or, you know, yeah,"]
+[2.630770683288574, 6.516873359680176, "I'm curious."]
+[4.976376533508301, 7.2174482345581055, "You know, it's, it's interesting, I think, yes, in a relative way."]
+[1.1909739971160889, -1.1027281284332275, "Like everything, it has its cycles. And it's tied to economics. So there have been times where the housing has been less expensive, where condo developments were coming in at a price that people could afford, right. And the rents. It's pretty acute, though, right now. This is one of the highest peaks and housing on affordability. So that means, generally, we need more affordable housing than we've ever needed."]
+[0.23543240129947662, -2.2192389965057373, "Alright, I'm, I'm all about partnerships. In trying to to get it developed, so to duplicate that or to have duplicative services doesn't make any sense. But I, I think it needs to be public private partnership. And I really strongly believe in that. And then we need to look at where there are just absolute gaps. Yeah. So yeah, yeah,"]
+[3.7161643505096436, 7.655063152313232, "I hear you. I hear you."]
+[0.19655966758728027, -4.340957164764404, "I'm looking at low income and I have no idea of they're receiving less attention than middle income, older adults or different attention. I don't know clearly, I have a rental subsidy that's only available to those that earn 50% Ami or below. So that's a resource that somebody who earns 60% Ami, who probably is considered low income in Orange County, because our median incomes are so high right, and our rents are pretty high. So If I could see that there are benefits that you know, low income individuals have that moderate, you know, older adults don't have. So it's hard for me to answer. If, if there if I see a distinct gap you know, one versus the other. Yeah, yeah, that's fair."]
+[-0.139753520488739, -4.002935409545898, "And so now I'm gonna ask you a very similar question. But so thinking about all the issues facing older adults in Orange County, and this could be drawn upon personal experience as well. Just completely overlooked. I don't I don't know"]
+[1.082074761390686, -1.6421881914138794, "about overlooked. I think the the greatest place for investment is housing and aging in place. I mean, I know I hate to sound like a broken record. I don't think it's overlooked though. I think that with the resources we have now, people are trying to, to use those resources to their maximum to help me we can I just don't sure we have enough resources to fill all the needs. Gotcha. Gotcha."]
+[1.434056043624878, -1.0324764251708984, "Okay. So I'm leaning into this work that you do around housing and affordable housing and permanent supportive housing. Yeah, I think."]
+[5.333350658416748, 3.7161545753479004, "I can't hear you anymore. Let me pause the recording. Actually, I'll keep going to see if he come back."]
+[3.538451671600342, 10.865155220031738, "opes"]
+[1.4665154218673706, 8.846074104309082, "But"]
+[-2.7162952423095703, -3.2901177406311035, "the primary goal today is to identify what needs you think are the most important to the older adult population you serve. Those who are 60 and older, we want you to think as broadly as possible taken into consideration of the older adult, caregiver, families and their community. I'm going to share my screen so you can see a list of common issues and concern impacting older adults. Please take a few minutes to read through this list and let me know when you are ready to begin"]
+[4.177750587463379, 5.35682487487793, "and when you're ready, just let me know as I can scroll now."]
+[-1.4109371900558472, 1.5915378332138062, "Okay, I got to the emotional well being okay."]
+[-0.26972222328186035, -4.281679630279541, "Okay, thinking specifically about older adults in Orange County."]
+[-0.930083692073822, -3.338512420654297, "Sure. So I am the Director of the Office for family life for the Roman Catholic Diocese of orange. I don't directly deal with older adults on a regular basis, but I oversee ministries and help train ministry leaders and volunteers who visit the sick and homebound or care centers to visit the elderly as part of their volunteer work in our churches. So sometimes I will get to encounter some of the elderly, but I'm kind of a step removed from direct contact most of the time, I'm working with volunteers and staff people who visit the elderly and the sick and then also interact with them at our churches."]
+[0.1339215487241745, -4.158712387084961, "Thank you thinking about Orange County and looking at the list of common issues and concern impacting older adults."]
+[0.081205815076828, -3.748903751373291, "Um This might fall under emotional well being or safety maybe but I know sometimes. Or even in recent years, there has been concerns around like violence towards ethnic groups. And so in our diverse community here in Orange County, we have elderly of multiple ethnic backgrounds and so I do you think there is maybe some fear and actual violence that's been done against some of our elderly of certain ethnic groups so I didn't see that directly listed in the examples or issues and it might fall under Community and Family Safety maybe. But I know that's been a concern."]
+[2.513948917388916, 3.802639961242676, "Thank you for sharing up the needs on the list include the one that you suggested Please rank the top three that you feel are the most important."]
+[3.1299631595611572, 7.654432773590088, "Yes, of course."]
+[-1.5212801694869995, 1.2077628374099731, "So I might be biased just because of the context that I'm working in with older adults. But I would say the emotional well being the healthcare access and delivery. And then"]
+[3.691697120666504, 15.119717597961426, "Yes."]
+[-1.5380029678344727, -0.006845276337116957, "And then maybe also the caregiving."]
+[10.679061889648438, 8.459809303283691, "Thank you."]
+[-1.6108179092407227, -2.071816921234131, "I think in most recent years, we've had the pandemic, which created greater isolation, even more so than before. So I think there's, although things are more open now, and people are gathering together once more, or were able to visit our elderly in more places, I think there's been an impact. For the many years that there was a lack of connection. Even now, the ability for some of our church volunteers to go back into some of these care centers to visit the elderly, it hasn't fully come back yet. So I think there's still some disconnection from, you know, the church community, we're not even able to go visit. And also, some, some of our elderly have family members nearby, but many children of our elderly have moved away, you know, the cost of living in Orange County is very expensive. So their children tend to settle and other areas where it's more cost effective for them. So then there's a distance there, and more challenges with staying connected to family members, especially children and grandchildren. And if if you're healthy, you're able to go visit but if you're not, then you don't get to see them as much. So I know those are some concerns that affect them in their relationships, and then also their well being because of a lack of connection."]
+[-0.6360163688659668, 2.581423759460449, "What barrier is just to see improvement in this area"]
+[2.7867634296417236, 6.072766304016113, "that's a good question."]
+[-0.14425227046012878, 2.3852999210357666, "barriers exist"]
+[-1.7370023727416992, -0.3656935691833496, "Well, I think for us as the church, you know, we're kind of waiting for more care centers to open up to allow visitors, things like that. I'm not sure if that's a barrier. It's just I know, we understand the situation"]
+[2.663581371307373, 5.9322590827941895, "Yeah, I'm not sure. I don't know if I have an answer to that."]
+[4.02375602722168, 7.253729820251465, "And that's, that's totally okay."]
+[3.6499998569488525, 10.96021842956543, "Um"]
+[-0.711742639541626, -1.0027210712432861, "I mean, I there are differences, but it's hard to really like, make broad strokes. I think, you know, some of it is based on kind of your culture and how your culture treats the elderly and they're positive. They're aspects of certain cultures that really help with the emotional well being but also other negative aspects that maybe bring them down. So there is that kind of there's differences, but I think there's pros and cons to All of them. I think also things like financial stability, affect emotional well being. And so that also varies across socio economic groups. So yeah, there may be some who, maybe they feel financially stable, but they don't have connections to family members. So that, you know, there's less worry and concern around finances, but maybe feeling a lack of connection or missing your family members. On the flip side, there are some who maybe their family is nearby. There is a tradition of gathering frequently and including your elders. Do I know what to do if there's an accident, or I'm diagnosed with something, but like really varies. So I do think there are differences. And I see differences people told me about the differences. But it's hard to it's hard to every case is pretty different."]
+[-1.3897985219955444, -2.0564019680023193, "I think it would be helpful if there is a broader awareness of maybe the loneliness and isolation of those who are elderly or who are sick or homebound. I think one thing that we try to share in our parishes to have more intergenerational ministries, where even right now a lot of our visitors to the sick and homebound are older and age themselves. So how can we encourage younger, you know, teenagers or young adults or those who are kind of the grandchildren age, to be a part of these ministries as well. So I think there, there could be a raising of awareness and an invitation for more people to make those connections with the elderly, so that they're not forgotten. And then, I mean, I think so much of emotional well being has to do with things, feeling that, you know, feeling cared for, and having things like your finances and your housing situation to be stable. So I think, you know, broader resources and stability in those basic human needs areas contributes to emotional well being as well."]
+[-0.36058276891708374, -2.2520670890808105, "Um, I think they're well, so in certain language groups, I think there's not a awareness of all the resources that are available to them. Some people understand that our health care system better than others, and so just even understanding, you know, the insurance and what's covered and how to get care, we encounter that, I think there's a great need for some navigation assistance. Some people have access to that, but not others, or they don't even know to ask for just even the availability of social workers, some places are really good about providing the social worker is to guide and others, you know, you have to ask for it. So it's pretty uneven Lee distributed, I think in terms of access to certain resources, and then certainly in your language. So I think that's also a barrier sometimes, although, I mean, all places, Orange County probably has a lot more than some other places. But I do find individuals are still struggling to get access and to know even what to ask. And then let's see. Sorry, I had had thought but it flew out of my mind as I was explaining my answer."]
+[3.4529154300689697, 5.940428733825684, "If it ever come back to you, you can you can mention at any point I'd be you want to so have some time to think about it."]
+[-1.540502905845642, -0.3422177731990814, "Oh, I think also, with things like advanced care planning, there are some groups who, you know, they take care of that as a part of estate planning or all that and and they get it done in a timely manner before there, they need to use it. But I do think there are many communities where advanced care planning is they don't even know what it is. And so I know that's something that we've been trying to do in the churches to inform our parishioners and raise awareness about the need for advanced care planning. And, and to be able to support them in doing that in their language."]
+[2.451719045639038, 6.919064044952393, "I'm."]
+[-0.70198655128479, -1.2349027395248413, "Yours I mean, I've heard, I've heard there are certain cultural groups. For example, with the advanced care planning, I've heard there are certain cultural groups that were that's very challenging. And I mean, I come from a cultural group where that has traditionally been challenging, but I've found that with, at least individuals that I've spoken to, there is more of an openness, or there's a recognition that this is important. And this is important to do. So I think maybe a barrier could be this perception that, you know, if we bring this topic up, it's going to be rejected outright. And that may may be a barrier or kind of a discouragement. But I think we should maybe overcome that and try anyway and find ways to raise awareness and educate families. I don't know exactly how, but I do. I've heard that there is a barrier, like a taboo. And I realized that too, because I've felt that in my own community, culturally, but when when you actually talk to individuals, or you allow space for family members to share their experience, and then there's opportunity for people to realize, like, Oh, this is actually really important. And this is a way of caring for my loved one, or preparing for things that are going to happen, or will likely happen. So I think that might be a barrier, at least with advanced care planning, and just kind of understanding what happens or what could happen as your health declines and you need to prepare to die. So I think the barrier is kind of this feeling discouraged, not wanting to offend in certain cultures. And we, maybe we need to overcome that and find ways to raise awareness anyway."]
+[-4.014839172363281, -1.8711374998092651, "But there are different experiences for different group of older adults from different backgrounds when it comes to healthcare access and delivery. Um"]
+[-1.8659666776657104, -1.2028008699417114, "I do see that those who have had either family members or friends or someone in their circle, who can really advocate for them as they go through a treatment journey, or you know, whatever it is, like, they tend to fare better and feel like they're being taken care of, and they get what they need. And those who kind of lack that advocating voice, don't necessarily get the same experience. So again, this is kind of I don't have like numbers to show but in just talking to different families or different ministry leaders. There is kind of an uneven experience and getting treatment or getting care, depending on whether or not you have an advocate, you know, whether it's your son who happens to be a doctor and speaks on your behalf or a parish nurse who says go ask them to do this. I think the advocate piece is for those who have it, it's very helpful and for those who don't, it could be a disadvantage."]
+[-1.691638708114624, -1.0831090211868286, "Well, I think even just education around the fact that you that you do need to advocate for yourself and then providing resources of the for people who can do that for you. So not everybody has children who are right there or has a caretaker or a spouse or someone who can play that Roll for you. Some people can do it themselves until you're in poor health. And then maybe you don't have the wherewithal to do that. So I know for us, I'm trying to encourage like faith community nurses, or parish nurses, so that at least there's somebody at our church community who can provide some guidance. Because if you have somebody like that in your family or circle of friends, that's wonderful."]
+[-2.0295114517211914, -0.8190234303474426, "When you think about caregiving, how a lot older adults struggling with this issue"]
+[-1.5573564767837524, -0.7493982911109924, "for caregiving, I think it's because some older adults are caregivers for like their older adult spouses. And so I think that's really challenging. There can be caregiver burnout, and then sometimes it's the caregiver who actually ends up suffering more. A lot of times, you know, family caregivers within the family, they're not trained, they're not medical personnel. Or they might have to give up their work prematurely to take care of their spouse. So I think there's kind of a reliance, maybe even an expectation of that happening and a family but not necessarily a lot of resources for those family members to rely on to do that successfully."]
+[-0.13786353170871735, 2.4216883182525635, "Um, barriers."]
+[-2.931769371032715, -2.2139194011688232, "We just have a lot of older adults. I know that's a barrier."]
+[-0.1278381496667862, 2.4226107597351074, "Yeah, I'm really struggling with the barrier question here."]
+[-2.3345694541931152, -0.9477914571762085, "I think it just like anything that prevents, you know, older adult from getting the care giving that they need."]
+[-1.4049140214920044, -0.7569218277931213, "Oh, I see. I see what you're saying. So I mean, I think with the caregiving issue, a lot of it is you know, lack of resources. So if you have, I mean, it kind of depends on your condition, right. So some people just need extra help. And it's at a level that your spouse can do it, it's not a big deal. But if you have greater needs, but not the resources to like hire someone, or then then it becomes challenging, or even if it's like a, you know, sometimes the health care issue does need to be taken care of by your spouse or your older child. But then there's still housework and financial management and just other life things that need to be taken care of. And some people can pay for that kind of assistance, but some people cannot. So I think some of that lack of resources, places a heavier burden on you know, spouses, but also children who are not so young themselves. I think now that our lifespans are so long, sometimes you're taking care of an older parent, but you're you yourself are in your 50s and 60s. So it's that places a heavier burden if you don't have resources and support to take care of not only the person who needs care, but just the regular household responsibilities and tasks"]
+[-3.9515109062194824, -2.0017809867858887, "their different experiences are different group of older adults from different backgrounds."]
+[3.6256766319274902, 10.952459335327148, "Um"]
+[2.306305170059204, 9.507838249206543, "yes"]
+[-1.5393061637878418, -0.33907151222229004, "So if you don't, or or if you have children or family members to informally care for you"]
+[-1.401305913925171, -0.6452809572219849, "it's the informal caregiving, I think, for some, there are burdens that are associated with it. But for others, it might, it might be actually more comforting to have a family member care for you. So there's, there's, you know, pros and cons to that. I think some people, if they're able, it's nice to be able to do that within the family and maybe even preferred. I think the burden or I think the challenge is, if it's more than your family member can handle then then it becomes difficult. For some people actually might prefer that. Whereas other people, maybe they can, maybe they can afford the home health and the nurse at home. But I don't know, that's great that they don't, but they still miss their grandchildren or so I think it varies and it kind of depends. Yeah, depending on your circumstances and resources and whether or not it's traditional for your family to be taking care of you."]
+[7.181373596191406, 6.162568092346191, "What do you suggest is the best way to address this issue"]
+[-1.3266892433166504, -0.7251586318016052, "I think resources for informal caregivers is pretty important. As I mentioned, as the population is getting older, I think there's going to be an increasing there, there's gonna be increasing number of families who are caring for an older person in their home or within their family, even if they're not living with them. And so I think just resources for those caregivers. Not even necessarily the actual older person would be really helpful"]
+[-1.260477900505066, -4.288147449493408, "Can you please describe how assessable and adequate geriatric care services in orange carry"]
+[2.5176801681518555, 7.817060947418213, "Or, I mean, what do you mean"]
+[-3.3250794410705566, -0.299409955739975, "jer cherry. Geriatric Care is basically just like any health care that are more toward older adults."]
+[3.6384048461914062, 10.963028907775879, "Um"]
+[2.172564744949341, 5.182239532470703, "I think there's there I think there's availability and there's been yeah, there's availability"]
+[1.0750868320465088, 2.3690497875213623, "Yeah, I think it's available and it's, it's accessible. I'm not sure that everybody gets to use it, but but it is, it's there."]
+[-2.197537422180176, 0.2889386713504791, "I'm not sure about like health care, because I'm not really. I don't like that doesn't come across my work specifically. Yeah, I'm not sure if I can speak to that."]
+[-1.258836269378662, -3.702796697616577, "That's okay. How assessable and adequate mental behavioral health substance use treatment services in Orange County"]
+[-3.241177797317505, -2.16084361076355, "for older adults,"]
+[2.3059136867523193, 9.508284568786621, "yes"]
+[3.64190673828125, 10.967037200927734, "um"]
+[0.9743667244911194, 2.364603042602539, "I mean that I believe is accessible as well"]
+[2.44826078414917, 6.72968864440918, "but I'm not sure. I'm"]
+[0.8344844579696655, 2.2450499534606934, "not sure how much it goes out. Like to the homebound for example, I think it has to be self initiated or someone has to initiate for you. And I don't know how I don't, I don't know that it reaches some people who might need it who aren't reaching out for it themselves."]
+[-0.7807466983795166, -3.8430540561676025, "Yeah. Can you please describe how accessible and adequate human social services in Orange County"]
+[3.1677989959716797, 8.93500804901123, "Yeah,"]
+[0.69320148229599, -1.2801647186279297, "I think that kind of varies, depending on what it is, I know a lot of elderly have trouble with housing, for example, not that they're going to be homeless, but kind of finding the right level of housing according to their needs, you know, kind of within their, their price range. Because, you know, some, there's a very broad spectrum between, like a nursing facility where you get 24 hour care and supervision and independent living. I think there's a lot of, there's a lot of possibilities in between and not all families know about or even know where to A identify what's appropriate for their older loved one. So that's something that we've encountered with housing at least Yeah."]
+[0.40044912695884705, 3.5420031547546387, "Challenges"]
+[3.0871825218200684, 8.389970779418945, "Oh, that's"]
+[3.645216464996338, 10.966344833374023, "um"]
+[0.2168126255273819, 3.492856979370117, "I guess I just feel like there's so many challenges already. I don't know I'm getting better or worse and we hope it'll be better in 10 years ah"]
+[1.206373929977417, 7.7315673828125, "well"]
+[0.5712685585021973, 3.605743169784546, "I mean, I think everything is challenging I"]
+[-1.9079391956329346, -2.051893949508667, "think there's maybe kind of the connections with just kind of staying included and a part of society. So I noticed I noticed digital divide is one of the lists on one of the items on your list here. And I think that's the, you know, increasingly we have technology tools and AI and all these things kind of infiltrating every aspect of our lives. And that that gap kind of grows as older adults don't adopt certain things. So whether it's in health care access, you know, I think a lot of our hospitals are using things. There's like an app where you make appointments, or you get test results. So I think there's that both of the technology and also even just recognizing that there's going to be more older adults with our aging population. And I do think there's a you know, if if, if nothing happens there, there could be a growing disconnect. Certainly on an individual level, for older adults who aren't, you know, adopting certain tools or staying connected to their family members, who are their children or grandchildren. So I think that will be a challenge that kind of keeping them connected with each other and with kind of the rest of the world as things are changing so rapidly."]
+[3.144162178039551, 8.425929069519043, "Oh."]
+[2.326939821243286, -0.07936547696590424, "You mean, in terms of like legislation, or funding or"]
+[1.7256311178207397, -0.036846060305833817, "Well, I do, I do think it, I do think the government should kind of ensure that"]
+[-0.7078745365142822, -2.408060312271118, "older adults have the resources and access to the things that they need as they grow older, whether it's, you know, the the human things that you mentioned, you know, housing, food, and then health care. And to, particularly to provide resources for underserved communities, to help kind of even things out there, I think that would be good for the government to do. I think there are nongovernmental organizations who are trying to do that too. But they need you know, financial support and and information and data and things like that. So I do think the government has a role in filling in gaps."]
+[-0.030014557763934135, -4.859405040740967, "Thinking about the older adult resident in Orange County, who is getting the least amount of attention"]
+[0.1565185785293579, -0.7164288759231567, "maybe the undocumented Yeah, definitely a documented and those for whom like English is not their primary language"]
+[2.2888872623443604, 4.176640510559082, "Yeah, I would say those are probably the main main ones."]
+[-2.237030267715454, -2.137321949005127, "I mean, I don't know. Yes, there are varying degrees of health and capability. But, you know, if people retire at 60, but they live till they're 85, that's like 25 years of contributions that they can still make to society. I do, I don't see that. I don't see that. As much as I think there could be, especially if there's going to be so many older adults, as the years go by like there's, I can't imagine that there's no space for them to be a part of our lives and"]
+[1.517215609550476, 3.4847757816314697, "in more than just a alright, I don't think that's part that's a need for them to"]
+[-1.1720010042190552, -1.646812081336975, "I say that, but I recognize that in a decade or two, I'm gonna be moving into the age of myself. It doesn't have to be work or a job but what role can they have in society in the community and in staying active and continue to share and I think that has to do with emotional well being to you know, feeling like you're still part of the community feeling like you still have something to do. There's still something for you to share with or contribute or bring life and meaning to so that's something I haven't really seen. Yeah."]
+[5.004079818725586, 3.4561100006103516, "So this concludes our interview. Thank you for your time, and if you have anything else to share, you can also reach out to us I'm gonna stop the recording now."]
+[-2.692479133605957, -4.783657550811768, "Good morning. Good morning. My name is Ron Barnes. I'm a part of the research team at Evangel. See in our in our organizations, the nonprofit conducting the county's older adult needs assessment. Thank you for your willingness to take part in this interview. And the purpose of this interview is to identify the needs of older adults and to gather insights from your expertise and experience. The information you provide will be used for the development of Orange County Master Plan for aging. This interview will last approximately one hour and with the With your permission, our discussion will be recorded for transcription and note taking purposes, the recording will not be shared. And it will be deleted after transcription. If you do not feel comfortable being recorded, turn off your camera and change your name attached to the picture. Your responses are confidential, meaning that we will remove identifying information in our report. Please note that your participation is voluntary. And you may choose to answer any question in part full or not at all. You may also withdraw from the interview at any time. If you're unfamiliar with any terms or use, please let me know. And I'll provide an explanation or definitions. Yes. Thank you. No. All right. So again, the primary goal of today is identify the needs that you think are most important to older adults and adult or adult population. Those 60 and older want you to think as broadly as possible, taking into consideration older adults, their caregivers, families and their community. So I'm going to share my screen and I have a list of common issues and concerns impacting older adults."]
+[1.8691372871398926, 6.460013389587402, "Hopefully you can see that"]
+[3.877976417541504, 5.140102863311768, "so I'd like you to take a few minutes to read through this and let me know when you're ready to move forward."]
+[-0.567848265171051, -3.834441900253296, "Thanks. So thinking specifically about older adults in Orange County. First off, for the record, could you please tell us your name, your role and how you engage or work with older adults."]
+[-0.5841892957687378, -3.7435271739959717, "My name is Dominic Makiko. Work with the Orange County Sheriff's Department. And we see or we we work with older aging adults, sporadically throughout the jail system in terms of providing resources, both in custody and post release."]
+[0.068323515355587, -4.136495590209961, "So think about my Orange County and looking at this list of common issues impacting older adults. Not that I see no. Okay."]
+[-1.8195080757141113, 1.34932541847229, "Behavioral mental health so anxiety, depression, etc emotional well being. And"]
+[1.435439944267273, -0.7430137395858765, "I would say housing, portable and long term housing options. Okay."]
+[0.6730807423591614, -3.2962751388549805, "Well, just just from where I or my team works with those individuals in custody, a lot of those individuals leaving don't have family and friends or loved ones. So they're leaving with nothing essentially. They do experience a high level of anxiety and depression because they are leaving without any of those options or people or loved ones. And, and many of them be complacent to short term temporary shelters, but they're looking for something more viable in terms of long term housing. Many of them are not working. And so affordability in Orange County is very challenging for those individuals to find housing options that they feel are appropriate"]
+[-1.4983149766921997, -1.9020309448242188, "Ah, you know, I think it's, you know, personal opinion is probably more wraparound services, both for the individuals who work at work within custody, and then post release, I think that a lot of them fall into drug addiction and, or alcoholism, because they don't have anything else to go to when they get released. So whether I mean, it sounds, it may sound, you know, unfamiliar but having a not necessarily a mentor, or aging population, but maybe just people they can talk to, I don't know if we want to call them mentors or not, but you know, people that can engage in conversation, talk to engage with check in with them, get them involved in other activities, which they are hobbies that they may have worked, or did prior to, you know, losing loved ones, etc, I think, thinks that those are some of the things I just don't know what the terminology would be for this population. I know, you know, traditionally we'd like to use mentor but, but something in that those lines would probably be really helpful. The other thing, though, is a lot of these individuals Leave and don't know how to navigate through the system, whether it be our healthcare system, or housing system, or even our, you know, reaching out to NA and a systems. And so having a, someone that we probably call a peer navigator. I mean, someone like a peer navigator that could help them navigate through the system to determine what they're eligible for, what they qualify for how they can get resources in the community would be really helpful."]
+[-4.166442394256592, -1.8443785905838013, "I would say yes, but at the same time, I would say even though the experiences are different, the resources that they need are very similar."]
+[-1.0280574560165405, -1.534360408782959, "I think it starts with, well, for me, because my you know, we work in the jail system, I think it's it's mostly developing reports and relationships with individuals when they're in custody, whether that be through Correctional Health Services, or Sheriff's Department, case managers. That starts the process of letting someone know that there, there's help for them, there's people form there's, there's assistance, as opposed to these individuals just leaving and not sure of what to expect when they walk out the door."]
+[-1.1368361711502075, -1.5237205028533936, "I would go back to say the same thing. I think it starts with the the in custody component of reaching out, starting to build a report, case management, follow up services, post release, direct linkage, as opposed to just, you know, flyer information. So we got to do, you know, some people say warm handoff, I like to think of it just as a literally whatever it takes, that means we got to walk them to the next person who's going to assist them or drive them to that next bodily, it has to be a direct handoff to resources."]
+[0.5891618132591248, -3.5112149715423584, "That was definitely education. So I think that that, to me is is finding the right people who fully understand how to navigate through the housing system within Orange County to assist these individuals with both short term housing, long term housing and even in shelters or temporary placement until they can get into the next phase so to speak, but I think it's finding the right people to navigate through the very complicated housing system, Orange County."]
+[-3.002737522125244, -0.2375406175851822, "Now, can you please describe how accessible and adequate each services Geriatric Care"]
+[2.744493007659912, 5.883387088775635, "Yeah, I honestly I'm not sure I can answer that specifically. Um,"]
+[0.9300473928451538, 2.1145942211151123, "You know, and connecting. Yeah. And that's so so some of them do provide feedback. It's it's feedback, because we follow up with them. Right. And the hard part is when when we say accessibility, there also has to be a once. And so I think, I think that's where I'm struggling a little bit, because I don't want to say there, the county doesn't provide accessibility, but I think there's a fine line between accessibility and the want to do it. Right. So if you don't want to do it, I don't want to say it's not accessible. Because the at that time, you may just not want to do it, right. But then there's also the other half of me that thinks that there may be a lack of accessibility, or confusion with what's accessible. And maybe that's why some people do not reach out to the services. And so I you know, I'm torn between the two, I don't have an exact answer for you."]
+[-1.431138038635254, -0.7294577360153198, "Again, that's a tough one for me, because we don't I mean, we follow up post release, but especially long term, the longer you go, the more challenging it becomes. So I think for us with the jail system, I think once you get past that six month mark, it's very challenging to continue to follow up and and determine what services are available and received. Right. And so I think the definition of long term may be different for different people. But for us, services are accessible for those individuals that that six month Bart it's hard to tell in terms of percentage and numbers just because we lose track of a lot of those individuals, especially if they're not on probation or parole. So for those people on probation or parole, we can follow up with probation and parole officers to determine what their success level is in terms of engaging in these resources. But for those individuals who are not on any type of supervised probation or parole, you really have to do your due diligence to try to track them down."]
+[0.697209358215332, -2.637695550918579, "And I know this is an interesting one, because I'm wondering if you have, you know, inmates that will be released to like a nursing home or some kind of long term care facility."]
+[1.0860227346420288, -2.5850510597229004, "For the most part, we won't and and that's because, again, the majority of them, it's voluntary, right. So all the services in the jail are voluntary. And so are individuals that we work with the majority of them don't want to get released to nursing homes right there. They, as crazy as it sounds, they would rather be homeless, then move into some type of nursing home with too much structure. And so what we hear a lot from our clients or our population is they don't want all the structure. They want, they want the comfort of the housing, but they want it on their terms. And so most of them will choose to be released to the streets, unfortunately, as opposed to going directly to some type of housing. That's why a lot of them choose shelters because shelters will allow them to kind of freelance with no restrictions, right you right, come in the morning, you get breakfast, you shower, you leave throughout the entire day, there's really no expectations and then you check back in at night. And that's what a lot of them like."]
+[-2.2586333751678467, 1.0820943117141724, "Now, this is the one that you talked a lot about how accessible and adequate our mental behavioral health and substance use treatment services."]
+[-1.5752294063568115, -1.8712338209152222, "I would say they're very accessible. I think we do a good job in the county of making sure those are accessible. The challenge is not enough. Bed Availability. So for people that do that require more than just outpatient care. They're looking for some type of residential detox residential treatment. That's where as a county we struggle with because we don't have adequate beds for those individuals."]
+[1.719351053237915, -2.6573970317840576, "I'm sure we do. I'm just not familiar with them. In our side of the shop, we really try to meet the client where they're at at that time. So Young, old in the middle doesn't matter, right. So in terms of us placing someone with a addiction problem, or even someone that's just homeless, for us, it doesn't matter. You know, in terms of age, race, gender doesn't doesn't matter to us, we just try to find them a place a safe place to go."]
+[-0.31169164180755615, 0.5425103902816772, "And then last service is human and social services."]
+[2.793911933898926, 5.849215030670166, "I don't have a fair answer for you on that one, to be honest with you. Okay."]
+[-2.3324761390686035, -1.4678435325622559, "Ah, you know, mental health would be probably a huge priority. And then most likely health care are aging. Population, one deals with a lot of mental health issues, which are not really talked about to be honest with you. And then our aging population also has a lot of health issues, and they don't know how to navigate through the system. So I think those are the two big challenges facing them."]
+[0.0827251523733139, 0.18524910509586334, "I don't know if we've ever done that. Because I think we we always assume what they need, but I don't know if we've ever gone directly the source to ask them."]
+[2.0674407482147217, 4.7141828536987305, "And we're doing that in this assessment. Just so you know."]
+[3.9200613498687744, 5.968424320220947, "Okay. Perfect. Yeah. See, there we go. Finally, finally getting there."]
+[-0.11764996498823166, -2.018860101699829, "Yeah, good question. So after, after identifying what the needs are, I think government naturally will have to provide funding targeted towards those needs. And I know one thing that's probably going to come up, and it's going to be a challenge for Orange County is finding suitable housing for these individuals. There's that whole thought of, you know, not in my backyard, you know, so you can put people wherever you want, I think it's a great idea, but just don't put them here. And so I think that's a challenge. And so from the government, I think, one funding to making sure we have resources, but then I think three is is added adequately educating the rest of our population or society, why it's important to provide these services to our aging, aging population. So we move on with our lives. And we're not at that aging point yet. And so people just feel like, well, they're gonna figure it out and do their thing, or because they've already gone through everything. They should have everything set up, they should know how to navigate through the healthcare system, or they should know how to deal with anxiety and depression, when in reality, they don't, you know, so I think educating the population is huge."]
+[0.1236950010061264, -4.78917932510376, "Thank, you know, thinking about all the older adult residents in Orange County, who is getting the least amount of attention."]
+[0.8700894713401794, -2.5910725593566895, "Ooh, that's a good question. I don't know. I mean, I'll probably be biased and say the ones incarcerated. Right, but I would I don't know. I mean, I would probably say that we forget a lot about the people in the nursing homes, right, like, because we, we assume they have meals and beds, that everything is fine. But I think those people are suffering from a lot of mental health issues just being there, you know, just being there and being alone. So yeah, I don't know, I guess I'll be biased because that's my expertise of the jails. But I think you could definitely argue for some other some other areas of the county as well."]
+[-2.3788440227508545, -1.49431312084198, "I would say mental health, I would say mental health, I think, you know, when when you showed me the list here, and I was going through the list, I think naturally, we start thinking about health issues, and we start thinking about health care, and we start thinking about homelessness. We just We just assume that, you know, because they have a health issue, meaning something more physical, right, that that's the number one priority, but we we neglect the mental health side of things. So I would say that, that mental health is a huge, huge piece to to our aging aging population that we overlook. Okay."]
+[4.723503112792969, 3.169872283935547, "So this concludes our interview. Thank you so much for your time, you've been credibly helpful, you know, to our research, and if you find that you have additional information to share, please feel free to reach out to me. Or you can contact us through our website, and that's oc.com and we also have an anonymous, confidential voicemail, telephone number 949-415-6898 that you can call anytime."]
+[5.093140602111816, 6.403743267059326, "Sounds good. Thank you."]
+[5.256502628326416, 3.609004020690918, "Thanks again and yes, I'll share with you or let me stop recording."]
+[1.0961908102035522, 5.346083164215088, "Out"]
+[4.755880355834961, 8.049450874328613, "Please"]
+[-2.728978395462036, -3.2630350589752197, "write. Hate the primary goal today is to identify what needs you think are most important to the older adult population that you serve those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families in their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through this list and let me know when you are ready to be able to see the list. No, no,"]
+[4.464788436889648, 6.242599010467529, "not yet. It might take a while. Sorry about that."]
+[4.522200107574463, 5.334757328033447, "And, you know, let me know if I need to make it larger, make it smaller. And we actually tried to figure this out when he easier to read but it may not be the easiest thing to read. So let me know I can totally score down or up or down however you like. So just take a few minutes to read through it and let me know when you're ready to begin."]
+[3.377822160720825, 5.4838409423828125, "Okay, yeah, you know, we can get started."]
+[-3.3894734382629395, -2.9950504302978516, "So for our record, can you please tell me your role and how you interact or engage with older adults."]
+[-1.2383922338485718, -0.8678750991821289, "You know, our organization. And I myself, we we work with unpaid family caregivers. Across the economic spectrum, we provide our services free of charge. And we're funded by state and federal funding. And we are the exclusive agency. Our exclusive group, our caregivers. And so we are part of a statewide system of Caregiver Resource Centers. Our services are not means tested. It's kind of been repeating myself here, I'm just saying another way that you don't necessarily have to be eligible for MediCal or Medicare. And because our target population are adult caregivers, caring for adult loved ones with cognitive impairments, the adult caregiver can be of any age 18 and over. We do have a large proportion of caregivers that are older adults 60 And over, usually caring for their spouses. And then we provide social support, which includes individual counseling, group counseling, support groups. And then we also provide information and assistance to a lot of older adult resources, because a majority of our folks work with older adults that are either frail or I have a cognitive impairment which includes Alzheimer's and dementia. And then we also provide tangible services such as respite care, which we pay for a similar to what Cal Optima pays for Kaeleen. But our clients don't have to be caring for somebody that's a Cal Optima member. It can be anybody and we provide respite, we actually pay homecare agencies to provide respite care. We also purchase goods on behalf of our clients sometimes to help them with durable medical equipment that's not covered by insurance for their loved one or, or assistive devices that helped them care for their loved ones or sometimes even things like incontinent supplies, which they are working towards getting covered through either commercial insurance or Medicaid or Medicare. So, it is a program that's been around since 1989. Now, we seem to add our data shows on a statewide level on a local level, is that a lot of clients, a caregivers are having to provide a lot of complex medical care in the home to their loved ones. And not only, you know, things like G tube feedings or changing dressings or, or managing multiple medications or administering certain medications, they're also doing this in the context of"]
+[-2.3227365016937256, -1.217327356338501, "folks with Alzheimer's or dementia, or clients that have Parkinson's, or that have Huntington's disease, ALS, or some of the other adult onset issues that occur. So, you know, those are the things that we provide. And what we're seeing in our population, the things that they're looking at, is one is the caregiver themselves, trying to get some emotional well being. And because it is difficult to provide care, especially if they're older, that emotional well being tends to also affect their health. Because as they're caring for their loved one, they tend not to care for themselves, or the older adult caregiver, that's one of the issues that we see happening, and that we try to help them avoid. That is, you know, we're as diligent as they are about taking their loved ones to their appointments, they may be foregoing their own appointments, or as diligent as they are about giving somebody their medications, they're less likely to maybe follow their schedule, as closely. Now, what gets woven into all of that, is economic security, especially for the older adults who, you know, every November or so have to decide about what they're going to do with their Medicare. So there's that kind of, you know, that exacerbates their not only emotional well being, but it also affects their economic security. And it also affects directly their health. So that's where we see especially the older adult caregiver, and caregivers in general, how Because Because, again, you know, a lot of a lot of our clients do we have a majority of clients that are working, not 30% are working full time over 50% are working, that one they want to because they're supplementing their income."]
+[2.8687663078308105, 3.4473791122436523, "I don't mean to cut you off, but we are gonna get back to a lot of these issues that you just mentioned. So yeah, so what I do want to refer back to this list. Oh, yeah."]
+[-1.4526132345199585, 0.13510183990001678, "So it would be the economic security, which I said, you know, caregiving off course, and then that emotional well being, and then kind of in the rank order, it would be for us directly. We deal with caregiving, and that emotional well being a caregiver, and then the categories that our caregivers are expressing is this health care access and delivery for themselves or their loved ones."]
+[0.19693496823310852, -4.117290496826172, "Okay. I actually haven't asked my question. No, no, no, no, no problem. No, thank you. Thank you. But I just want to make sure you know, I asked all the question in the correct sequence. So when we do the transcription, you know, I'm not missing anything. So that was that was question number one. Now number question number two, really referring to this, this chart or this graph. Let's start with thinking about Orange County and looking at this list of common issues and concerns impacting older adults."]
+[0.07128763198852539, -4.109703540802002, "No, I think I think that it's, it's, yeah. Okay. Yeah. The only thing I would say the only thing I would say though, is that this list Yes. The age range of people that look at this list is not these are issues that are very universal to a younger adult population. There's nothing magic about being 60. And over, that minimizes any of these things. Especially in Orange County, which is a very affluent, expensive place to live."]
+[-3.145613193511963, -2.2482688426971436, "I think that everybody that's an adult"]
+[2.438530206680298, 2.8223979473114014, "would have this on their list of issues. Okay, personally,"]
+[2.475189685821533, 3.7749381065368652, "I'm gonna have you do that shortly. So what I've actually right now, so of the needs on this list, right, including those that you want, you haven't you said that according to this list, you're not seeing anything missing. So just based on what we're seeing on this list, Please rank the top three that you feel are the most important."]
+[-1.344193935394287, 0.8307108283042908, "And this was for the older adult. So I would say health care, I'm sorry, health care access and delivery, that would include mental health, economic security. And I would say, transportation and mobility. Now, last lesson would be housing. I just want to pick four, three, or four, three out of four."]
+[-1.062684416770935, 1.004635214805603, "Okay. So I would go with economic security, health care access and delivery, and."]
+[0.5218867063522339, 1.1903966665267944, "transportation and mobility."]
+[-0.5409244894981384, 1.4380508661270142, "Okay, and I will ask a series of questions, short questions, or each of the three. Okay, so we'll start with the first one that you identify, which is economic security."]
+[0.2996756136417389, -0.8806754946708679, "I think it's the you know, it's a generation that was it's still relying on on Social Security is the primary source of income."]
+[1.4608949422836304, 8.858030319213867, "And"]
+[0.22291836142539978, -1.109724760055542, "our health care system with regards to Medicare, and premiums to be paid. And other expenses are the costs of living, especially those that don't have affordable housing is outpacing their incomes. So it cascades from, from that. I think that that's it, it's this as this this age group has still is still relying primarily on Social Security"]
+[0.765533447265625, -0.10625427961349487, "income. And very few"]
+[0.19060735404491425, -0.7897791266441345, "have personal resources or other retirement accounts that can supplement a lifestyle that make them relatively secure."]
+[-1.1417304277420044, 0.4180629551410675, "I think the cost of health care is one barrier. And the cost of housing is the other barrier."]
+[0.08327978104352951, 0.036050621420145035, "For example, where they live, their disability status, income, education level,"]
+[0.3112843930721283, -0.895643413066864, "I would say yes, I mean, those that immigrated here, and are able to have at least 40 quarters and with Social Security, have to rely on SSI or they have to rely on family. So I think the immigrant myself being from an immigrant family, you either start saving early or if you have family members that come over later in life, they haven't contributed to the system. So therefore they're not going to get as well. They essentially have to become impoverished to get anything from the system. So that that has some economic security issues. And again, you know, it's just a matter which popular which demographic we're discussing. I, I couldn't speak to, you know, the other demographics in terms of what economic security means to them or, or why, what barriers they have you know, other than, you know, maybe inequities and in in employment, discrimination when it comes to employment, whether it be, you know, the traditional due to race or just access to education at a younger age, or just access to opportunities. But yeah, I just don't feel comfortable speaking to that."]
+[4.11497688293457, 6.793632984161377, "That's fine. That's fine. Well, I think, to educate, what we do,"]
+[0.07680097967386246, -0.9764993786811829, "is we educate the caregivers that are not older adults, that are caring for an older adult, and families that are caring for an older adult. When we address that we we educate them on the realities of aging, and the cost of aging, and what they need to plan for in the future. It's not something you can start planning forward at the age of 60, or 65. If you haven't been paying for it before, then by either getting some sort of long term care insurance, or for somehow managing your finances or having a plan for creating your own social support system within your family, then you're going to have to rely on what what the system has. And I think that, you know, that's one of the ways education, but not education, as you're older, it's education. Prior to that, and also certain aspects of when you become an older adult, trying to understand how to make social security work for you. And some of these economic things, you know, I really don't know, I mean, I'm just looking at economic security is as it's hard to, to look at it other than it doesn't start when you're older. It just starts before that. And then after that, you're just at the mercy of how you and you and your your years of work, and have to rely on your own financial investments prior to that."]
+[-1.6947051286697388, 0.578943133354187, "That's fine. So now going back to the second issue, you identify, which is health care access, and delivery. Right."]
+[-1.9756466150283813, -0.5856080651283264, "I think part of it is the complexity of the healthcare system, the complexity of understanding your benefits, and the different forms of contracting, especially if you're on Medicare, and you're dealing with commercial plans, and having to re enroll every year. The cost of premiums, the costs of co-payments, how they are administered, the different contracting in a managed care environment, which most people are, are having to deal with. Managed Care is very difficult when you have to rely on a gatekeeping a primary care physician and formularies they change every year. So every year instead of having comfort in the fact that you do have Medicare you're also now have to think about which supplemental plan you may want to buy which supplemental drug plan you're going to have. And you have to balance that with how much it's going to cost you. And then, you know part of the other health care piece is understanding what is going to be reimbursed by your insurer. So that's it you know, that's what I that's what I said"]
+[-2.030845880508423, -0.8719251751899719, "It would just have to be a tighter regulation of the commercial market for which is, which is kind of unpopular. But yeah, streamlining, streamlining, the Medicare plans and streamlining the process for re enrollment and the formularies. bulk purchasing have a single payer system for pharmacy to get to start with, and really redefining the rules of some of the managed care contracting, so that, especially older adults, don't have to worry about being charged for something out in network or be worried about which whether they're seeing the right specialists or whether or not the drug is on the formulary, it's covered this time, and whether it's generic or non generic. So I think that that's, that's, you know, the solution would be expanding the Medicare benefit, and the medical benefit. So that once you're over the age of 65, there is no wrong choice in health plans, or Drug Formularies. And that, you know, the benefit follows you, you don't chase the benefit from, you know, insurer, insurer or group, medical group to medical group, it just goes with you. And it's applied equally to whoever you choose to be your provider."]
+[-0.5986968278884888, -1.2555872201919556, "Why I think the language capability, I think one is one because, you know, even even if you not only is it complex, even if you speak the language, like it's just the complexity of it all in, you really can't have a native non native speaker, hearing some of these complex explanations about especially when it comes to medical and insurance terms, in terms in formularies, to really understand it, unless they're getting it directly in a format that they already know and language they recognize and can understand. Because even that is nuanced. So you know, again, a lot of this definitely thinks those that are non native, non English speaking, when all the materials are complex, and complicated as it is, even in written form, they need some explanation. So I think that that's partly then and again, trying to get providers that are culturally competent. Because it's not always about the actual clinician that's providing the care that needs to speak the language. I think you always want to have the best, the most competent or the best clinician, regardless of what language they speak, but somehow facilitating at conversation, and that again, ethnicity does matter. For some people. Studies have shown that, at certain certain rate, racial and ethnic groups prefer different styles of medicine and in prefer different types of interaction. So you just need culturally competent and Representative clinicians providing the health care. And the next question you"]
+[7.121722221374512, 6.1266865730285645, "probably already answered or partly anyway, so what do you suggest is the best way to address this"]
+[-1.109958291053772, -2.2769086360931396, "Well, you know, promoting, promoting an understanding of the needs of an older adult in terms of language"]
+[-0.5726653933525085, -0.47224825620651245, "and understanding having some cultural sensitivities. So that that's it and then having clinicians that are representative of their culture when at all possible"]
+[0.5666518211364746, 1.1601567268371582, "And the third last topic that you chose was transportation and mobility."]
+[0.06214675307273865, -2.7116940021514893, "It's just the cost and the fact that we live in a very, there not a lot, there are not a lot of walkable neighborhoods in Orange County, in the sense that you could walk to your care provider or could be driven a short distance to your care provider, in any way, shape, or form or, or accessible to grocery shopping. It's, it's just you need to have the public transportation system is, is not does not facilitate that for an older adult. There are two, the windows of ride times and travel times are or are just too long. For some older adults, especially if you're impaired, sitting and waiting 45 minutes to a half hour prior, prior to an appointment or after an appointment adds adds tears, some difficulties accessibility for those that are that require accessibility that ambulation or are using an assistive device like a walker or a wheelchair. It's just the public transportations doesn't suit that in the private commercial transportation is expensive. You know, Uber requires a great deal of technological, you know, these little bit of technical savvy that. holder or no, they're just trying to catch up with. But also, again, it's not the least expensive way of travel, it's actually the most expensive or similar animals. So I think that that's why your transportation also leads to isolation. The lack of transportation, the lack of being able to get out sometimes limits folks who otherwise if they had transportation would be able to be less isolated."]
+[-0.7214755415916443, 2.2319610118865967, "What barriers it's nice to see improvement in this area."]
+[0.53141188621521, -3.322439432144165, "One is in are the barriers are the cost of door to door service, the limited availability of public transportation in Orange County. And the again, it's it would be just the cost of any other alternative transportation if you don't already, if you cannot still drive and maintain a vehicle."]
+[0.5772380828857422, -3.214334011077881, "I think it depends on how urban the urban communities the more residential communities in Orange County, I think where the socio economic incomes may be higher it is actually has less public transportation and creates more isolation for those that are living in those those neighborhoods that are considered non urban. And also your services are probably further apart. But yeah, with regard to ethnic you know, I just think it's more of a urban versus suburban issue with regards to the transportation"]
+[-0.01481691375374794, -2.63026762008667, "Again, discounts for seniors, increased bus routes at certain periods of the day and expansion kind of the what used to be the dial ride or access bus service with congregate trips"]
+[2.491008758544922, 7.331659317016602, "and maybe, you know,"]
+[-0.042063746601343155, -2.6064541339874268, "some sort of true ride sharing program that emanates From service providers such as number one be access to transportation services sponsored by the medical groups or health insurance companies that ensure that people get to and from their physicians an expansion of rideshare services to and from congregate meal sites and then an expansion you know how to deliver on delivered meals or, or services that can somehow can make and subsidize or make manageable the cost of having certain things delivered to the home instead of having senior get in and get transportation but, but I know I support, I think the solution would be more opportunities for the senior to leave their home than to have things brought to them to increase their socialization so so it has to be some sort of increased public transportation increased Agra ridesharing into strategic areas, whether that be shopping centers, health care centers, or even senior centers where other programs are occurring."]
+[-2.8672025203704834, 0.29580381512641907, "All right, moving on to the next set of questions. I'm going to give you four subcategories and I can I'll just read out the four read all four and then I can we can come back to each one of them. Okay, first one, geriatric here. Number two, long term care. Number three, mental or behavioral health or substance use treatment. Number four, human or social services."]
+[0.9043757915496826, 2.3708102703094482, "How accessible."]
+[-2.912041664123535, -0.7015525698661804, "for geriatric care. I think it's probably I think it's, I think it's adequate. I'll give you think it's adequate. And I give that with a very biased perspective. In that there are a lot of physicians, primary care physicians that work with a lot of issues that not only older adults have, but younger adults have. And I don't know if Geriatric Care necessarily addresses it any better sometimes. And so I think that we can always use more geriatric physicians don't get me wrong. But I think we just need to educate physicians that we have now that are working in a primary care world to see geriatric issues similar to other disease groups that they would screen for. Because there are the physicians are out there to create another subspecialty creates another Access Challenge for seniors. Because if you're telling me that my primary care physician who happens to be across the street is not the best position for me, but that I should take a 30 minute bus ride, if I could get one to a geriatric physician that's in another city. That's probably going to limit my ability to get even a cursory screening for some of my issues. So that's why I'm a little bit suspect about these specialties. It just creates a demand and it creates a perception that even just on the base level, you have to go there or you're not going to get what you need. And I'm, and I think their perspective is it's been Better to have something than nothing, or have something and hope for the perfect and habits so inaccessible, that it becomes detrimental. So, so I think geriatric care with regards to the initial screening is fine. It doesn't most geriatric patients that we work with, end up seeing a specialist anyways. There isn't a general geriatrician, but is actually dealing with the cancer when dealing with the Alzheimer's dementia or dealing with the Parkinson's are dealing with the liver functioning or develop delivery, you know, dealing with hypertension. You know, they're already seeing specialists. And the specialists, you know, work on titrate. And so, geriatric care, I think is is fine, long term care is, is only good for those that have mediCAL, and everybody else is just struggling, I think the long term care is unaffordable on two levels at the skilled side, unless you are there for acute care covered by Medicare. And for long term, it's just inaccessible to the average family to pay the rates that exist without some sort of subsidy. And I'm talking about assisted living residential care facilities for the elderly, and for even, you know, memory care. It's just, it's just not affordable. So similar to affordable housing, it's very in Orange County is very poor. Because of their cost of real estate, provide different reasons, just mental and behavioral health. Yeah, that's it's under, it's not provided well. But again, it's it's something that is on even for, even for adults that are commercially insured, there is no mental health equity. So it's still I would rank that as very not as accessible but could be improved. So sign scale, you know, again, it needs to be improved. human and social services. Ah, you know, I think that, that there are a lot of programs. They're just not well coordinated. And the incentives to coordinate are not there. Because of the way they're funded. Especially the governmental programs experiences that government programs are relatively inefficient, and very, very expensive to run, and I run a program that state and federally grant funded. And I've worked in government, and I've just seen it, it's just, there's just no sensibility sometimes in managing the money well, and redirecting it in the right way. So I don't know if I did a good job of that. But, but I think that just going down the list here, you know, long term care. Options in Orange County are kind of poor, not very good. mental and behavioral health is just not good all around. At any age group needs to be improved human and social services. I think they're fine, but they need to be improved, because they're not gonna say fine. I think there's a enough, they just need to be very coordinated. And the issue of Geriatric Care, I think there's enough, again, we just need to educate the physicians we have without having to create a whole sub specialty again, where you have a few far between end up forcing people to chase something that may not help them or overlook a resource that's more available. So I think we should you know, we need to train train our train the dogs, so I don't know if I answered your question. Thank you. Okay."]
+[0.14365412294864655, 3.4631433486938477, "Now, what do you think will be the biggest challenges for older adults will face in the next 10"]
+[0.12506474554538727, 3.4423108100891113, "I think the same challenges that we've had since I started it's always about been about it when I say that. I heard I heard the term silver tsunami. I graduated with my master's degree in 1988. And in 1989, I worked professionally and silver tsunami was what everybody talked about. So that's over 35 years ago. Nothing has changed. Nothing has changed. It's always been about health care, it's always been about affordable housing, it's always been about minus the first three I pick, it's still going to be those things. Because their foundation."]
+[-1.7237240076065063, -0.7705274820327759, "If you always feel like Medicare was going to go bankrupt in 1990, here we are 25, 30 years later, Medicare is going to go bankrupt in 2025 2425. It's a very cynical view, except for the fact that I, I can actually go back and your archives, microfiche, and you can look at the headlines on aging issues, and they're all the same."]
+[-1.9332730770111084, -0.7314522862434387, "You know, it's just really, it's those things. And I think that it's just because we adapt to it. As we get older, that it just we're always behind. You know, Medicare was never enough. Or in terms of finding providers, you know, your Social Security benefit was remember more than enough, boarding cares, were never really the first choice. And paying for them was always difficult for families and older adults, long term care facilities, again, you wanted to pay with medical, otherwise, you choose your Medicare and your days, nothing's really changed. And actually, it's gotten even more complicated when managed care kicked in. So I think 10 years from now, I wouldn't be surprised that we're still talking about this same list. is the same one we use that is what we use now. So it is it is you know, it is a cynical view, but it's probably I would, I would I would say just based on experience, I don't know where if 10 years is really enough time to transform anything. Certain changes have been made, there probably are some improvements. But again, it's it's it's still, I would still say that this list would be very, very resonate well, 10 years from now. And I would suggest that if you're talking to me 10 years from now, I would pick the same three items that I think today."]
+[-0.9615086317062378, -2.8392486572265625, "Now, in your opinion, what do you think the government's role should be meeting the needs of older adults in"]
+[-0.309793084859848, -2.9848077297210693, "Yeah, you know, I think that the government's role in Orange County, probably would be I think, I think that they need the government's role in Orange County should be to support the independent nonprofits"]
+[1.4601223468780518, 8.85831069946289, "and"]
+[-0.49618810415267944, -2.347487211227417, "businesses that address the needs of older adults, to be supportive of them in a way that eliminates to the best that they can some of the inefficiencies in in how funds are distributed. And that's difficult to say I I don't know. I mean, so that's a philosophical, political question. And I just think that sometimes it's it's the government's role is whatever it's mandated to do. And if they're mandated to do something to do it in a way that it probably is, eliminates as much of the complexity or red tape, so to speak. I don't know if I mean, I don't know I think, again, affordable housing is not just a senior issue. It's an everybody issue. And our local governments are having a hard time dealing with it. On a broad level, much less even the local level. So I think that government really is something that we cannot rely on to provide the comprehensive solution. So government's role needs to be to partner with local nonprofit agencies, but to take the lead from them in terms of understanding the efficiencies, and service delivery that they extended"]
+[0.0953005850315094, -2.3116657733917236, "that. You know, there's the right one. So, so yeah, that's a that's a difficult question. So to summarize my answer, I say, the local government just really asked to have a role as a partner, but not not necessarily the lead the lead, they should be directed by the service community. And, and their role is to minimize the difficulties in accessing funds and spending them efficiently."]
+[0.10121434926986694, -4.868177890777588, "Now, I'm thinking about all the older adults residents in Orange County, who is getting the least amount of attention."]
+[-0.5163669586181641, -1.273614764213562, "Oh, I think that definitely the folks that are not qualified for any of the entitlement programs. I think that as a percentage, a lot of the programs that address those that aren't means tested. still require. And I'm talking about title three programs, even though they're not means tested, which means they're available to anybody that's 60. And over, they still require that half of the people you target would qualify for entitlement programs anyways. So the people that are really being missed. And especially because in my organization, that's where the carrier resource was created to address families that didn't meet any of the entitlement requirements. There definitely is that middle is that middle income family, that whatever that is, nowadays, they cannot afford the daily weight of a licensed nursing care facility, Oregon care, or can pay for in home care. on a consistent basis. If you can afford that, it's an inherent is. It's never it's never it's not that there aren't services available. For somebody to live in the community, and thrive in the community. There are services and vendors and providers. It's just can you afford them. And if you can't afford them, you're at one end of the continuum. Relatively, I would say wealthy in this day and age, if you consider that a memory care facility can run anywhere from starting at 7000, up to $11,000 a month, you know, memory care, to impoverished America where your benefit as a MediCal beneficiary, and if you're lucky enough to be medical and Medicare eligible with no shared cost, you're community based, and even healthcare options are far more robust than the average retiree that has maybe a small 401 K or even Airties 401k has maybe a small pension because they worked a job and they're Medicare and are just trying to live off of that in a home. That nowadays probably you might have paid off, or you still may have a small mortgage on those who are when's that at 65 and 60. When you know 62 They're the ones that are struggling is the older adults, they're working till they're 70 to 75 because that's just what they have to do to pay for their gas pay for their utility bills. Because we see that a lot, because again, our clients are caregivers, family members, and they express this, they see that they're caring for their loved one. You know, how am I going to deal with this, my mom and dad, or my aunt and uncle or my spouse is lucky, I'm here to be able to support them. And even I'm struggling. Because I have to supplement some of their things to give them the care that they need. So, so I think that that's, you know, I even forgot the question, but that's where I see this."]
+[4.3253302574157715, 6.567657947540283, "No, no worries."]
+[0.39038512110710144, -0.10442421585321426, "But that's the group. That's the group that middle income."]
+[0.08237497508525848, -3.9180614948272705, "Okay, so thinking about all the issues facing older adults in Orange County, what issue is being"]
+[2.259310007095337, 2.890592575073242, "I think, you know, I think we've overlooked"]
+[-0.3602498769760132, -1.8067374229431152, "I think the only thing I would say, is that have we we kind of overlooked, maybe coordinating the resources that we already have. It's not that it's not that, you know, these are not valid issues. But, but maybe consolidating them and saying, Look, if I'm looking at emotional well being, then I'm addressing behavioral and mental health. And then I'm also addressing health care. So maybe collapsing these things into broader categories. If I'm looking at economic security, well, that also means I'm probably looking at housing. And, and there's this old adage about legislating by body parts, you know, you create laws and things to, you know, this is how we're going to pay for you to address an issue, and a person's right index finger. And we're gonna have a set of rules and laws and reimbursement methodology for how to reimburse you for character, that right index finger. What are we going to, and you start to have all these competing legislative interests that don't work well together. And so I'm looking at some of these things and thinking, you know, there still is a bias to, in terms of older adults already account for huge amounts of the federal budget, just in Social Security, Medicare and MediCal alone."]
+[2.811211109161377, 0.0639154314994812, "From a policy level, I think we just need to look at that. And see."]
+[-1.7079144716262817, -0.6820940971374512, "These are all real issues. But if we keep looking at them individually, we're never going to have to be, we're never going to have enough money to address them individually. And the more we as a group, or as an advocacy group, you know, say that we need more and more and more, the less and less, it becomes a legitimate ask, when you look at what's already being spent out there. And I'll share this with you. I used to work with people in my other professional life that wrote Medicare regulations. And they worked in Washington, DC, and they just, you know, just kept pointing to the budget and had kind of, you know, after work and just in casual conversation, yeah. You know, this is always a federal government spends more on people 60 And over than it does in its defense Budget. And this is even after 10 years of Afghanistan, you know, fighting that we actually were at war, and our defense budget is still reasonably a little bit more maybe even a little bit less than what is being spent already on older"]
+[-3.1638331413269043, -2.2176380157470703, "adults."]
+[-2.1936099529266357, -1.579108715057373, "Just because older adults are high utilizers of health care, older adults, or are using Medicare, Medicaid, there are social security benefits, which is fine. And, you know, that in and of itself is something so, I think that where we need to look at is, hey, we need to start grouping these things. things and not and not creating competition between, hey, you know, we're just going to look at Alzheimer's and dementia, but we're not going to look at hypertension or Parkinson's disease, or we're not going to look at this, you know, everybody, everybody has a special interest within a special interest within a special interest. You know, well, emotional well, being doesn't mean mean anything. We need more behavioral health. Well, you know, maybe is just an offshoot of emotional, you know, we can't be raising money or, you know, being so siloed in our thinking with these issues."]
+[3.0566484928131104, 4.808903217315674, "Okay, so I'm doing a time check. It's world six, I have a few more questions. And again, you were continuing. Okay. Yeah. All right. So in addition, I'll try to speak up a little bit, a little bit. Now, in addition to what we have already talked about, let's dig a little deeper into your area of expertise."]
+[-0.5877225399017334, -2.862255811691284, "Oh, you know, older adults in Orange County. What's working for them is that it's a very, it's a cohesive system. Orange county's fortunate that we have one, one organization that is dedicated to the caregiver, at any age, especially the older adults, and it's already integrated through the Office on Aging, with the other title three programs, and is also integrated, or works with, collaborative with individual nonprofits. So in that sense, that's where it works, because at least focuses the state and federal funding at one level. And and which comes to the cost, then is, we're able to, to work with others, to maximize the use of that. You know, I think it's just the same thing that that happens everywhere. If when you have older adults, caring for another older adult, or somebody that's impaired. There's no supports to ensure they run into the same issues that the older adult does, with regards to what I said, economic security, my short being, but I'm going again, you can't fix up but at least we have an agency like ours that can address that. And I think the focus should be not to create more agencies, but to again, consolidate and, and work on issues. That are specific. I mean, what I want to say is that organizations can't specialize in everything. So we don't we don't specialize in everything that works with older but we do specialize in working with caregivers at any age, and address their issues and point them in the right direction so that we can have no wrong doors. They can access what they need to access, whether they're the caregiver or it's for their loved one their caregiving. I don't know. I think what doesn't work is when you have a lot of competing interests, and you get a lot of silos where people just focused on. Caregivers just don't deal with Alzheimer's and dementia. We work with that. The caregivers deal with Parkinson's caregivers deal with hypertension caregivers with a lot of other comorbidities that go with that. So you can't have a specific agency all the time that says we only work with caregivers that work with Alzheimer's. Yeah. So what works is, you know, again, kind of putting these things together. So I think that that's where we do well, where we don't do well, I would, I wouldn't. I don't want to. I wouldn't want to say that we don't do anything well within our area caregivers, but we're always just limited by what we're funded. And that's all you can. All you can say is the funding could be is always limited and sometimes a little bit short sighted."]
+[3.0295767784118652, 0.060674455016851425, "What new or revised policies are needed Writing, again, your your area of expertise."]
+[-1.1654750108718872, -0.7553197145462036, "Oh, yeah policies, I think a lot of it would be like tax credits for family caregivers. Additional lead time for family caregivers recognizing that similar how they recognize maternity other family leaves, because we're finding a lot of caregivers are are providing more care, more supportive services to families at discharge from acute care and long term care settings, more statutory requirements, that these long term care discharges from acute care and rehabilitative facilities. And even physicians that they refer back to that they address first and foremost that they address and identify the family caregiver when they know that we're working with somebody impaired, and that they be more strongly there already, but more strongly mandated to seek out the Caregiver Resource Center system, which is statewide, I mean, every every area in California has a caregiver resource center that they can refer and identify family caregiver to. So I think that that those kinds of policies, you know, addressing the financial needs of caregivers, whether it be through tax credits, or through additional Lee, and non discriminatory, you know, not having your employer say, oh, you know, we might not hire that person, because they're caring for an older adult, you know, things like that. So those are the kinds of policy changes that I'd like to look at"]
+[-0.054452985525131226, -2.864497661590576, "Well, I think the biggest area is our legislature, they can pass those laws at the state and federal level, especially when it comes to to taxes and especially when it comes to family leave statutes."]
+[1.9067833423614502, 0.9537291526794434, "And what sources what sources of data do you find relevant to your work, if any of"]
+[-1.1742403507232666, -0.9250227212905884, "you, we, we collect, we do our own. We do our own needs surveys, we, we actually report to a statewide evaluator. So we look for that data to come back to us we we actually ask our caregivers what they think they need. Again, the demographic of a family caregiver. They exist in every demographic. They exist in every culture. They're not just limited to a zip code area. You know, they're not just you're not going to find a pocket of family caregivers, out in Silverado Canyon. that's any different than family caregivers that are in downtown Santa Ana. Family Caregivers exist everywhere. And again, across that age, from 18. To on up, so I think that the data were looking for is data that reflects what their needs are, and what are the needs, what we're hearing, is that I'm being sent home, or while I'm having to care for a loved one at home, with complex medical needs, that I'm not trained for. And I need training, because the alternatives of placement are not really an option for us at this time. So I think that that's part of what you know, we're I think that that's the kind of data we need, that that kind of experiential quality of data that we collect from our caregivers that are telling us this that I need, I want to be trained. And then I also want to have information on how this can be financially doable with what I have, or what my loved one has. So that I'm not spending money or losing resources, I happen to provide care."]
+[-2.1401584148406982, -2.0018630027770996, "I think that there might be I'd have to think about that. But I would, I would say that knowing who you are going to talk to, I think yeah, the bases covered. I just think that again, the master plan. for aging is not just about talking to people 16 and over. I think the master plan for aging is talking to folks, especially caregivers that are experiencing vicariously, not vicariously, but through experience of being a caregiver of what they can anticipate when they get. Because they're seeing the issues from a whole different perspective. And they're trying to prepare for it. And the master plan for aging, I think provides provides everybody an opportunity to see what it's like to age and address those issues and some of the people that are best to kind of talk about what they're afraid that they see happening when they get older. I will tell you, because a lot of this is not coming what I'm what I've said is not going to resist from reading the charts looking at the population we serve. You know, it's not Jack like thats saying Gosh the medical medical system is complicated, even though I would say that myself is my caregivers, caregivers, we serve to say that Medicare doesn't cover that. It's how much to pay for in homecare, it's how much to pay for, you know, give me You mean that a long term care facility is, is I can find Medicare for long term care, but I can't find medical for assisted living or memory care. It's that it's that kind of thing. Now, it's more about what are we doing for the 40 somethings that are caring for the 70 Somethings, and then realizing that I'm not too far away from that. And, and especially those that run into a disability at the adult age, that all of a sudden become disabled, which is also part of this master plan. What happens if I become disabled, prior to age 60."]
+[2.4331576824188232, 6.86827278137207, "And I am not"]
+[-2.008939743041992, -1.154772400856018, "qualified yet or a median, that middle group, but I'm not going to be fully disabled, I am functionally impaired, that I essentially I am having to address the rest of my life in much the same way that we're kind of describing the challenges of the older adult. So again, I think that we talked about, you know, caregivers are a great, great, and the younger caregivers are the great ones to look at and get fresh eyes and say, hey, you know, you they'll tell you right away what they think the problem is because they don't want to experience what some of some of them are experiencing with their loved ones, the surprise and the shock of what it takes to really be age well in this in our society. Right."]
+[4.7731099128723145, 3.1752254962921143, "Yes, by all means, right. So this concludes our interview out. Thank you so much for your time, you have been incredibly helpful to our research. You know, if you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website, www.advanced oc.com. And you can leave an anonymous voicemail on our telephone line. And then of course you can just also reach out to me."]
+[4.706228256225586, 5.009018898010254, "Hey, I'm sorry, I got on there late Tammy. Sorry. I'm sorry, I got too late."]
+[5.320568561553955, 3.5936338901519775, "Oh, no, no, no, not a problem. I'm going to stop the recording now. Okay."]
+[4.165470123291016, 7.620641708374023, "Okay. All right."]
+[-2.6836650371551514, -3.257371425628662, "To the primary goal today to is to identify what needs you think are the most important to the older adult population you serve. Those are 60 years old and older. We want you to think as broadly as possible taken into consideration of the older adults, caregiver, families and their community. I'm going to share my screen so you can see a list of common issues and concern impacting older adults. Please take a few minutes to read through this list. Let me know when you are ready to begin."]
+[-0.4529421329498291, 2.5372581481933594, "Yes, these areas definitely resonate."]
+[2.1886675357818604, 5.5063371658325195, "Yeah. On the bottom"]
+[1.83626389503479, 2.4014029502868652, "yes, there very extensive This is good."]
+[-0.25973770022392273, -4.217495918273926, "Think specifical things specifically about older adults in Orange County."]
+[-0.9568933248519897, -3.2938852310180664, "Certainly, my role. At Second Baptist Church is Executive Director of Operations. I interact with all members of the church and encounter senior citizens who attend or are at home home based but consider themselves members of the church. We have over 3500 members and I would venture to say about 40% of them are over 50 probably 35% or over 60"]
+[0.19180890917778015, -4.153248310089111, "Thank you thinking about Orange County and looking at the list of common issues and concern impacting older adults. Is there anything that missing from the list"]
+[2.6214611530303955, 4.825558662414551, "I don't I can't think of anything. Just when I something comes to mind I see it on the list. So it's very good. Thank you. Just one one item Wait let me just double check I'm sure."]
+[-0.6338654160499573, -2.4822466373443604, "Where senior citizens are bombarded with telemarketing phone calls and are subjected to financial hardships as a result of pursuing something that is being offered to them."]
+[2.4868226051330566, 3.7418441772460938, "Thank you for sharing. Of the needs on the list including that you have suggested. Please rank the top three that you feel are the most important"]
+[0.5818690657615662, -1.711766242980957, "that's tough. Um I think affordable housing would be critical for senior citizen, I think emotional well being which kind of ties to Alzheimer's and dementia and"]
+[-0.820795476436615, -0.7568279504776001, "maybe emotional isolation they may have lost a spouse or their children don't live in the area."]
+[1.1694517135620117, -1.2022041082382202, "Good, thank you. When you think of affordable housing, how or why are adults struggling with this issue."]
+[0.5646902322769165, -1.4912488460540771, "Unfortunately, they probably are retired or should be retired and their financial security is much more volatile than perhaps someone who's younger and able to work and gain the resources necessary to pay for their housing. I also am concerned about the increasing cost of property taxes. You know, a senior citizen going into retirement thinks that their property taxes are going to be at one level, but as they continue to escalate, but that person is retired, that really takes from the limited funds that they have. And the fear of becoming homeless is increased exponentially."]
+[0.7065318822860718, -1.7644572257995605, "What barriers I think, the I'm not an expert in this area, but I am not seeing a whole lot of affordable housing that is safe and structured for senior citizens, meaning they may have mobility issues, or transportation issues where they might need to use public transportation. Excuse me, or maybe wheelchair bound. I don't know of a lot of affordable housing that accommodates those, those concerns and challenges."]
+[-4.191360950469971, -1.940824270248413, "Are there different experiences for different groups of older adults from different backgrounds."]
+[-0.25693947076797485, -2.372166395187378, "Absolutely, language is a big barrier in Orange County. So being able to communicate with those that they encounter, if they need assistance, is a challenge unless they have someone with them, who's able to interpret for them. I also think that there are fears associated with whether or not someone is a legal citizen. And, you know, harassment that sometimes occurs from governmental agencies, fear of perhaps being separated from their family members, is another dynamic in in the diverse population that we we enjoy in Orange County. And then racism is huge, not only in the Asian or Latino, but also in the black community. Here in Orange County, that results in people receiving poor care and treatment in the hospitals or at the doctor's office, if they are experiencing pain or some kind of symptoms seeking relief. The assumption is that they're perhaps just seeking to use drugs, which may not more than likely is not the case. They just need some help and some relief. And we've we've seen that in Orange County as well."]
+[0.8062795996665955, -1.71187424659729, "I think it has to be a collaborative effort to understand the needs of senior citizens, from senior citizens and then with real estate developers who have the ability to create communities that are safe and accessible for senior citizens. I also think that city and county government can provide incentives for developers to to create affordable housing that specialized for senior citizens, perhaps who are wheelchair bound have encounters that are lower, and just making accommodations for them. Even like in the tubs, you know how we see. Walk in tubs that are available for seniors who perhaps can't lift their legs as high as a younger person. Those types of accommodations really need to be sought out and provided for senior citizens."]
+[-2.828589677810669, -1.680507779121399, "So when you think about second item issues that you think that is the most important for older adults, which is the emotional well being Yes, how are why older adults struggling with this issue."]
+[-1.5666615962982178, -2.2094714641571045, "Um, because I, I, when I encounter older adults, I see a marked difference between those who have family members who are residing and interacting with them. And those who do not. So there are many senior citizens who are either widows, widows, widowers, they're their family members no longer live in Orange County. Perhaps as they get older, their friends have passed away. And so they become isolated, and almost retreat in a shell if they're not able to get to church, or their community organizations, that that creates even more loneliness and separation, which has a major impact on their mental capacity."]
+[-1.3469173908233643, 1.7108256816864014, "What barrier exists in seeing improvement and this emotional well being area."]
+[-1.37971031665802, -2.4161746501922607, "So I think there is a lack of safe safe spaces for senior citizens to find community. That is kind of an alternative to perhaps family members, or church or just a social environment where they can go and enjoy life with people like minded people in their in their age group. It may be a diverse environment, which is wonderful. But just allowing them to create community with people of their own age, or even younger people. I've seen programs where grandparents are volunteering at elementary schools, and they're able to speak wisdom into the children, but also enjoy the effervescence of young people in their lives and build relationships that nurture both ways. So those are some of the thoughts that I have."]
+[-4.181089401245117, -1.939092993736267, "Are there different experiences for different group of older adults from different backgrounds."]
+[-0.2195555418729782, -3.520599365234375, "I would imagine so, um, I think culturally there are different celebrations festivals that some groups enjoy that others have no idea about, but maybe they would be interested in learning. I think there's a great opportunity for Orange County to share those festivals in the meanings behind them with one another to amplify and perhaps broaden the the perspective of people from different cultures."]
+[-0.45440635085105896, -3.2455365657806396, "I think addressing it, calling it out. Ensuring that Orange County is communicating with those who are entering into their golden years and those who are caring for those in their golden years. That emotional well being is critical. The mental health of a senior citizen is critical. And there are certain hygienic mental hygienic practices that can be implemented to help stave off loneliness and isolation. There are venues that are warm and safe and welcoming to people who are senior citizens and let them know that there's a plan for them, that they are valued and needed in our society."]
+[10.725491523742676, 8.379124641418457, "Thank you."]
+[-1.4665625095367432, -2.1165833473205566, "Well, I think about some of the members of our church and unfortunately their children are not in the home, not as not visiting them as frequently as perhaps the senior citizen would like. And then there are some physical limitations that the senior citizen has or can have, that would hinder them from being able to get out as much as they perhaps would like. So they would perhaps rely on someone coming by to visit them. Is this person going to, you know, care for me, and be honest, and not try to take advantage and perhaps steal items out of my home or steal my identity or, you know, get access to my bank account. And we've heard terrible stories in the past of, you know, senior citizens who have caregivers that have taken advantage of the situation. So that is a real fear. And perhaps if we had some organization that is certified and has background checks that can come in and provide some kind of companionship to that senior citizen on a regular basis, perhaps that might might help."]
+[-1.281591773033142, -2.4401466846466064, "I think there's a limit of there's a limitation of volunteers. And there's a shortage of volunteers, I should say, from various diverse backgrounds that are able to end desiring to communicate and to be a part of the lives of senior citizens. Some, some cultures value their elders and nurture and care for their elders, in a very significant way. Others don't, and unfortunately, senior citizens, who seem to require time and desire time from people are looking for the most precious commodity that people have. And they younger people have not given a whole lot of time and energy to ensuring that they're spending time with senior citizen."]
+[-4.180914402008057, -1.9551411867141724, "Are there different experiences for different groups of older adults from different backgrounds,"]
+[-4.02604341506958, -1.6797631978988647, "different experiences, I guess, they're just like we are diverse. In race. There's diverse experiences that will cause someone to light up and get excited and others. Not so much. There's crafting, there's religious practices, there's athletic activities that resonate with different people."]
+[-0.8125371336936951, -1.98103928565979, "I think that the best way is to devise a plan that is multi prong multifaceted with multilingual aspects to educate and provide safe spaces where seniors can practice good self care, mental health, well being classes and participate in activities that help them to address perhaps some of these other issues that can surface in their lives if they are applicable."]
+[7.174994468688965, 4.670353412628174, "Thank you for sharing."]
+[4.73747444152832, 4.115188121795654, "Katie,"]
+[0.9384549260139465, 2.4487152099609375, "Now I can. You said Please describe how accessible is the and that's where I lost."]
+[-1.2751548290252686, -4.304561614990234, "Okay, can you please describe how assessable geriatric care and Orange County"]
+[-1.1839746236801147, -4.154244422912598, "Well, um, I have very little knowledge around geriatric care in Orange County other than I have seen nursing homes and adult daycare centers throughout Santa Anna and and Orange County, but my limited knowledge is it's extremely expensive. And not all of them are as clean or staffed with people who are as nurturing as perhaps some would want."]
+[-0.28514933586120605, -4.1088080406188965, "I have no idea what what those are for Orange County."]
+[-1.147385835647583, -4.146284103393555, "No, I understand what the long term care is. But I don't know. For instance, in Los Angeles County where I grew up, right, I know of long term care facilities that that are near my mom. Right. But I don't know, of long term care facilities in Orange County, because I just haven't had a need. Nor have I been exposed to those places. I am familiar with one only because some of the deacons at our church visited on a regular basis. But I can't speak to anything about that facility other than I know our deacons visited and visit people in that facility."]
+[4.824906826019287, 6.629056453704834, "No, thank you."]
+[-1.7937676906585693, -1.2789859771728516, "That's an interesting question. Um, so I am aware of mental health services being being offered in Orange County, but the waiting list is extremely long. I also am familiar with the Be Well organization where there are services available for people who have no insurance and people who do have insurance on a sliding scale. The challenge that I have observed is that it's very light on diverse counselors, meaning if someone is struggling with mental health issues, and from the black community and looking for a black counselor, they will be waiting for a very long time to get served by a counselor of the same race. Also, people who speak various languages like Vietnamese, or Mandarin, people who speak Farsi. We don't have very many diverse counselors available to the general public. On the flip side. I am also aware of many, many people in the black community not being aware of services available through Be Well, or other organizations like sift where there's a sliding scale. And so therefore, they go without getting mental health services, thinking that it's just none available or the waiting list is so long that they'll just figure it out on their own or go to their church or go to a friend and try to explore other alternative solutions."]
+[-1.2799327373504639, -1.844223141670227, "I don't. I think that human services and what what was the other one social services and social services. I think human services are available. Identifying where to go is a challenge. I know that we have online tools that are readily available, but they are very convoluted and require are training on how to navigate to get what you're looking for, in those tools, social services, I think that there are many, there's a plethora of social services available. But communicating those sorts of those events and social services to senior citizens who may or may not be on the internet, and may or may not know where to go to find them is the challenge."]
+[0.14678464829921722, 3.470161199569702, "The biggest challenge that older adults will face in the next 10 years."]
+[0.4537935256958008, -0.5475853681564331, "Well, if they're a minority, I think incomes going to be a big challenge for them."]
+[-1.6832127571105957, -0.572826087474823, "Financial financial security and in stability will be huge, because prices are going up so quickly. You know, when when your needs change from a pharmaceutical perspective, and from a physical perspective, on top of transportation costs, etc. and financial stability is going to be a huge challenge in 10 years."]
+[3.6609222888946533, 15.534703254699707, "Yeah."]
+[-0.8193693161010742, -2.0702805519104004, "Gosh, that's tough. I think that the government would do our senior citizens a service a good service by providing quality information in language in writing, perhaps by mail, in addition to digital on what what services are available and support around how to engage those services. So that they are not overwhelmed and the the pathway to to access those services is a smooth and efficient process. Make things easy for them."]
+[-0.0004225205339025706, -4.830580711364746, "Thinking about all the older adults resident in Orange County who is getting the least amount of attention."]
+[0.2982494831085205, -0.8163269758224487, "I think the those who are refugees, and undocumented individuals are getting the least amount of attention."]
+[0.1190822422504425, -3.940739393234253, "Thinking about all the issues facing older adults in Orange County, what issues is being overlooked."]
+[-2.0837385654449463, -2.507779359817505, "Issues for seniors that's overlooked."]
+[-1.6564193964004517, -1.4647139310836792, "I would say taking a stab at it because I haven't really given it much thought before today, I would say it's transportation. Because oftentimes, when I see public transportation, there's, you know, sitting outside on a bus stop, and then they have to step up, and then they're in close proximity to strangers. And just navigating that whole experience, especially during the pandemic can be dangerous. If someone is on in a wheelchair or has, you know, a cane, that that could be dangerous for that senior citizen and they don't, if they don't have anybody to help them, then that might be a daunting experience for them to be able to get to the doctor or the grocery store or wherever, you know, they they need to go during the day or the night. So that's why I say transportation perhaps is the biggest issue that's overlooked."]
+[-1.53745698928833, -2.7962942123413086, "Any organization that you think that we should talk to that serve older adults"]
+[1.8142071962356567, 6.150282859802246, "I think let me think about that. I think you're already talking to Abrazar"]
+[2.2978429794311523, 9.504889488220215, "yes"]
+[1.6879154443740845, 6.700204372406006, "I would say"]
+[4.942922115325928, 3.387408494949341, "hey, thank you. So this concludes our interview. Thank you so much for your time, you have been incredibly helpful for our research, you find out, you have more to share, please feel free to reach out to us. So you know, my contact and contact information is also on our website. You can leave a voicemail, or or on our telephone anytime as well. When I stop recording now. Thank you so much."]
+[6.265806674957275, 5.5768585205078125, "You're welcome. I got tongue tied there for a minute. I'm like"]
+[7.118965148925781, 4.707722187042236, "no worry. I'm gonna read it from the service scream. Five times still got tongue tie. You know, really good. Very insightful. So thank you for sharing your perspective."]
+[-1.7173106670379639, -2.956632137298584, "My pleasure. My pleasure. I'm just so glad that you all are doing this. And any way I can help, please don't hesitate to let me know because it's critical. I'm Yeah, actually in the senior citizen club. And"]
+[2.0398643016815186, 6.3714919090271, "I can tell you don't think"]
+[-0.06488636136054993, -4.735162734985352, "well, you know, think of thinking about my you know, what I'm going to encounter in 10 years. It's kind of daunting, but you did ask some questions that made me think okay, maybe I need to look at long term care because I don't have children. Yeah, so my husband does but they all live in Michigan. So I don't think I went to Michigan though."]
+[-0.24858629703521729, -4.151932239532471, "Not after you've been in Orange County already."]
+[1.8170504570007324, 6.2130889892578125, "Laces"]
+[4.225940704345703, 8.970261573791504, "Nope."]
+[-2.6685667037963867, -2.658820152282715, "That's defined as those who are 60 years and older. We want you to think as broadly as possible taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through the list and let me know when you're ready to begin. I will share that list now."]
+[3.6957602500915527, 15.096953392028809, "Yes."]
+[3.9960711002349854, 5.25870943069458, "Okay, so feel free to take a few minutes to review that and let me know when you're ready."]
+[4.746433734893799, 8.033015251159668, "Okay,"]
+[5.607429504394531, 8.827781677246094, "okay."]
+[-0.829512357711792, -3.372380495071411, "Sure. So my name is Yosef, followed by truly, I'm the executive director and co founder of CIELO and we serve budding entrepreneurs, particularly those from immigrant bipoc lower income neighborhoods throughout Orange County. And it's within that context that I do, we do interact with folks above 60."]
+[-1.6484150886535645, -0.37168753147125244, "And then personally, I have a mother who's"]
+[-0.503545343875885, -3.914013624191284, "above 60, and, you know, aging parents, as well as my own lived experiences of being a caregiver of my grandfather, before he passed away, several years ago, so I think direct, professional and then personal experience. Thank you. Thinking about Orange County and looking at the list of common issues and concerns impacting older adults."]
+[3.7525529861450195, 9.830764770507812, "Hmm."]
+[2.940573215484619, 4.11836576461792, "I think these are pretty broad categories that"]
+[2.1822562217712402, 5.233989238739014, "I think anything that I would have brought, I could bring up sort of feel like they fall into one of these. So"]
+[0.38284754753112793, 0.17518320679664612, "let me think, for what about fraud"]
+[-1.8149176836013794, -2.066588878631592, "That's something that I definitely know and experienced, is a big issue is that our elders are being inundated with mailings with calls with not as much emails and texts, because that's not their mode of communication, but through snail mail, and phone calls,"]
+[0.1597437709569931, -0.011968511156737804, "constantly inundated with like, you know, fraudulent opportunities, who you know, to win money or to support someone in some other country. And so yeah, I think they fall prey to that type of those type of activities."]
+[7.1853413581848145, 4.637550354003906, "Thank you for sharing"]
+[1.997144341468811, 3.6549320220947266, "the needs on the list."]
+[3.2968599796295166, 4.626158714294434, "Yeah, go ahead. I was just gonna say to clarify, is that is what I bring up included in any of these categories issue. Not that I can see. Okay, okay. Cool."]
+[5.392564296722412, 6.493641376495361, "That's it. Thank you."]
+[2.5549726486206055, 3.829759120941162, "Okay, thank you. So other news on the list, including the one you just suggested, Please rank the top three that you feel are most important"]
+[3.7522900104522705, 9.828829765319824, "Hmm."]
+[2.3234291076660156, 6.554062366485596, "I think that's easier for me to wrap my head around."]
+[1.4830259084701538, 6.21651554107666, "So one is I think,"]
+[-1.3558241128921509, 1.3064271211624146, "I guess it might fall under emotional well being but like, loneliness, depression, feeling of not belonging."]
+[1.5771024227142334, 6.170446395874023, "So I feel like that's, that's a big one. And then"]
+[-0.07854823768138885, 0.9787992238998413, "I'd say economic. Right. So"]
+[1.1568478345870972, 5.4459710121154785, "for a lot of our folks who"]
+[0.2472543567419052, -0.8798125386238098, "Um, you know, didn't enroll in Social Security or sorry, like, didn't have pensions or 401, K's or retirement plans, which a lot of our immigrants fall into, you know, there's not that safety net. And so it's, it's a"]
+[-0.3286808133125305, -0.617046058177948, "it's a demand on like the family household. And so, you know, that's why a lot of our older generation lives with their children as part of the economic model."]
+[1.7246983051300049, 6.677608966827393, "So I'd say,"]
+[-1.1850842237472534, 1.3698264360427856, "Yeah, I guess economic security, emotional well being."]
+[3.5059115886688232, 7.575184345245361, "I was saying."]
+[1.3306927680969238, -1.2370847463607788, "And I guess it's related to maybe what I just mentioned, but like, I think housing is a big issue of like,"]
+[3.147937774658203, 4.572854042053223, "Thank you. So the next few questions will be going through each of these topics that you have brought up."]
+[-1.7753523588180542, -1.0504201650619507, "Hmm. I think in particular, because as their partners, you know, age can pass if they are widowed. Certainly having a life partner, um, move on is, is challenging and common."]
+[0.8846805095672607, -1.0172183513641357, "I think having to transition into like different housing dynamics, whether it's with from family member to family member, or from home to some group"]
+[-1.076839804649353, -0.13960742950439453, "support care dynamic, I feel like there's,"]
+[2.5161540508270264, 7.410726070404053, "you know,"]
+[-0.7345597743988037, 0.6388787031173706, "a lack of community at times, to feel a sense of belonging. So"]
+[2.8397769927978516, 5.318337917327881, "No, we'll go back to the second one after. Okay."]
+[-0.770416259765625, 2.353398561477661, "Thank you. So the second part of this is what barriers exist to see improvement in this area."]
+[0.18704502284526825, 0.8682039380073547, "I mean, the, the economy"]
+[-0.675311803817749, -0.34040510654449463, "forces us to have to work. And so instead of having, you know, family around to"]
+[-1.4937175512313843, -1.1999316215515137, "be a part of their aging experience, are we're having to work and make ends meet. And so that leaves, you know, I think the elders at home if they're living at home with family."]
+[-0.7367332577705383, 1.0865439176559448, "So I think that is part of the cause."]
+[-2.6788570880889893, -1.9961309432983398, "I also think, like I mentioned earlier, a cause is that, as you age  your friends and your peers and your partner's"]
+[0.5777677297592163, 3.6454668045043945, "pass. And so that that becomes a very challenging"]
+[-3.9956812858581543, -1.913835048675537, "experience. And they're no longer working necessarily, right. So they don't have that work, community"]
+[1.173831820487976, 5.043001651763916, "to connect with."]
+[10.66553020477295, 8.45761775970459, "Thank you."]
+[1.5921748876571655, 6.6089911460876465, "Yeah, absolutely. I think."]
+[-0.18299968540668488, -0.5721837878227234, "Yeah, I guess one of the upsides of, of our immigrant, you know, people of communities of color, is that you tend to live multi generations together."]
+[-0.38655877113342285, -0.3227006793022156, "Sometimes that's economic or not, sometimes, oftentimes, that's cultural, but that also has like economic impact. And so I think, with that being the case,"]
+[-0.8652772307395935, 0.5144253969192505, "the sense of loneliness might be lesser than those who might have means and just can't afford to"]
+[-1.452494740486145, -0.9048687815666199, "put their father or grandfather or mother or grandmother into facility. And I think there's a sense of like, discernment or disconnection from family when that happens. And I think that's, that's probably more common with people's means."]
+[4.144062042236328, 5.99237060546875, "Oh, man, mary. Okay, you're getting in there"]
+[1.1271696090698242, 5.1295061111450195, "to test."]
+[1.7161765098571777, 7.457549571990967, "It"]
+[2.25726580619812, 2.5573301315307617, "Yeah, I mean, obviously the issues, I mean, obviously a solution would be that"]
+[-0.1365506798028946, -0.3412889242172241, "financially, families can afford. Our families aren't,"]
+[-0.9440780878067017, -0.5531483292579651, "are, it's not so demanding on on family members to be working so that they're, you know, there's a sense of connection with family if they're living at home. I think the same could be said about those who are living in a facility and like, having their family or friends be accessible or visit often, I think,"]
+[-0.8003730773925781, -0.51705402135849, "you know, the increase in like, family engagement"]
+[1.977856159210205, 2.1585495471954346, "is certainly a solution. But I think, how do you do that is another is another question. I think that's where, like, our economy has a lot to do with"]
+[-0.9461399912834167, -0.40735751390457153, "the availability of family members and friends to be present and engaged."]
+[2.390026807785034, 6.546990871429443, "And I'll go straight to that. And I think"]
+[0.11565238237380981, 0.8401428461074829, "with with economics, I think"]
+[0.05334238335490227, -0.9648855924606323, "a lot of our older population who are immigrants"]
+[0.3332047462463379, -0.9528950452804565, "who didn't have access to, you know, the benefits of retirement and savings programs, are now left in that baby boomer generation, but don't have the financial stability that"]
+[-0.08016649633646011, -0.2598201334476471, "others who have had those benefits"]
+[1.5760259628295898, 6.172860622406006, "have. So I think that's a"]
+[-0.6766066551208496, -0.11238955706357956, "that that's a big one. And I think the cost of like, of support, so whether it's in home"]
+[-0.7439205646514893, 0.15581847727298737, "support"]
+[-1.1619302034378052, -0.24012281000614166, "in home care, or, you know, facilities, those are expensive. And so I think that creates a challenge"]
+[-0.7990076541900635, 2.3591763973236084, "Thank you, and what barriers in this to seeing improvement in this area."]
+[0.13336069881916046, -0.9133945107460022, "So for folks that don't have the appropriate documentation to work in this country, it puts them in a situation where they can't enroll in 401k. Right, they can't benefit from some of these, some of the infrastructure that exists for our seniors. And so that makes it extremely challenging for, again, that that particular population, I'd say, those who are,"]
+[0.4406788647174835, -0.5511141419410706, "you know, have the ability to work here legally."]
+[0.2814883291721344, -0.9280154705047607, "Having access to 401k, 403b, some sort of retirement programs, in all sectors. And I know that more recently in the nonprofit sector, it's been orange sorry, in the small business arena, it's been something that's more"]
+[1.6497079133987427, 3.477670431137085, "it's been more it's been required more. And there's, I think,"]
+[2.4997127056121826, -0.04604590684175491, "legislation that's, that's supported that. So I think that is, is one"]
+[-0.07559143006801605, -0.30532756447792053, "and I think the ability to still earn money generate income at later ages. So for what we do, we find that a lot of people are coming to us who are above 60, who are at this point in life where they want to follow their passion or their dream and want to open up a business. So I think that's, that's a key ingredient. It's also like a form of dignity and purpose and value that and belonging right to the community. So I think entrepreneurship Small Business Ownership could be a"]
+[0.571024477481842, -0.2977119982242584, "have multiple benefits for that this population."]
+[3.310631275177002, 4.902155876159668, "Thank you. And I know you already touched on the next one."]
+[1.0789811611175537, 5.651118755340576, "Well, for"]
+[1.1425994634628296, 6.368203639984131, "Last part, I think the"]
+[0.8076517581939697, -0.16568675637245178, "and I obviously, I'm biased, but like that part of the reason why CIELO exists is to extend that ecosystem to the underserved populations"]
+[-0.15094883739948273, -0.09905959665775299, "to become entrepreneurs and small business owners. So I think the ability for the small business entrepreneurship ecosystem to be intentional, and accommodating of that of that population is is one avenue."]
+[1.8671737909317017, 8.383378028869629, "And then as it relates to folks who can,"]
+[3.4323348999023438, 6.855109691619873, "who cannot"]
+[0.22828075289726257, -0.7476471662521362, "access retirement"]
+[10.712677955627441, 8.34640884399414, "Thank you."]
+[0.8120629787445068, 0.5263561606407166, "It's expensive."]
+[-0.83012455701828, -0.09695111960172653, "And it's, it's kind of a daunting task, if you don't have the support system to help you figure out sort of housing for your neck for your silver phase of life."]
+[1.8129526376724243, 3.9586610794067383, "So what do we need"]
+[1.4732990264892578, -0.9235240817070007, "For housing, yeah, I think I feel like I might be repeating myself, but I think you know, with"]
+[0.1201333999633789, -0.7170143127441406, "bipoc immigrant,"]
+[-0.11805780977010727, -0.41648727655410767, "basically families of color, I think they tend to"]
+[0.48962080478668213, -1.0472677946090698, "keep multi generations in one home. Because a sense of belonging, connection, community."]
+[1.737459421157837, 8.070762634277344, "So"]
+[-0.06077888235449791, -0.49226802587509155, "versus I think, are less, you know, maybe are whiter, more affluent, folks tend to have access to facilities that are, you know, well regarded. And, oh, that's the other thing. Like there's, there's a very, it's very, there's a spectrum of these types of, of"]
+[-0.8031541705131531, 0.1575915813446045, "facilities, right in terms of quality. And so, certainly when you're not as wealthy, or you don't have as many resources or the means, you can find your put your self in facilities that are very substandard. And lack, I think the"]
+[-0.28314757347106934, 0.4218674600124359, "the warmth, and connection and the services and customer services"]
+[-0.9523288011550903, 0.2776387333869934, "from the lower and to the higher end of of facilities."]
+[0.6611654162406921, 1.4356403350830078, "I mean, one of the things I'm seeing is like the building of ad use,"]
+[-0.696575403213501, 0.07262058556079865, "or which are accessory dwelling units, right, I think they historically would be called the in laws. And so"]
+[0.9783909320831299, -1.6820908784866333, "and that's, I think it's with that purpose of like, how do you create more housing stock in a dense place like Orange County or Southern California, and that's one way as you can build these adu issues where family or elder or your aging parents could live with you but still have a sense of independence."]
+[1.7033504247665405, 2.1247990131378174, "Obviously, that that's more towards those who have the resources and the means to you know, even have the power"]
+[1.7509275674819946, 3.8598227500915527, "Pretty space and to have the"]
+[-0.1402510702610016, -0.40482762455940247, "cash to, you know, develop something like that. So I think that's, that's key for folks with resources, I think, a key for folks that you know, more of our families of color."]
+[-0.892272412776947, -0.5663731694221497, "Because they're so busy, I think having like, accessible in home care, I feel like that's still something that isn't adopted as a normal practice for families of color, because it might even be a pride thing. Like, why do we have to hire someone if we're family, and we're close, and we take care of each other. But I think both can be true, you could still"]
+[-2.133435010910034, -0.7082007527351379, "love and care for your elders and, but have to work and also want to make sure that they are cared for while you're not there. And so"]
+[-0.9808316826820374, -0.3202892243862152, "I think that's an opportunity is to socialize to create more access to in home care for our lower income."]
+[-0.1492459923028946, -0.4358172118663788, "families of color."]
+[10.633894920349121, 8.421531677246094, "Thank you."]
+[3.912104368209839, 4.444336891174316, "We have a few more questions, but I will stop screen sharing."]
+[3.5353007316589355, 7.613048553466797, "Yeah. Okay."]
+[5.418533802032471, 6.856391429901123, "Yeah, thank you."]
+[1.6537177562713623, 6.158506393432617, "Yep. And if you would like to even elaborate on if it's, I don't think I can elaborate. Yeah. I mean, I'll just give a because I don't know, to be honest, and I don't have like a"]
+[-1.2747657299041748, -4.302348613739014, "strong sense. But I would say, access to geriatric care In Orange County"]
+[4.248331069946289, 7.283177852630615, "is good."]
+[2.9823360443115234, 7.652055740356445, "Generally, right, obviously, as I mentioned before,"]
+[0.6870983242988586, -0.08429741114377975, "not good for a population of folks that,"]
+[0.6672424674034119, -0.10592091083526611, "you know, a large population of folks, but I think the"]
+[3.5853185653686523, 8.846307754516602, "Not yet. Yeah."]
+[1.7303402423858643, 6.46375846862793, "I'd say the same."]
+[1.3225370645523071, 5.094661235809326, "Medium."]
+[5.56763219833374, 8.807451248168945, "Okay."]
+[3.059196949005127, 8.374346733093262, "Oh,"]
+[0.4840867221355438, 3.596646308898926, "I say that's a big, big challenge and opportunity for"]
+[1.119981288909912, 5.327855110168457, "for people of color."]
+[0.5370360612869263, 3.387760639190674, "I think it's a cultural challenge, right. And you don't address cultural issues with necessarily like big policies, I think a lot of it has to do with"]
+[-0.6410872936248779, 0.6036880016326904, "socialization and education and awareness."]
+[-2.655080556869507, -2.209960460662842, "But I do you believe that our aging"]
+[-2.1177573204040527, 0.46778711676597595, "And I think it affects them in many different ways. But I think we even though meant it's mental health awareness month, and there's a lot of like, better help, and, you know, apps and different things. I still think it's not as accessible. Or there's not enough awareness and education and engagement with the population. I know, I mentioned."]
+[10.68533706665039, 8.42159652709961, "Thank you."]
+[0.3403202295303345, -0.06679502874612808, "Yeah, I think I see a couple of different things happening in our in our neighborhoods of color, that are that this area that that that arena of services is strong, and that is that"]
+[-0.0018142362823709846, 0.12868551909923553, "they meet them where they're at, right. So in many cases, with our government and with our different types of services, including small business services, the approach is largely build it and they will come."]
+[0.013708383776247501, -0.7928639650344849, "Whereas I think human and social services and health services have evolved to understand that for this particular target population, again, lower income immigrant bipoc neighborhoods"]
+[1.9208694696426392, 5.909910202026367, "they're unique"]
+[0.22519227862358093, 0.1102590560913086, "to meet them where they're at. And that's not just theoretical, that's like geographically physically, like, meet them where they're at. And so, in neighborhoods you see, like family resource centers, you see"]
+[-0.15882441401481628, 0.2777312397956848, "these beacons of sort of trust that are built in these neighborhoods through the pro mythos model, right, like the health promoters in the train. The trainers, like these are incredible."]
+[1.3843721151351929, 4.880216121673584, "I think, mechanisms"]
+[-0.08553556352853775, 0.22655194997787476, "that exist and channels that exist, that have helped, I think, engage this target population, and particularly around health and human services, than health services. I feel like they're really good about being intentional about reaching and meeting people where they're at."]
+[5.518791198730469, 8.738624572753906, "Okay."]
+[1.1143200397491455, 6.458843231201172, "I think"]
+[4.52235746383667, 5.355426788330078, "care."]
+[-2.4227535724639893, -1.8393415212631226, "I am thinking personally, because I'm in this situation where my, my parents are aging. And so in the next 10 years, they're going from like, your late 60s to late 70s, maybe early 80s."]
+[0.28470367193222046, -3.23468017578125, "And so I think it's going to require a lot of physical movements, I think, in in Orange County, there's a lot of, of our workforce that are transplants. And I think, where as their parents age, a lot of them are going to have to go back to where they come from, and sort of leave."]
+[0.6634132862091064, 1.192682147026062, "Leave where they are working and playing right."]
+[1.7388386726379395, 8.07034683227539, "So"]
+[0.13118764758110046, -1.9876354932785034, "yeah, I'll stick with that. I think that's obviously there's a lot of different common things. But I think that's an interest. Because I'm experiencing that myself personally, with folks in a family like moving back to where they came from to care for, or, or bringing your elderly parent to you. So like, potentially, you can find, I think these folks that have come to California as young professionals, right, over the next 10 years are building a community here and a family potentially here in a life here. And I can see them taking their mom from Ohio, or their dad from New Jersey, and bring them here to be their part of their support. I think that's more of a, you know, the population who's coming here and has means because they're here for biotech, or they're here for Silicon Beach. And so they're going to have means and they're going to be able to bring their, their their aging parents here."]
+[3.7891786098480225, 15.480996131896973, "Yeah."]
+[3.0660758018493652, 6.908351421356201, "That's a pretty good one. Yeah."]
+[2.492276191711426, 6.700725078582764, "I'm feeling like I'm, I'm, I'm actually more insightful on this topic than maybe I thought coming in."]
+[1.74741530418396, 8.08491039276123, "So"]
+[2.4775328636169434, 7.303633213043213, "just giving myself a pat on the back."]
+[10.710336685180664, 8.386759757995605, "Thank you."]
+[4.6594414710998535, 4.428147792816162, "It's very, it's very odd. Mary, as I mentioned, at the very beginning that like, because you preface this by saying that you're neutral, and you're not going to have any emotion. It's like, I'm speaking, and this is no fault of yours. Cuz, you know, we're used to like getting some some form of affirmation or pushback, and, you know, it's not a dialogue. So anyways, just wanted to"]
+[4.733211994171143, 6.44741678237915, "note the dynamic here. Go ahead. Yeah. Thank you."]
+[-2.6405389308929443, -2.0932679176330566, "Hmm. Well, first of all, I think our most vulnerable aging population"]
+[1.4511973857879639, 0.06519696116447449, "needs the government the most, right. And so"]
+[-0.4246479570865631, -2.9529120922088623, "as we talked about, like maybe legislation around older adults who are here and don't and are immigrants and don't have like, documentation, there's a whole lot that's a"]
+[0.057483915239572525, -1.0189884901046753, "if you think about all of the immigrants that have come here in the 70s 80s, right, and now we're here"]
+[0.5443695187568665, 3.159137725830078, "2030 years into 40 years into"]
+[-0.16238325834274292, -0.8344609141349792, "here being here, they're now at that age of aging, and they don't have all of those benefits. And so there they are almost a drain on the family's income of their kids, because they just like another dependent. And so I think that's a big challenge that we need to figure out how to tackle."]
+[0.06264805793762207, -4.942786693572998, "And thinking about all the older adult residents in Orange County, who do you who is getting the least amount of attention."]
+[1.4535951614379883, 6.042047500610352, "Those that I just talked about, I think the"]
+[-0.06497965008020401, -0.5423290133476257, "immigrant low income, families of color or individuals of color."]
+[0.1269894391298294, -3.992542028427124, "And thinking about all the issues facing older adults in Orange County, one issue is being overlooked."]
+[3.3720309734344482, 3.945561647415161, "Well, I'll just say it because it wasn't on that list, and I think it's indicative of where it's at on people's radar. But this predatory"]
+[0.2353508174419403, 0.17492899298667908, "scams and fraud, active fraudulent activity is not only economically"]
+[2.3027844429016113, 7.854172706604004, "disastrous, but also like,"]
+[0.26716288924217224, 0.03192708268761635, "like, you end up getting into these, what he call run arounds, like trying to solve for all of these issues of fraud and like, it's such a complicated system that you kind of just give up. And so I think, you know, extorting money to getting people's hopes like preying on people's emotions, right, their hopes and feelings because they're lonely, and they want connection. Like, that's a huge deal. And I just like cybersecurity, obviously, is a huge deal. I think we're over looking that there's still some old school fraud and security issues that are, are not being addressed."]
+[0.37099188566207886, 0.1916549652814865, "So from like, predatory loans to like, fake"]
+[0.2699684500694275, -0.5311789512634277, "What do they call it back in the day, like sweepstakes, like, you know, those, those kind of things. So, I think that's a big one that's being overlooked."]
+[10.682085037231445, 8.409993171691895, "Thank you."]
+[2.882753610610962, 4.801964282989502, "In addition to what we already talked about, we can dive a little bit deeper into your area of expertise,"]
+[-0.34127041697502136, 1.2293362617492676, "income security, or economic security."]
+[3.8046607971191406, 15.500920295715332, "Yeah."]
+[2.156776189804077, 4.884034156799316, "I think that what's working is that, at least, with us, we're seeing the"]
+[-0.3215552866458893, 0.3542203903198242, "both social emotional and economic benefits of entrepreneurship."]
+[2.502828598022461, 4.465065956115723, "You know, these a lot of folks have been working in in the same industry or whatnot, because that's just how things had been done. And so there's a sense of like, one's own deep"]
+[-0.24829907715320587, 0.352704793214798, "aspirations and dreams and hopes that had been squelched."]
+[-0.7940154075622559, -1.5750787258148193, "oppressed in a way because they had to show up as the nine to five like, I'm, you know, I get my, get my Social Security and my, my, you know, retirement plan and all that stuff, like on the, but they lack sort of that creative, inspirational part of their life that has been so sedentary for so long. And so I think that is a, an incredible experience that we're observing a lot with older folks as they're transitioning from either retiring or"]
+[-0.03619826212525368, -0.4553148150444031, "Yeah, retiring and then shifting to this path of like, entrepreneurship."]
+[3.0771212577819824, 0.12777310609817505, "Thank you, and what new or revised policies are needed"]
+[0.25266435742378235, -0.6589069962501526, "like I said, like a retirement savings type of options for folks that don't have access to that."]
+[1.136197805404663, 6.442831516265869, "I think"]
+[-2.1356751918792725, -0.5315765142440796, "education advocacy around mental health support"]
+[1.981986165046692, 4.263575077056885, "for four individuals in that target and my target."]
+[1.1633081436157227, -0.31762176752090454, "Target community and yes, we are talking about finance"]
+[-0.3289586901664734, 1.1604602336883545, "job security. But what we found is, in order for"]
+[-0.02112412080168724, -0.1435757428407669, "an entrepreneur to create the best business possible, they need to become the best version of themselves. And so if they're not, if we're not looking at the whole person, then we're not really"]
+[1.1288853883743286, 3.0364112854003906, "accessing the full potential"]
+[1.9195681810379028, 6.820808410644531, "of someone,"]
+[1.559064269065857, 7.210151195526123, "you"]
+[2.713813304901123, 1.7518783807754517, "and who or what entity is best suited to address this issue."]
+[0.7956624031066895, -0.09685803949832916, "Again, by I'm biased, but CIELO, I think is well positioned to target that the target population we're talking about, and use the tack, like, tactics that are necessary for this population, where you're building relationships building, trust"]
+[-0.009944201447069645, -0.8724022507667542, "me and making the instruction in accessible. So it's not like going over people's heads, like, you can't take, I think, necessarily a retiree who's or let's say an aging immigrant, who may not have may not may have only gotten like a sixth eighth grade"]
+[1.3432542085647583, 0.8395256400108337, "level of education, and then take them through like, the UCI incubator program, right, or the accelerated program is just, or even the small business development centers, like programming."]
+[0.737851083278656, -0.09348493069410324, "We're kind of not meeting people, this population where they're at. So I think that's where CIELO is unique."]
+[1.754332184791565, 6.379790782928467, "So I think looking at"]
+[-2.5337517261505127, -2.4171032905578613, "I'm gonna be focused on this this context, I think, looking at our aging population, and understanding like, once they get to that retirement age 63, 65."]
+[2.0562336444854736, 6.295518398284912, "And they don't, they aren't on like, part of"]
+[0.23148611187934875, -0.6745849251747131, "a retirement program, right with, with the corporation or company."]
+[-0.0980948805809021, -0.026652200147509575, "Or they are their programs are there they have to lean on their family, as I projected."]
+[0.39376845955848694, -0.5332592129707336, "So yeah, unpacking specifically, that that population of immigrant, undocumented."]
+[-3.229612350463867, -2.5018486976623535, "Elder, and how, how, you know,"]
+[2.439643144607544, 8.09943675994873, "I guess validating or,"]
+[2.2701923847198486, 8.306565284729004, "or control or"]
+[-2.7411420345306396, -2.1577138900756836, "proposing an opposing or creating an opposing view of, of where I'm coming from, like, I could be very wrong, right. And my assumptions based on these anecdotes, and so like, I would love to know if that's at all accurate, and what is happening specifically with that aging population."]
+[10.582988739013672, 8.498838424682617, "Thank you."]
+[2.5607447624206543, 8.047048568725586, "Yeah, I guess like,"]
+[2.0722098350524902, 5.510006904602051, "I don't have anyone in like anyone in particular. But I do think that these"]
+[-0.17201614379882812, -0.3204272389411926, "family, these family resource centers, which is part of like the fact FFA are fact, at the county level, they run the different"]
+[0.4676305055618286, 0.24900312721729279, "family resource centers. And I think that the directors of those centers, a director of those centers, right, because they're embedded in these neighborhoods that we're, I'm talking about with the lower income immigrant communities, and I'm sure they have a lot of"]
+[0.6865336298942566, -0.110142782330513, "anecdotal information around this population as it relates to"]
+[-2.9810664653778076, -2.195733070373535, "age or aging, folks. So that's, that's one that comes to mind. Another is like, folks that are promo Thoris, like, part of Latino health access, for instance, that they're the ones that really the Pioneer"]
+[2.765211820602417, 8.15158462524414, "that model."]
+[-0.315276563167572, -1.0951452255249023, "And so I know now HOAG has a problem with Toto model. And others have applied that that approach. And so I don't think they Latino health access invented it, but they certainly have made it"]
+[-0.3491099178791046, -4.155402660369873, "popularized it, I think in Orange County."]
+[3.9143691062927246, 6.080129146575928, "No, I'm done with this process, and I'm just kidding. Yeah, absolutely."]
+[4.657412528991699, 3.1583797931671143, "Okay. Great. Thank you. So this concludes our interview. Thank you so much for your time, and you've been incredibly helpful to our research. If you find that you have more to share, feel free to reach out to us. Our contact information is available on our website. That's www.advanceoc.com. And you can also leave an anonymous voicemail on our telephone line at any time."]
+[5.284764766693115, 3.5988471508026123, "I will stop the recording"]
+[-2.679800510406494, -3.193418502807617, "Quick this. So the primary goal today is to identify what needs you think are most important to the older adult population that you serve those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Now, I'd like you to take a few minutes, as much as tight as much time as you need to read through this and this list. And let me know when you're ready to begin. Thank you."]
+[4.679327964782715, 5.4332804679870605, "And let me know if I to move it. This is the entire page we're trying to fit down to one page. But let me know if you need me to move it down or enlarge it or shrink it down even more."]
+[2.7161669731140137, 3.256574869155884, "So these are listed, just so some clarify questions. So these are listed as issues and concerns with examples of what what might occur in these areas. We're asking before us. Go ahead. Go ahead, Tammy."]
+[3.165620803833008, 4.122822284698486, "It's not an exhaustive list. And I'll be asking you about that. But just would like for you to take a look at the list. And again, these are just some of the examples. I'm sure there are others that are not listed here."]
+[-1.2995573282241821, -3.1800076961517334, "So I think for me some of the two things to the top things that stand out are the need for elder transportation. Access and transportation go hand in hand. I think for me, looking at the county that's important."]
+[3.027373790740967, 6.081986904144287, "Well, I haven't asked you my question."]
+[3.4492268562316895, 4.052752494812012, "I thought I was just giving you a list."]
+[3.984246253967285, 5.604495525360107, "I just want to show I want I would like for you to take a few minutes."]
+[3.8787155151367188, 4.700874328613281, "And I want to scroll down that would be good that I think the list ends here on the screen."]
+[2.437004566192627, 5.428410053253174, "Yeah, it's this is yet on in the unintended. That was that's one"]
+[3.338773488998413, 5.479048728942871, "thing. Okay, go ahead with your questions. I will not get out of here."]
+[4.522263050079346, 6.548864841461182, "No, no, no, thank you. Sure."]
+[-0.9992481470108032, -3.6154308319091797, "So I serve in the community both as a private owner of a community of a companion homecare business and also as a medical management services business we manage other physician practices. And we also do physician staff recruiting of nurse practitioners, physicians, nurses and allied professionals throughout Southern California. I also the volunteer incoming chairman of the board for Meals on Wheels Orange County, and I frequently speak on topics related to care and access for older adults, those with Alzheimer's and dementia cognitive impairment, brain injury and the need for companion level care and respite services for both the client as well as caregiver family member"]
+[0.10600138455629349, -4.051180839538574, "Yeah, thinking about Orange County and looking at the list of this the common issues and concern as we have in front of in front of us and you know in the concerns impacting older adults, is there anything missing from this list"]
+[-0.8553136587142944, 0.5461534857749939, "think companionship is missing"]
+[1.9861491918563843, 5.859760761260986, "anything else"]
+[-0.8637126684188843, 0.6100178956985474, "I would say let's let's let's change that to state I don't see it here so I'm gonna make sure I'm not duplicating it isolation loneliness still looking"]
+[-1.2988781929016113, -0.1157664805650711, "right respite for the family caregiver. That's what I have as additions."]
+[2.5304462909698486, 3.863461971282959, "Okay, now, often often needs on those lists, including those that you had just mentioned. Please rank the top three that you feel are the most important."]
+[0.5365386009216309, 1.2000077962875366, "transportation and mobility"]
+[-0.9235455393791199, 0.6412962675094604, "loneliness and isolation which I mentioned would be number two."]
+[-1.9162496328353882, 1.2385004758834839, "And behavioral and mental health."]
+[0.4890945851802826, 0.9750004410743713, "Now I'm going to ask you a set of questions for each of the three that you identify. So we're going back to the first one transportation and mobility that you just mentioned. So how, or why are older adults struggling with this issue."]
+[0.2338360995054245, -2.2741734981536865, "So as it relates to transportation and mobility, it has to do with their lack of ability to drive their their lack of access to owning a vehicle, their geographic location, with their home from where they need to go for basic resources, I think are the primary drivers for that particular question."]
+[0.5274389982223511, -3.222325563430786, "Public transportation is very poorly designed in the county of Orange. The cost and limitations to"]
+[0.21325677633285522, -2.8561325073242188, "Disability Access Services for transportation have been reduced and limited throughout the county."]
+[-4.085716724395752, -1.8312468528747559, "And are there different experiences for different groups of older adults from different backgrounds, for example, where they live, their disability status, income, education level, etc."]
+[-0.06356489658355713, -0.7601781487464905, "I think their income level and their education, education specifically about the resources available, varies by geographic location with throughout the county. And I also think there is a cultural barrier as it relates to access for those who have specific cultural needs and desires. Because there's limited resources based on on ethnicity, and and based on location and clustering of those ethnic groups throughout the county."]
+[0.19194811582565308, -2.6299490928649902, "That's a huge, that's a huge question, Tammy. I don't know that I have the answer for that. I do believe that our taxpayer dollars should go more towards identifying public transportation for those with disabilities or limitations or older adults, beyond just typical busing services. That also needs to include more than just a curb to curb service. It needs to be door to door service in some instances."]
+[-0.833743691444397, 0.5566413998603821, "And we're going to issue number two that you identify which is loneliness and isolation."]
+[-1.2397375106811523, -2.1344406604766846, "While there is a network of assisted livings and a network of community, local community, city based civic centers, there needs to be more of a network of senior activities, and geographic places of gathering that don't exist at a, I think a strong geographic level. I think it's limited based on city. And I think the county could play a role in weaving together a better roadmap for gathering places for seniors to have access. And the reason I state that we're talking specifically about those who are dealing with loneliness, and isolation, is being able to bring them together in areas where they can have, you know, common experiences. The other issue that I think significantly drives this is that it ties back to transportation if somebody can't get out of the house, but even have has the financial means they might or may not know how to access the resources. So I do believe enhancing programs like Meals on Wheels, programs, and sabich Excuse me, and homecare companions, being able to go out and do wellness checks and companion visits. To check on the elderly who live alone, who have limited access would be some things I would add."]
+[-0.9530662298202515, -0.5279784202575684, "I think the biggest barrier is cost. While I am suggesting opportunities for these services, I think cost is a huge driver. I think there's limited tax taxpayer resources to do this. And so is there a way to model both and increase In taxpayer dollars, but also a, a pay a paid program, or both the individual pays a portion. Because I believe that, you know, if you get something for free, you're not always apt to use it. So if we build these resources, and they're free, they're not always going to be out to be used. So maybe there's some type of copay, or, you know, minimum payment requirement for participation in the services. So the value is, is increased to the individual."]
+[-1.412753939628601, -2.3534860610961914, "Absolutely, I think there is, you know, safe communities and unsafe communities, which makes these individuals more apprehensive and the unsafe communities to seek access, or to get out and seek access. So I think, you know, safety and security is typically what an older adult is looking for. So there are some barriers that do to do play into that. I also think that their living environments can limit their ability if they have poor mobility, or are disabled. And so I think those are some of the things that would reduce their participation or access."]
+[2.6887614727020264, 5.920463562011719, "I don't know that I have an answer for that, Tammy, I think I would pass"]
+[-2.004185199737549, 1.4771665334701538, "it problem. The third one, you, you, you mentioned is the behavior and mental health. Right."]
+[-2.495572566986084, -1.574872612953186, "Well, this is typically an 8020 rule, roughly, statistically, what we've seen is somewhere between 18 and 22%, of older adults, have a primary, psychiatric or psyche, psychosocial, behavioral health diagnosis, along with chronic comorbidities. And the problem, I think, is twofold because most older adults also have chronic disease, at least one form of or multiple forms of chronic comorbid disease. And when you're not managing your mental health, well, it is very easy to fail and not manage your clinical health well. So I think that's a double edged sword, both the behavioral health component being a major and mental health issue being a major issue, it also has a secondary impact on your overall physical health."]
+[-0.7528559565544128, 2.253638744354248, "And what barriers exist, you see improvement in this area,"]
+[-2.173091173171997, 0.4742642641067505, "behavioral health services are incredibly limited. The services are easily disqualified through health plans, because it's a very high cost. The county resources are also very limited, as far back as mental health hospitals being, you know, uncoupled from the federal health system back in the mid 80s, during the Reagan era, and that has really compounded itself over the decades. And I think those are some of the significant restrictions."]
+[-2.0296883583068848, 0.27931585907936096, "Absolutely. We don't have a diverse group of mental health providers. And so it is going to impact those both who have, you know, ethnic, specific needs and beliefs and behaviors, as well as the ability for strong communication in the primary language of their choice. And I think those are definitely some barriers that we see."]
+[-2.131721258163452, 0.2598779797554016, "Yeah, um, you know, these are, these are big questions that you're asking. And it really, by the way, to me, this is just an aside, these would be good to get to the people you're interviewing a little bit in advance, even though we're experts in our field. These are very contemplative questions. And so I feel like I might be doing a little bit of disservice in this, this kind of quicker q&a, but I will certainly give it a shot. So that's my, just my comment. But I think behavioral health access needs to be integrated between the county and the health systems, not just the county hospital, but with the private hospitals and health systems like Hoag Providence Health System, the Memorial Health Systems, and also the small community based hospitals. There needs to be a coordinated effort that mental health is contained within the county and that dollars are contributed some equal or poor already prorated portion where the health systems take a responsibility to health plans take a responsibility and and the county takes responsibility. And at the same time I do believe the patient has has a qualifying copay needed as well based on financial ability or accessibility to pay for it to make a stronger system for access. But I think mental health issues are are really kind of a cost driven issue. Additionally, we all see we also have a very we have a gap or a lower number of mental health providers available in the community to serve the the number of folks who need it. So I think there needs to be a focus on developing a mental health behavioral health specialists, larger pool of providers throughout the county."]
+[-2.182314157485962, 1.136736512184143, "Thanks so much, surely Now, moving on to the next question or set of questions. So we're done with the three that you identify. I'm going to just read off the floor and then we can go back to each one of them or you can just answer them, you know, in the aggregate, however you feel most comfortable. Number one, geriatric care number two, long term care number three mental slash behavioral health slash substance use treatment. Number four human slash social services."]
+[-1.39471435546875, -3.621636390686035, "So the accessibility of Geriatric Care. I think that Geriatric Care is a huge issue for this county and quite frankly, every county in the state, because the number of Geriatric trained physicians and allied professionals has the largest disparity in the in the population here in Orange County, we have more geriatric patients to find geriatric patients who need support, and we have far fewer licensed physicians and nurse practitioners, physician assistants, Allied providers to support it. So I think that's a major access issue for us right now. And that's consistent with the theme of what I see in our resource or resource salary surveys across the country that the number one largest disparity and need is for geriatric trained providers. So that's number one."]
+[1.0299863815307617, 2.3897972106933594, "So we're talking about then redefined, the question is accessibility."]
+[0.9586590528488159, 2.424203872680664, "Yeah. Accessibility and adequacy."]
+[-2.6898341178894043, 0.2982405424118042, "Okay. So Long Term Care has a lot of definitions."]
+[-2.6921944618225098, 0.25413990020751953, "Yes. Well, we figured this is something that folks may ask. So we, I have here long term here is a variety of services, which help meet both the medical and non medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. So much generic. This is Yeah,"]
+[-0.9764135479927063, -3.7412993907928467, "so um, so first, we'll start with the skilled nursing access within the county of Orange, there's both the definition of short term skilled nursing and long term skilled nursing. I think we're poorly resourced and under what I would call bedded B E. D, D. D bedded. There's not enough beds in the community to serve long term chronic, skilled nursing needs. As it relates to long term care. I think there is a limited amount of low cost resources to house individuals and to support them with activities of daily living or activities, or independent activities of daily living outside of the lowest cost environment, which is six bed board carers, which are essentially privately owned by citizens who are business people who are running it as a business. There's not really a long term care solution, run or managed by the county. And Ergo that impacts I think, the reason for an increase in geriatric homelessness, which happens to be on the list."]
+[-2.1694023609161377, 1.3825783729553223, "And the third one on mental slash behavior, health slash substance, substance use treatment. I think I think,"]
+[-1.3441311120986938, -3.4958364963531494, "yeah, I think I talked a bit about accessibility in in this the earlier questions you were asking me, I think once again, I think there are but too few clinics or access points geographically throughout Orange County, whereby individuals can't get the mental health treatment they need. And more importantly, there's not a follow up system to continue a process for these individuals to be seen on a regular basis to, you know, source, mental health improvement drug therapy improvement. And, you know, that's also coupled with what you mentioned, drug abuse, which mental health and drug abuse don't always go hand in hand. But there's a high proportion of individuals who also abuse medications, both psychotropics that they should be taking regularly, that they either do do not take, or they take them in an abuse situation, along with the illegal or illicit drugs, which usually is fostered in, in the communities where individuals have a mental health needs. So I don't know that I have much more on that."]
+[3.408154249191284, 7.376755714416504, "Oh, no, this is this is this is fine."]
+[-2.238889455795288, 0.35960739850997925, "Well, I know providers, who are independent providers that provide behavioral health services for those who are accessing either medical or who are Medicare, Medicaid patients, I'm not directly familiar with, you know, county based services for mental health. It's an it's an area where I don't have a lot of knowledge or access."]
+[-0.3470741808414459, 0.5592036843299866, "That's fine. And of course, the last one was the human slash social services, including basic needs, food, shelter, housing, things like that. Right."]
+[-0.6397750377655029, -2.8357338905334473, "Absolutely. I, you know, it's interesting, you know, being at having worked with Meals on Wheels, Orange County, knowing that we also run and manage several adult day health care centers, as does age well, as does, you know, Alzheimer's, OC, there are access points for people who to to get services. But again, I think part of it is under resourced, because I know we had Meals on Wheels, Orange County, are limited in the number of people we can serve in those areas. So we're constantly looking to subsidize or fundraise around the already provided county approved dollars that come through, you know, either the office on Aging, or filtered from the older American acts act at the federal level."]
+[3.8274142742156982, 7.914024353027344, "Right."]
+[-0.6439096927642822, -2.6484084129333496, "Well, I think the county has a very large problem as it relates to the rapid shift in the aging population, the cost of living in our county is only getting higher, and therefore we're not seeing the community by the younger population and people who are aging or aging in place. And so I think the resources are going to grow in a disparate fashion to the number of adults who are aging into the geriatric ages of 65 plus 75 plus 85. And beyond 85 and beyond. I think that's going to be one of the issues is the rapid growth in the the over 65 that we will see in the coming both now and in the coming years."]
+[-1.7021815776824951, -2.186845064163208, "The government can only do so much. I think it's, you know, I think sometimes we over rely on what government can and cannot do. I do think that the county could provide continued tax incentives for older adults, both local and county taxes could be reduced for those individuals so that their ability to live on a fixed income is is more sustainable. I don't know if it's going to be obviously completely sustainable, but I think it would allow for greater financial resources for the individual to remain independent. I think the county has a opportunity to do a better job educating the community through digital media through really paper and male media. I think one of the things that we are a rapid growing, you know, society and, you know, the mainstream of computer access is important. But ironically, even those who have computer knowledge as they age those skills, soften or they deteriorate and so finding ways To still create basic communications about areas that the gov that the government has created as resources, I think I think needs to be enhanced to kind of the where to go. FAQ type access points would be good for the government to focus on."]
+[-0.4998157322406769, -1.4932516813278198, "You know, I think I think there are still some cultural ethnic divides that cause the older adults to get less access. So I think when you have limited resources in a, in an ethnic population, that are well educated to actually train and educate, I think it reduces it. So I think, you know, I'm concerned about just kind of the ethnic diversity is growing here. But I don't think we're seeing the resource materials specifically to help the Hispanic community, the Asian Pacific Islanders, whether it be Vietnamese Filipina African American is that population, while small in Orange County is still growing. So I think there's limitations based on on culture and ethnicity."]
+[-1.9028913974761963, -2.084040403366089, "You know, I don't know that one answer is enough, because I think there's I think there's grades of of, you know, things being overlooked. But I think, specifically, the older adults, I, you know, I look at the list, and I think about the digital divide, as I mentioned earlier, I think that's a huge gap for older adults. And I think we have to find ways to create easier accessibility through digital media, because I think as we cognitively decline as just a normal course of aging, our ability to manage a rapidly growing digital age is adults. Because I can hop on in an app and say, okay, hey, good to see my test results, I could never see that, let's say went to the office. But as we move through this, this access point, older adults are not comfortable doing that they're going to have to rely on either, you know, dependents, spouses, older children, grandchildren. And so I think we need to find ways to make accessibility to resources, healthcare resources, healthcare information, more accessible."]
+[-1.0125818252563477, -3.614372968673706, "Right. Now, in addition to what we have already talked about, let's dig a little deeper into your area of expertise. And by the way, we're almost done. So no problem thinking about thinking about your area, which will leave you have a sign. Let's see, I'm referring to the California master code for ag now. So your particular area of expertise is caregiving. That works so fast. Right, right."]
+[-1.209804654121399, -0.8161875605583191, "So I think there's a variety of different variety of things. I'm in the business and our business is very expensive. So private duty companion caregiving, it creates exclusivity. And and and unfortunately, it divides those who have the means against those who don't have the means. And I think that's one issue. The second issue is developing a well educated companion caregiving workforce. That's a huge challenge in this environment. What we face and this is very ironic. Our caregivers come for for more of the clustered inner city areas, lower socio economic areas of the county. One of the distinct issues not only for my company, but every company that works in Orange County that does companion caregiving. We can't get caregivers to geographically drive into Believe it or not wealthier areas. So where people do have means science Sanclemente are quoted AKAZA caregivers are unwilling to drive that distance, they keep themselves closer because they have unreliable transportation, the cost of transportation fuel, so it drives up the cost, which then passes on the cost. That's an issue for those who have the needs. But the bigger issue is back to the sense of loneliness and companionship. For those who don't have the means we don't have good answers for that. I think organizations who are private, are in the business of making money. So profit is important. But I'm wondering if the county can work with some of our organizations to create some subsidies where we would offer homecare services at a discount, because the family then has a county subsidy to offset them. Now, the beauty of that is, I want to mention this, this is an area where I think things are really going in a good direction. Those who are now working through the Kaleen program, I think that program, which just started here at the beginning of this year, is doing will be doing wonderful things for those who have needs access who are in medical. So I think we are seeing some of those things that I just mentioned taking off, I think we're gonna have to do a better job as a private sector and as a government sector to kind of educate people, but how to get access to, to the CalAim benefits. And, you know, applying for HSS, you know, creating resources. So I think the county is doing a good job, especially with this newly announced you know, Calaim program. And I there's a couple other programs that are going to be launched in June that I'm aware of. So I think we're making some strides there. But I still think that is I still think that is a major gap."]
+[3.5904242992401123, 7.189939498901367, "Yes. Okay."]
+[0.05837719142436981, -2.167795181274414, "Think I'll just make a general statement there, Tammy, because I don't have a deep knowledge or focus on policies that exist or don't exist. today. I think one of the things we see in the state of California, which I think also applies to the county, is that we're trying to apply policies written 30 years ago, and, and partially adapting them to fit today's needs. I think government resources should be put into policy development, that really re architects policies that meet today's societal needs, and the diversity that is Orange County, versus what it was 30 years ago. And granted, we had a you know, we had a multicultural county 30 years ago, we had nowhere near the amount of integration of our society today in this county, it's it's, you know, 100 times more diverse than it was 30 years ago. And so I think some of the policies should be viewed at what are what are the what are the policies that are trying to be adapted from policies that are aged out and should be started from the beginning."]
+[3.055417060852051, 5.65887975692749, "That's fine. I guess the next question I kind of answered for you."]
+[0.6049755215644836, -2.145385980606079, "Well, I always believe that the private sector typically has a greater passion for innovation. And I believe that if the county or government would be more inclusive, and more willing to take risks around innovation, and collaborate with the private sector, I think that we could create solutions that allow us to be more nimble, to create better access and key areas of what we've been talking about. And I think the county is trying to do that. I'm not suggesting they haven't. But I think I think there's a lot there's a long way to go there and in creating that, that that kind of collaborative approach and being able to take calculated risks that maybe an entrepreneur or a good business would take to to you know, advance some of these areas of really great concern."]
+[1.6175305843353271, 0.5811352729797363, "So on our medical group management side, we access a tremendous amount of both Medicare and Medicaid data or for your medical looking at Patient diagnosis, length of stay in the hospital. medication utilization, specific medications based on on diagnosis. We look at socio economic data as it relates to clusters of populations who might have a higher set of of disease path than another population. Those are those are critical elements for us. We look at geometric mean data as it relates to length of stay people staying in the hospital, people staying in skilled nursing facilities, both short term and long term. And that's probably a big list of the the areas that we that we access and then other business related resources that we access, but but I don't think that would be relevant here."]
+[-1.1770566701889038, -3.259031295776367, "Well, Tammy, I know you know, a lot of folks that I know. So, you know, hopefully you're talking to some of the great leaders in the industry like a Jim McAleer, and a holly and an esteem warrior. I think those are really key people. Yes, good. I do believe the Chief Executive Officer of Garden Grove Hospital would be an individual that if you're if you haven't targeted him, he has a very unique population he deals with in his in his area, actually, he's the CEO of both guard Grove Hospital and he's the CEO of Huntington Beach or Huntington Memorial Hospital as well. I think he would be a really, really great resource that is Dan Brockman, br o th ma N. I've spent some time with him recently and thinking about the challenges that he has. And you know, they're they're a community based hospital. And I think that's where there's a, I see a gross disparity between community hospitals and those individuals who are at our larger tertiary centers, like the St. Jude's, the St. Joe's the hopes of the world. I would also suggest that you take the opportunity to talk to some researchers, I think about the Alzheimer's Disease Research Institute in UCI where the the director of that program, Dr. Josh grill, GRI LL, is phenomenal. I don't know if he is on your list. And also above him, the Dean of the School of Biological Sciences, that his name is Dr. Frank laferla, la fer LA. They are studying Alzheimer's disease and related dementias, both locally, nationally and internationally. And they're dealing with a large cross section of our population with dementia at all socio economic levels. So I think those would be a couple of individuals I would recommend."]
+[5.513273239135742, 6.046118259429932, "It's awesome. Thank you so much."]
+[-1.4274173974990845, -2.1078176498413086, "Yeah, I'm honored that you asked. And again, you know, I feel like I did an okay job, I think I could have done a better job had I had some chances to think about these questions. And I know you've got a process in place. I'm not suggesting it's bad. It's actually Tammy did a beautiful job. But there's some very, very heavy topics here that I will step away from and think more about now that we've spent this time together. And I applaud you all for doing this. I applaud the county for reaching out. Just the fact that this is, you know, looking at the master plan on aging has been in place, and growing and developing now for several years. So I'm not negative. I think it's actually I think you guys are doing the right things. I think we just have to figure out how do they intersect, I still feel like there's just big pieces that are either flying over or under one another. And we'll get there I think if we continue to do this as as a community. But, you know, I I'm not discouraged. I'm more encouraged about what I think I'm seeing at the government level. And I just think we need to do a little better job kind of mirroring both the private sector in the government sector together to kind of come come to the end of trying to not come to an end, but kind of solve more of these problems. So thanks, Tammy. I really appreciate Oh,"]
+[4.049291610717773, 5.864131450653076, "Absolutely. You do that because I'm going to be doing some thinking about this. But the reality is, is you know, we can only dissect it to kind of one section at Time, so be sure to do that. And again, thank you for asking me. I appreciate it. And of course,"]
+[4.854589462280273, 3.362544298171997, "of course, you know. Yeah, I'll just conclude the formal part of this interview is I just want to say that so this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research and, and then if you find that you had more to share, please feel free to reach out to us. Our contact information is available on our website www.soc.com. And you can leave anonymous voicemail or not anonymous on our telephone line at any time. And of course, this is off script you can reach out to me anytime, Randy. So let me let me just end the recording for now. Great."]
+[4.118521213531494, 6.869139671325684, "Okay, come on. I know how to do this okay. I apologize."]
+[-2.7051069736480713, -3.181133985519409, "Okay the primary goal today is to identify what needs you think are the most important to the older adult population you serve. Those who are 60 and older we want you to think as broadly as possible taken into consideration of the older adults, caregiver families and their community. I'm going to share my screen soon so you can see a list of common issue and concern impacting older adult please take a few minutes to read this read through this list let me know when you are ready to begin. Okay, I'm gonna share my screen and when you want me to scroll just let me know"]
+[4.308471202850342, 5.391847610473633, "you're going can you just scroll down a little bit"]
+[3.60522198677063, 4.930511951446533, "skip it right there. Want to make sure I'm reading through everything Yeah."]
+[4.311352252960205, 5.377185821533203, "Buying a scroll down"]
+[1.2691023349761963, 6.403463363647461, "okay, I think I got it"]
+[5.1301422119140625, 3.926008939743042, "I think you're on mute. I can't hear you."]
+[3.9404420852661133, 7.274128437042236, "I'm sorry."]
+[-1.3544827699661255, -1.6232959032058716, "Sure. So my role I work as the health and wellness coordinator at the Newport Mesa YMCA. And my role here aside from overseeing the personal training and health and wellness staff, I also do personal training, I lead health and wellness classes myself so the main classes I lead are active older adults strength and conditioning. And I leave that three days a week and my pride and my target audience for that is all is active older adults so So the vast majority of them are their seniors, they're retired. Quite a few of them have, you know, have have hip pain, simple shoulder injuries, and a lot of them the common you know, wear and tear, older age, older age injuries to major joints. And so I've made it a priority to make sure that at least in my classes, we do a lot of functional functional movement to help build up those joints, especially through the shoulders and hips, work on functional movement through certain muscle groups. So like side like the like the glutes, forearms, grip strength area that tend to slowly deteriorate over time, make sure those areas are strong and functional, as well as I put a really big focus on on the neuro muscular aspect of of strength training. So I tried to make sure that a lot of exercises we do have a have some kind of balance component, or is more of a kind of a different a different exercise style than what they're used to just so that their brain is used to having to having to relearn new movements. You know, just because just because over time, you know, people that are older, they don't need to they don't need to learn new things very often. And it's overtaking more so I try to have my classes take more of an exercise approach to that. You know, so so they're so their body sounds like maybe coordinate a little more of itself while have the right arm lifting and doing something different than the left arm so they're having to put a little more cognitive processing into the movements that they're doing. Balanced coordination instability are another really really big vital parts of the exercises that I do with my with my clients, and as well as as well as with my with my strength training active older adult classes, that I try to remind them as often I can in in the Delta in a delicate way like hey guys, you know, it takes one fall to chain it takes one fall to change your life forever. So we're gonna so we're gonna do we're gonna work we're going to work on on movement patterns and exercises to help you already have a pre programmed response so in the event you do have a forward stumble, we've we've strengthened the right the right joints, specifically through the ankles through the feet through a lower body. And we try to work and we tried to make as many proactive strength training as we can. So in the event someone does have a in maybe a an unexpected stumble forward or backwards that they're advised able to at least respond to it to hopefully minimize the risk of injury so so my active older adults have been having they're having their strength training be focused on on fall prevention is really big, as well as reminding them as well, the value of what what proper strength training does for their independent quality of life. You know, because in the in the past work I've done in seeing in senior livings and assisted livings before most, most seniors are there because their fall risk, their hips are really weak, their legs are really weak. And so my and so my kind of long term goal for every client I see. And then for members who regularly take my class is that they can maintain their independence as they get older, if we reduce their risk of falling, then we're going to increase their total their total independence and their ability to choose to live where they want to live. Because that's my, my, my major role here. But from from an administration perspective, I oversee this I oversee a lot of the group exercise classes I oversee all the group exercise classes and oversee the personal trainers, and then from more of a men also take on that training role myself and leading and conducting my classes."]
+[5.6764750480651855, 6.813652515411377, "Thank you. Um,"]
+[0.2997977137565613, -1.2969136238098145, "a lot, a lot of it see off the off the top of my head a lot of this seems, seems there, I can't think of anything really specific. I mean, I mean, I would say other I would say some of the other concerns and this can probably be in this comprise you put into you know, things like diabetes, obesity, diet, fitness and wellness, I would say a big concern is loss of like loss of leg strength as people get older. And especially with with with women loss of bone density, is because women will typically, you know, be postmenopausal right around the same time they retire. So all sudden, they retire, they have all they have all this new free time, but they're their estrogen levels have dropped pretty significantly, so their bone density gets lower, so there's a much higher risk of things I have osteoporosis and osteopenia. And that's a really big thing I see with a lot of my client with a lot of my clients and a lot of members who were asking me things about that. Yeah, and then and then on top of that, when people have had those issues start to rise up it's gonna affect their emotional well being and sometimes even their sense of respect. But in terms of things that are missing here, I'm not I don't I can't think of anything off the top of my head that would be missing there are some maybe there are some specific things that I would like to see more of but it can be but the specifics I'm looking for again as someone who works in like the strength training side of things and strength training for seniors and I think that can be kind of covered I think that can be covered under the under the diet and the diet and fitness side of things. But here's what we currently have for my for my role here and what I've seen here I think that's fine."]
+[2.558375835418701, 3.8256053924560547, "So up the next on the list, including those that you suggested, Please rank the top three that you feel are the most important."]
+[-0.9981520771980286, 1.064673900604248, "I would say things are the things that have the highest priority would be I'll say number one, probably Community and Family Safety. Let's see diet, fitness and nutrition and then can go scroll down to the second half"]
+[-1.4025335311889648, 1.1469343900680542, "then I would say either healthcare, healthcare access and delivery or unintentional injuries, I think those two can kind of go hand in hand because you can have an unintentional injury then you're gonna need a health care access. But I would say probably the probably the health care act Access and delivery, it's hard to say a top three because they all have they, they're all they all are, are very, very important. But I would say those are probably the top three and and if those three are taken care of, then that, you know, self respect and emotional well being are usually taken care of as well with those."]
+[3.1154305934906006, 7.875797271728516, "Can you screw up a little bit just saying, yeah."]
+[-1.388863205909729, -1.985228180885315, "Yeah, so with Yeah, so the Canadian Family Safety, I mean, yeah, domestic abuse, elder abuse. I mean, there's, there's issues of elder abuse where, where the senior doesn't even know that's happening to them. Because a lot of seniors, they rely a lot on their on either their, you know, that like a live in nurse, whoever their main caregiver is, their kids, their grandkids, and they and they are in a very, they're in a very vulnerable, vulnerable position, especially nowadays, as you know, as, as far as financial security gets more and more sophisticated, there's more technology that is that is included in that. And so I feel like a lot of a lot of seniors from the conversations that I've seen here, you know, they can feel really overwhelmed and having to navigate all that new all this, you know, the independent living in our, in our modern age is getting more and more modernized more and more quickly. So I think Elder abuse is it can can be very, very prevalent. I think that in the exploitation side as well, where they don't even know that this is happening to them. So trying to have maybe some maybe some some safety nets to make sure some safety nets, or some or some resources for seniors who maybe they think they might they might be being taken advantage of by a family member or caregiver, but aren't quite sure about it, you know, having some form resources, or having some kind of resource for them would be valuable there. And then at the wine at the YMCA, you know, we you know, we we make we make safe safety and issuing time, we make safety a priority and make it very inclusive. So we need so so from a personal trainer perspective as a mandated reporter that also extends not just to kids, but to seniors as well. Are they going home to someone to someone that is taking care of them and to something safe. Because then because as they get older, they're not quite, but not as physically strong. They're not mentally as sharp or quick as maybe making as some of the other financial decisions that need to be made. And so it can be it can be easy, it's easy to be to be exploited. And trying to prevent that it's always a priority."]
+[3.309448003768921, 6.200619697570801, "Can you repeat that question one more time,"]
+[-1.5211985111236572, -1.742635726928711, "Um, I would say the, I would say the main barrier for that would be probably just information to the seniors and to try to show them try to show and educate them like here, here here are signs of, of financial abuse of elder abuse, Hear hear this here. Here's some things that you can be you can look out for. Because there's even issues of elder abuse where, where the elder and and the caregiver don't even realize that that elder elder abuse going on. I've seen that in my own family before where you know, where, you know, I've had family members who have, who no longer are capable of living on their own anymore. And their refusal to get help can you know potentially be seen as as, as elder abuse by you know, by the family for not trying to intervene, provide that better quality of life. That's important. A big part of that is just education and then making it and making sure that that senior knows that okay, if I have something going on, then I know that I need to know that I know this is who I can call or talk to in order to get that taken care of."]
+[-4.043572902679443, -1.9396547079086304, "They're different experiences for different groups of older adults from different backgrounds."]
+[-0.4183492660522461, -0.7193389534950256, "Um, yeah, I imagine so I'm sure there's a big cultural component to it. I mean, Orange County has a has an extremely diverse group of people in it. Many different cultures, nationalities. And while I'm not going to speak to the the cultural differences to maybe an Asian American or Middle Eastern American family, you know, like, because that amount from those parts, I can't I can't speak on that accurately. I'm sure there, I'm sure there is. I'm sure that is quite a difference between I'm sure there's quite a difference between how how different families from different cultures will treat the eldest members of their of their family,"]
+[-1.406012773513794, -2.0264501571655273, "Um, I think the best way just to address that issue is just to provide resources and a sense of security to the senior If so, like, so for. So for a space like here, like if my specific branch of the YMCA, having you know, having a having a staff, that the having a staff that seniors feel supported by and the seniors trust a lot, whether it's their front desk, or their group fitness instructors, having them trust us enough to say, hey, here's what I think may be happening. And many, many personal trainers, you know, get they have very, very close relationships with their clients over time. So it's really common to talk to talk about family members, I had a client this afternoon, who was telling me about how excited they were to see Yeah, ditzy there and to see their grandkids later in the week, grandkids who are older, and like their mid 20s are really excited to see their older grandkids. You know, but but when they say that they also will, you know, occasionally bring up, you know, read, you know, things that could be seen as red flags, or just like to shoot the breeze for a while. Yeah, and so, so do so developing that those community relationships where seniors feel like they have someone that they can tell something to and even in my relatively limited role as a trainer like yeah, sure, my main job is to make sure that you are that you are strong, you're fit, you're healthy, you're balanced, you can walk well, those are those are my main roles, my clients still will have have have adopted the reassurance and the comfort, to tell me you know, the tell me maybe some other other things that are going on, and some little family problems. Thankfully, I haven't had a client tell me anything that would make me need to, you know, call Protective Services, thankfully. But it is always something that I am cognizant of, and it is very, it is nice to know that my, my clients, as well as the other personal trainers hear their clients feel safe enough to tell their trainer. Hey, I trust you enough to tell you, here's what I think may be happening to me at home."]
+[-1.3543554544448853, -2.0136139392852783, "Yeah, the senior are very fortunate to have you guys. Somebody they can talk to. So when you think of diet, fitness and nutrition, how or why older adults struggling with this issue."]
+[-1.231967568397522, -1.8942718505859375, "Um, I think there's a couple of things for that one, the food is a lot, it's gotten a lot more complicated over the last 50 years, we have, you know, at least at least in the United States, people don't die of hunger anymore. That's not a thing. But we're seeing on the exact opposite side. You know, there's mounting like malnutrition through excessive eating. It has been a really it has been a really big problem with with with hyper processed foods and foods that we can get a lot of calories out of but little new little nutrition out of. So I feel like for last seen for a lot of seniors and this applies to really every age bracket. Anyone who buys their own food experiences this seniors especially though, where you have where you have, yeah, you have so many options. You don't know what is good for you. Why the trans fat bad and why is a saturated fat also bad for me, but some fats are good. Were the good ones were the bad ones. Why it was so complex that this carbohydrate, why is this simple one bad for me and just not having the educational tools to know how to read a food label and how to identify maybe someone like the you know, the grocery store marketing tricks to make a food seem healthier than it is. And I think the other side of it is some folks are you know, you hit 8590 years old. Yeah, you know, I'm older. I've gotten to this stage of my life. I'm going to eat what I want. Because food is an emotional experience for a lot of people. And some seniors want to just lean into that and say, You know what, I'm going to do what I want. It's my body. I've been I'm old enough, I'm retired. I'm allowed to live this way. So We'll just go for it. So I think it's a combination of, or at least the issues with, you know, with with, especially diet, it's a combination of maybe lack lack of a lack of education to the senior of what the right things are to eat, and why it's good to eat these X y&z good things. And Pro, and probably the personal choice of saying, Yeah, I decided that I don't want to put in as much effort anymore. And so I'm just gonna eat whatever feels good to me at the time."]
+[-1.2178188562393188, -1.5312213897705078, "So I look at that in two different ways. You know, because I gave two answers there. And I think the easier one to answer is you have the barrier for why people want to just eat what they want all the time. I think that if I think that if we were able to do a better job of explaining, okay, let's, you know, here's why what you eat matters a lot. Because if you eat if you eat really poorly, your quality of life, cognitive, pretty poor, as well, if you eat really well, that's going to help you have a better quality of life. And so, you know, so I think part of that is trying to help people, maybe separate the emotional response and the emotional age relationship to food and have it be more had them observe food, and what they eat is more of a here's fuel that I need. For my body, I'm eating, I'm eating this thing so that my body feels good. And I bike thanks. And you by performing well, and by then by living, you know, in a less painful way. And I think the other and then I think the other, I think the other barrier to entry there, you know, is with with the educational resources is there's just not enough educational resources, or at least not not as many affordable ones. And that's something to work through. So the YMCA over the summer, we're starting off in piloting a, a nutrition plan where we partnered with a with a registered dietitian, who's going to be actually, you know, writing out nutrition programs for individual members that sign up for it, we're still definitely in the pilot stages. So we're not doing anything. It's not super widespread or really being marketed out out yet. But that is something we're doing because we've had members who have asked us, you know, for quite a while now, hey, you know, what, what do I eat, I need to get my diet under control. I feel like I don't have control. I feel like I lose all sense of reason. When I see certain foods, I just need help managing that, what can I do so we're actively trying to provide the new nutritional resources. Again, that's still it's still a couple months away from from really, from really hitting our members. But that is something that that we are doing. So we're actively trying to eliminate, we're trying to eliminate that barrier to entry by providing educational resources, and providing someone who can actually walk with a member in their in their journey to have a more structured diet with less chaos in it."]
+[5.122622966766357, 7.168659687042236, "Yeah, that's very interesting."]
+[-0.7500542998313904, -0.7814829349517822, "Yeah, you know, a lot of people now, kind of like what the previous with the previous question about community safety, different, different cultures will have a different have a different kind of priority towards certain foods or a different or different bias towards certain foods or against another, you know, there's, you know, like, you know, like, like, like seniors who maybe have some more more Greek and Mediterranean roots, they're gonna be all in on a med train diet a lot, a lot, a lot of veggies, a lot of veggies, lamb fish that's been really, really big for them. You know, and then you have some Hispanic, Hispanic families really big, really big on on beans, carne asada, rice, and a lot of, you know, a lot of meals like that. And not to say that not to say that one, one cultural diet is better than the other. That's not no, it's, it's a little challenging to say that because we all processed foods, there's general rules, but every person processes food a little bit differently, and there's that major genetic component, that that that's part of that so, you know, so So the culture differences, it's really, really it's really hard to say, but I would, I would, I would say I'll say by and large from a cultural perspective, each culture can agree to maybe take a step back away from fried and processed foods that will be okay. I have noticed I've noticed as well though, that the you know, there are a lot that you know, selling some of the some of the days the Asian families Around here, as well as all Hispanic families, yeah, they like to they cook in house a lot, which is good, you know, they go for more of a more of a home cooked meal, which is always which is always always desired. That's almost a lot of times what we better for you than most things that you get out from the the cultural differences with with food are going to be very, very fast."]
+[-1.2183690071105957, -1.9113571643829346, "Um, I think the YMCA is on the right path to addressing that issue by providing a in house nutritionist I say okay, this, this is a person that is going to be leading our big diet in it, I'm being nutrition initiative. So providing so providing the resource, the resources, and resources well, as well as the options then that the seniors have to feel like okay, to feel like, okay, you know, maybe maybe this isn't out of control, and there is something I can actually do about this, you know, because every time because every time you you know, if you just go on the internet, and just, you know, go you know, go to Google or any search engine and look up what are good things to have, you know, you're gonna have some consistent things you'll find and then you're gonna have a lose 10 pounds in a week program, and is there gonna be some really quick flush diet and so seniors going through the seniors who can easily get trapped, or, or get easily pulled into the into like the flesh diet fad, it's gonna be really hard for them to bounce back from it because they're naturally older and little more frail. So, yeah, so that's saying, okay, you know, everyone's gonna do things a little bit differently, but you for sure, should not do these types of diet plans will be would be ideal."]
+[-1.9524054527282715, -1.1922709941864014, "Yeah, um, you know, with the, with, with the cost of medicine and health insurance, a lot of seniors are there on their on a, a fixed income. So, so for them, it's, you know, what is what is worth me spending my limited income on. I mean, I don't know if I can find a for a copay to go into to go to go get my health care for this right now. Maybe I'll just put it off, you know, but with but with law seniors, you know, with seniors have, especially an injury, or maybe some something internally wrong, you know, the more than put it off, the more expensive is going to be and then they really can't afford it at that point. Yeah, and then on our side said, that is, you know, do do seniors feel like they have, they have have a doctor or a place of medicine, they can go to where they do feel like they're being, you know, respected and treated well and actually treated like, like a person and not just like a baby, I feel like I feel like a lot. I feel like a lot of people have a tendency where, you know, as, as seniors get older and older, we kind of like regress in our talking and always talk to them, like their toddlers, you know, instead of fully functioning adults. So having access to having healthcare professionals who are capable of an cognizant of talking to their seniors, as adults and not just like grown babies would be a good step in the right direction."]
+[-1.6301853656768799, 0.5395708084106445, "health care access and delivery."]
+[-1.6028696298599243, -1.3328696489334106, "Yeah, I'll say the barrier there is going to be probably I would say maybe cost would be would be a big one. You know, you know, while my role here in the YMCA doesn't Yeah, we don't transport people to the hospital or do it or do anything in actual in actual medicine in a traditional sense so it's hard so it's hard for me to say in my in my role here you know, but there but we do take take an element of Jerry of Geriatric Care. And then trying to provide for that population just through, you know, through, through through structured exercise that is specific for that for that group or for that type of population. But one of the barriers to that is having is is is laying seniors know that there are that there are options to them, you know, good telehealth care access and delivery. sure a lot of people are going to consider that, you know, your your trip to urgent care to hold the pharmacy, and those are definitely really, really big parts of health care. Yeah, because of her ex, like, because time spent in exercise is less money spent in the emergency room, typically. So just so just having having, having seniors be, oh, be aware of what are other ways that they can other ways that they can invest in their health care, that would be more it would be just as if not more cost effective than actual, then actually just going to the doctor all the time, because you can only you can only medicate yourself so much like, yeah, that's a that you're just you're just buying time at that point. It's not, it's not quite, it's not quite quite as quite as valuable is actually yeah, encouraging encouraging seniors and getting seniors to actually exercise themselves with with a trusted professional"]
+[-4.095073699951172, -1.946988821029663, "attire, different experiences for different group of older adults from different backgrounds."]
+[-1.1222740411758423, -1.5296145677566528, "I imagine I imagine there are, I've noticed that. And again, this is in my in the scope that I've noticed here, I've noticed that our I noticed that seniors, seniors have an Asian background, they tend to be very, very on top of their exercise program. Yeah, this is not uncommon to have to have seen you to have, you know, seniors in our bootcamp classes and our biochem classes in itself are kind of higher intensity classes, you know, it's it's these, these all of these older, these or Asian, Asian Americans who are trying to who are there, they look, it seems to me, like they're enjoying the physical investment in their health, through through strength training, whereas a lot, whereas a lot of a lot older, maybe all the older, Caucasian seniors here they will be, you know, they'll work out, they'll work out the stuff, they will still make that that investment and that investment in their physical well being but the kind of like dragging their feet doing it and not quite as like, excited about it. Yes, yeah. So so so culturally, yeah, it's gonna definitely, this can definitely change a lot. And that also is probably more dependent on the location, I am at the border of my locations at the border of Newport Beach, Costa Mesa. So it makes sense is going to be you know, there's not going to be quite as many Hispanics in this area. Whereas maybe like the Fullerton YMCA, it will be a much different group of people over there or in Huntington Beach, much different group over there. So it's hard to say exactly when with respect to eat to each branch of the organization. But But yeah, yeah, I've noticed that culturally speaking, there is a definitely a different a different kind of Geriatric outlook on on your on your healthcare access, and some and some seniors just have a built in distrust of, of going to Doctor sometimes that says, yeah, that's, that's, yeah, that's how it is."]
+[-1.8715764284133911, -1.2570432424545288, "Um, yeah, so aside from kind of a back into why just answered I was saying the obviously their thing is trying to maybe maybe, like, maybe D stigmatize some of them, some of them in the medical profession. You know, because I I've had I've had a lot like, like older grandparents who, yeah, who, again, they look like me, you know, some older white guys who are just not who, you know, naturally out, I'll kind of trust doctors, they're in it for the money. They're today's kind of a very, yeah, they're very apprehensive and distrusting of certain professions. hire new doctors are one of them. So trying so trying to provide resources and say, Okay, well, you know, I get You know, maybe not, maybe you don't trust doctors as a whole, but here, but here are some some really well, so really highly regarded, you know, medical professionals in our local area that would serve, there was certainly well, as well. And I think the other part would be also educating seniors on you know, just because you need to go the doctor doesn't mean, you also need to shell out 1000s of dollars for a medicine, you know, maybe, maybe, maybe try try, try our best to equip seniors ahead of time and say, okay, you know, here's, here's kind of like, yeah, sure, here, here's the pain you're feeling or the discomfort you're feeling. And you won't get checked out what you're scared to. Here's, here's a list of questions that you should ask, and try to provide, and try to provide some kind of a rubric of here's how to make here's how to make the doctor's office less scary, and more informative, by by asking these, by asking these questions, specifically about your health."]
+[3.7423882484436035, 7.899590969085693, "Um, oh, make sure that I Right."]
+[-1.8310297727584839, -0.7605775594711304, "I would say it depends on your income bracket. So if you're, and, yeah, that may sound a little vague, because that can apply in a lot of different areas. You know, if you have more income, you have more accessibility and to different things. You know, they're, you know, for them every time they get sick, there's a major fear component of, am I going to am I going to, cannot do I know, I cannot afford to go to the doctor for something that may be life threatening. And so there is that. So there there is there is that risk there. So I would say the accessibility part of it for at least and this is in the mind, in the mind of seniors, I don't have the data. I don't have the data in front of me to to accurately say if this is, you know, generally for sure applied, but I think in the mind of seniors. You know, can I afford health care whether or not I absolutely need it, and ask me health care both with you know, both internal medicine and even like dental care as a part of that as well. You know, because we're having getting getting a new a new a new top bridge. That's $20,000. Right there. That's a big ask for a lot of seniors to commit to. Yeah, so. Yeah, so yeah. So trying to trying to make things more affordable would definitely be would definitely be good. And if you're older, sure. If you're I mean, if you're well, if you're wealthier come from a wealthier family, maybe you're tired with more more in your bank than most people did. Then yeah, those things are accessible for you. Great. I will say that I will say the inaccessibility gets dramatically bigger as we get to like, kind of the lower middle class and below that is when the accessibility becomes really really limited. From there and then the accessibility you do kit do get is not particularly high quality."]
+[3.7805941104888916, 15.469717979431152, "Yeah."]
+[-1.5850335359573364, -1.2665669918060303, "I would say it is. Maybe maybe a little, maybe a little bit below average. A lot. A lot of it depends on where you're going to see. I think a lot is gonna depend on where you seek that care from. Yeah, okay. So yeah, so because most seniors who are on your medical or Medicare there, they have some kind of health insurance you know, in the in their insurance covers a YMCA membership which is great. So that can so that that's really great long term care for them just so that they just they know they had they have a place they can go exercise and put some effort into their physical health and wellness, which is great, wonderful. But but from a from a medic, a medicine perspective. Yeah, it's harder. It's harder. For me to say exactly what exactly how how good that would be, but I do know that. But from my experience here, I know we have a lot of numbers. And I have most of my clients who they are putting their who they're putting their, their time in the gym and in their classes as weights as a way to invest in their long term care, because they're saying, okay, you know, I just retired, I'm 65 years old, I want to be able to run around with my grandkids and my great grandkids later. So I have so I have older clients, I have clients in my, in their 70s and 80s, who are still looking 10 or 15 years in the future of saying, I'm investing in my health, I'm investing in my long term care here. So that I can, you know, still have that still have that time later. Yeah, so as far as Orange County, Orange County as a whole, there's probably probably some work probably definitely some work to be done for the long term care of things. But remember, but for members that come the members that I see here, they they make it they make it a big personal commitment to invest in their in their long term care."]
+[-2.1104166507720947, -1.6049549579620361, "Yeah, so I feel like with, I feel like the the mental health, the mental health conversation is, it's relatively new, especially for seniors. 20 30 years ago, that just didn't happen. And so and so I think a lot right now is is, is helping seniors to identify what what that what the mental what mental health even is, and what that looks like, you know, because because it's not as simple as, it's not as simple as you know, someone in their early 20s, who just wants to have who just wants to like sleep in a little bit on a Wednesday when they shouldn't be at work. And then like from at the office, it's a little more as a little more intricate, and little more complex than that. And so trying to trying to break down the stigma between mental health and trying to make sure that make sure there is an understanding of Yeah, your mental health is, is really valuable. It's really important. It's going to it's going to be it's going to be the difference between, you know, and wanting to wake up in the morning versus hoping to stay asleep. To try and try and just to correct some of the some of the misconceptions about what, what, what mental health is and how to actually invest in it."]
+[3.69199538230896, 15.104841232299805, "Yes."]
+[0.6352693438529968, -3.081310749053955, "Um, yeah, it's gonna vary depending on where you live because orange with Orange County is why why it is it is going to have really well we're really wealthy areas like Laguna Beach and Newport Beach. And that's going to have really large, maybe lower income populations like Santa Ana says, uh, so it's, it's hard. I would say I would say in the I would say, south of Costa Mesa is going to be pretty good. Yeah, we're looking we're looking at Irvine, Aliso Viejo Mission Viejo Laguna Laguna Woods, especially those areas, you know, they're gonna they're gonna be great. And then I will say for Costa Mesa, maybe about half of Costa Mesa, going up towards maybe the back end maybe the Santa Ana slash test inside of Santa Ana. That area, you know, and then extending out to like Garden Grove Fountain Valley, maybe maybe this May the social and human services aren't they're not they're not gonna be as great over there can. Yeah, that area is known for being maybe a little bit lower income, maybe having a little more issues with a little more issues with, you know, with fluent language with with death and gang related stuff out there. So it's not so it's not quite as, as, as great of a place for you know, for for an older population for seniors that feel somewhat vulnerable. So it sounds so when you're taking Yeah, we're we're taking Orange County, and you're, and you're kind of had to split it in half like that, you know, half of the half the county is doing pretty well. Maybe 25% is doing medium to well, and then the other 25% has definitely, definitely some work to be done less so work towards less successful and less and less acceptable."]
+[3.733386754989624, 15.471553802490234, "Yeah."]
+[0.10218800604343414, 3.398099184036255, "Um, I think that depends on what your definition of the word challenge is. Given given my my my background in health and wellness, and especially one educate people, the purpose of exercise, my opinion, is that the biggest is that the biggest problem is going to in facing seniors in the next 10 years, is going to be a lack of straightaway to phrase this. People not investing in their, in their, in their own health, that that's the biggest one, I am a big big proponent in being proactive about our health because there's a lot of times I'll see people who they'll have, you know, they go to the doctor, and they get a major health scare where the doctor says, Okay, you're, you're pre you're pre diabetic, you have osteopenia, yeah, your your mental health is starting to deteriorate, go access, people who will start who will begin a geriatric exercise program because their doctor, more or less scare them into feeling like they need to do it. I take more I take and I encourage everyone else, you know them around, to take a proactive approach to say, Okay, I'm gonna start, I'm gonna start doing exercise program, and I'm gonna start trying to clean up my diet and eat better early to prevent that, to prevent that health scare to make sure that I will still live longer, because there's a lot of times because because medical science has gone a very, very long way. And you can keep someone alive for a long time with a terrible quality of life. Like he missed a lot of lives. easy part. Yeah, we have, we have no technology to do that. But making sure that someone has a has a high quality of life and enjoys, and enjoys the life that they have left. That's a whole nother story. So and then so in the next in the next 10 In the next 10 years. We know how, you know, things are pretty good things are fairly convenient for a lot of seniors, you know, I would say I would say, the next 10 years, they're going to start to unintentionally lose a lot of a lot of their independence because they're not going to they're just going to kind of forget about you know what happens when you get when you get older. Let's say I say after him just in short, next 10 years, I would say an individual's physical health will be their biggest challenge in the next 10 years and then the maintaining of that physical health"]
+[-0.7608518004417419, -2.2779483795166016, "Um I think that I think the government's role should be not financial assistance in the way of just giving a lump sum of money to seniors, but providing providing more more affordable affordable resources. And would that be a okay yeah, here's a here's a here's a a affordable government sponsored exercise program and nutrition plan for seniors maybe hard to say off top my head but Neva maybe that maybe that could be a good resource for the seniors or but they're always they're always scared and worried about money slash their remaining amount of money to live off of and their health. Probably not. But at the very least, I think it's the government's responsibility to give resources and say hey, here's here is what we have for you or here's some organizations that we partner with, that can help to address these things. They can help to address these these concerns for you. Because if someone 70 80 years old, and they feel financially comfortable. And they feel like they are strong enough to independently move, move themselves around and not feel like a fiscal burden to others, then they're going to be doing great. So yeah, so yeah, I think I think the government does have, you know, it plays a role or at least has some kind of obligation to, again, we don't want to force seniors to work, but provide them with, you know, but provide them with resort with a poor resource take care of themselves. And maybe even, you know, you may even some higher quality senior volunteer work. Yeah, because as as seniors get older, they're retired, you know, they left their career they're in for 30 or 40 years. What am I How am I contributing to society at large, because seniors feel a very, a very, you know, what I think is a noble a noble sense of, I want to contribute to, I want to contribute to what is going on, they want to be involved in, in society and in their communities. So, so the government having Kevin made me some, some more volunteer programs will be great. Like, yeah, like, like, as for a little example, you know, at Fairview Park in Costa Mesa, every like second, every, like, second or third weekend of the month. You know, there's this little train track for children, and it's 100% volunteer community runs, always seniors, always, always, always a few, a few grandfathers out there, just, you know, you know, conducting a train with all these little kids on it is, is really great volunteer service that we get to see. And you know, kids love it. And you know, and the seniors that are out there running it, and the volunteers that are running it, for them, they're like, yeah, yeah, this is great. Look, we're happy these kids are, you know, sure, I may not be, I may not be in my professional career anymore. But I'm doing something that that brings, that brings me joy, because bringing joy to others in this area. Seniors, they love they love community, and they love community involvement, and belonging. And they take a real sense of pride and wherever it is they in wherever it is they volunteer, grew up and just kind of live in."]
+[4.7838592529296875, 3.457778215408325, "So just want to be my full time. I only have two more questions to the interview. Yes."]
+[-1.6076942682266235, -2.70809006690979, "Well, I haven't met every senior yet. So it's hard to say. But, but I would say I would say those in the lowest those in the lowest income brackets are going to be the ones that hard to get the most tension made, mainly because they're not going to put themselves out there as much because they can't afford to."]
+[3.639052391052246, 10.9638090133667, "Um"]
+[-1.3566993474960327, -2.1668217182159424, "Let's see. I would say, reflecting on the list that you provided, I would say the emotional well being is probably one that's been overlooked a little bit. Is I think it's easy for senior, it's easier for seniors to feel lonely. You know, which, as in, you know, their kids get older than their kids are raising their own kids. And so it's easy for, you know, for a grandma or grandmother and grandfather to kind of spend more time by themselves, especially if they're if they're widowed and spend more time by themselves and they would have expected Yes, I think I think that I think that if if you know if neighbors took a more kind of proactive, proactive role and trying to make put themselves out there to some of their older neighbors a little bit more of our even do or even little things of offering to go hey, can I can I take your trash cans down for you like little, little personal acts of service like that will go a lot or go a long way. I've seen Yeah, seniors having that emotional well being, in a sense, that sense of belonging somewhere and making them feel like they didn't, you know, they don't want to age out of the society they grew up in or they don't want to age out of a belonging to a community and trying to try to minimize that would be important because that's something that people aren't going to talk about very often, especially, especially see, I noticed that senior men are a lot more closed off in saying anything that remotely relates to feeling lonely or forgotten about things like that. That you know, that could also be You know, in some ways be characterized as elder abuse, if it gets really to the if it gets, you know, really to the extreme. But yeah, I would say I would say, I would say the emotional well being, and maybe even even a sense of respect and feeling seen and heard, is important, because we've we've had, we've had members here before, who will, you know, they'll bring up, they'll bring up a concern, a concern to, you know, to a staff member. And, you know, depending on how the staff member addresses it, or how proactive they are about whatever that concern is, I've had, I've had Mara swallow me before saying, hey, you know, I brought this I brought to someone's attention. I felt kind of brushed aside and I didn't, I felt like I wasn't being heard. And that's and that's a really, that's a really big deal. When someone doesn't feel heard. You know, younger folks are better at expressing their discontent with that. Older folks. They feel that they struggle to get to get those thoughts and feelings out there. So, yeah, I would say emotional, emotional well, being and respected."]
+[4.975235462188721, 3.4448299407958984, "Yeah, thank you so much for all your input and wisdom. So this concludes our interview. I want to thank you for your time. If you have anything more to share, please feel free to reach out and I'm gonna stop the recording now."]
+[-2.6869893074035645, -3.251779556274414, "Okay, primary goal today. Sure. I'm always nervous, just want to make sure that that that is working. That is the primary goal today is to identify what needs you think are most important to the older adult population that you serve. Those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families, and very community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Now, I'd like you to take a few minutes to read through this list. And let me know when you are ready to begin."]
+[4.684352874755859, 5.415810585021973, "And I tried to It looks small because I tried to fit on one page, but let me know if I need to move it down or enlarge or anything like that just"]
+[4.199288368225098, 7.385975360870361, "for right now. It's fine."]
+[3.712416648864746, 4.524354934692383, "If you take as much time as you need to go through this list Okay."]
+[3.6672937870025635, 7.118253707885742, "Yes. Okay. Okay. And then."]
+[-0.755735456943512, -3.091986894607544, "Sure. So I am the Human Services Manager senior with In Home supportive services with the county of Orange. And so my role is to oversee our Office of almost 200 staff. And so I have two managers under me. And then we have supervisors and social workers. And then of course, you know, the rest of the administrative staff and clerical staff. So my job is to make sure that we are following our policies and procedures, not only with the county policies and procedures, but also our state mandates to make sure that we are providing the services for eligible older adults to stay safely in their homes. So making sure that our social workers are going out within the 45 day mandate that they're required to go out to assess clients, making sure that we are meeting with the clients once per year, as that's also a state mandate. And then making sure that you know, we are providing resources for the families or the individuals that we're seeing that we're giving them information for any other services that we provide such as CalFresh. You know, any of the additional services that the county provides as far as basic services, and then making sure that we are sufficiently staffed in order to provide the services that we are mandated to provide for our community. Okay,"]
+[0.06334003806114197, -4.173318386077881, "just thinking about all right, thinking Orange County and looking at the list of some of the common issues and concerns impacting older adults. Um,"]
+[-1.374997854232788, 0.846228837966919, "this is a pretty good list. I would say we probably see all of these. When I was looking through I was like, Oh, yes, that one for sure. Definitely. I don't I just looking through it. I think this is a pretty comprehensive list as far as what we see, a lot of times, you know, we'll have to call Adult Protective Services APS because of you know, self neglect, food insecurity, different things, you know, where they're, you know, they don't have the means to provide, you know, basic necessities for themselves. So I think a lot of these issues that you have listed cover at all, I can't think of anything that is missing from here"]
+[2.484801769256592, 3.79537296295166, "after needs, and this list is ranked at top three that you feel are the most important. Okay,"]
+[3.6258809566497803, 6.585482597351074, "um, let's see."]
+[-1.901899814605713, 1.3182930946350098, "I would say behavioral and mental health for sure."]
+[-0.38118886947631836, 1.269265055656433, "Economic Security"]
+[-1.5139553546905518, -0.12438905239105225, "and probably for us, I would say caregiving, because that's a huge issue for us with the lack of caregivers that we have."]
+[3.2115838527679443, 4.741182804107666, "i Sorry, that's okay. Go ahead. Okay. So I will ask this ask you a set of questions based on the three areas that you identified."]
+[-0.5182105898857117, -0.13317841291427612, "I think a lot of times, what we see when our social workers are going into the home is that a lot of them either don't have family around, or they have isolated themselves from the people who do want to help them. You know, it seems like there may be some of these things happening. So I think that's probably why it's a big issues, because there's really nobody seeing some of these behaviors or these health issues."]
+[-1.831059217453003, -1.3271461725234985, "I think, barriers to seeing improvement. They, you know, a lot of older adults don't think that they need help, you know, they think that they're fine, and everything's fine, because, you know, they've been getting along this, this long for with what they have. And I think, you know, a lot of times there's access to medical care, whether they don't have transportation to get there, they need accompaniment to get to and from their medical appointments. I think those two barriers of, you know, not really thinking you need it. And then, you know, if you do think you need it kind of getting to those places, and kind of figuring out where you need to go and how to ask for help, I think are probably the biggest two."]
+[-4.029772758483887, -1.8952369689941406, "Yeah, alright. They are different experiences for different groups of older adults from different backgrounds, for example, where they live, their disability status, income, education level, etc."]
+[-0.3444712162017822, -1.1396682262420654, "I think so for sure, I think, you know, it all makes a difference. You know, if you are someone that has a lot of family around and maybe higher income where you'd have more access to people and resources, compared to if you have less family around and you have less access to people and resources, then I think that is going to make a difference. You know, where you who, who you go to for help, how you ask for help, who sees that you may need some help and maybe make suggestions. All of those things are kind of factors that would contribute to it. You know, and definitely, those would be different if you're in lower income. or higher income areas, as far as you know, education and stuff like that, I think that does play into it too. Because if you are educated on these are kind of some of the symptoms of anxiety or depression, or these are things that you know, I think, think this may not be right, you know, not feeling right. So I think some education plays into that as well. So I do think there are differences, when you're talking about, you know, the, where you live, how you live, your economics, all of that,"]
+[1.197677493095398, 5.373260974884033, "play a part in it."]
+[-2.1550490856170654, -1.036771535873413, "Good question. I think that, you know, the first thing would be making sure that older adults are getting into their doctors, you know, at least once a year, twice a year or as needed, depending on you know, what's going on with them, I think that's the first step is making sure that they are getting the care that they need, and that they are getting, you know, transportation to and from all of those things. So I think that would be the first step is making sure that they're they have access to medical care, and that they're actually utilizing it if they do have that access."]
+[0.10117509216070175, -0.6919563412666321, "So the second issue, you identify economic security, again, how or why are older adults struggling with this issue."]
+[0.08687108010053635, -1.0754443407058716, "I think a lot of times, with the older adults, when it comes to, you know, a lot of most of them are retired, they don't work, but the cost of living has increased. And they're, you know, whatever they're living off of whether it's social security or retirement, a lot of times that is not changing. So it's not fluctuating with what they need in order to pay their rent, get food on the table, pay their bills, you know, so a lot of times, what we see is that these older adults are not getting the food that they need, are not keeping up with the medication that is required to manage their different, you know, issues that they have. So I think, though, for economic security, you know, we do see a lot of the cost of living and being able to afford basic needs, and that includes food security."]
+[-0.7942636609077454, 2.2271037101745605, "And so what barriers exist to see improvement in this area."]
+[-0.9180964231491089, -1.4352847337722778, "As far as you know, like I said, a lot of times, these individuals are not eligible for other services, because of their income, whether they're getting, you know, some kind of retirement, they may not be, you know, eligible for, you know, food, you know, like CalFresh, or something like that. Or they may not know where to go to get those services or apply for them. And they really need help, and someone to kind of walk them through the steps in order to apply for these services. You know, and I think that, you know, some of the time, they just think, Well, I've been getting by this long, so it's fine, I don't need anything additional. So I think, you know, getting them to understand why it's good for them to apply for different services and benefits, so that they can afford basic needs and food and all of that."]
+[0.14862629771232605, -1.2235336303710938, "Yeah, I mean, definitely, obviously, if you you know, if you are, you know, of a higher income, and you don't have to worry about, you know, your money, and you're comfortable, you probably have enough money to afford basic needs and food every month. You know, the long term you know, how long will this last me if somebody's gonna take me shopping, you know, I have to make this last for a week because the next time isn't going to be for another week. So I think that is a lot of you know what Our older adults tend to look at"]
+[-0.927352786064148, -2.000105142593384, "I think, you know, I know we have CalFresh. And I know that there's food banks and stuff, but a lot of times, and we have, you know, Meals on Wheels, and we do have some of these different food, you know, services. But I think, again, just educating the older population on what's available to them, when they can get it, you know, providing transportation if needed. So really kind of making it more well known what is out there, and what's available for them. Because I think that lacks, especially for older adults, a lot of things, focus on families and children. Because, you know, they have lack of, you know, a lot of the same issues that struggling families and children have."]
+[-1.993760108947754, -0.7209482192993164, "The third topic, caregiving, so how and why are older adults struggling with this issue."]
+[-1.2228561639785767, -0.9478579163551331, "So what we normally see is, you know, especially with caregiving, one, they don't have friends or family around, or available to provide the care that they need. So that would be the first line. And then the second one is, you know, our public authority in Orange County provides caregivers, for the recipients on our program, referrals, you know, they give referrals, but we are so short on eligible providers, and, you know, we just don't have the amount of providers that we need in order to provide to our clients. So lack of caregiving, lack of caregivers, and then you know, lack of friends or family member who are able to provide services as well. So I think with those two, it's, it's unfortunate, because the needs of the recipient and of our older adults are not being met, because there isn't anybody to provide these services."]
+[-0.7449051141738892, 2.2806057929992676, "And what barriers exist to see improvements in this area,"]
+[-1.0954052209854126, -0.5559043884277344, "I would say the first barrier is, especially for IHSS, the amount that the providers get paid, you know, at minimum wage, or a little bit over minimum wage for the amount of work that they're doing. You know, not a lot of people are going to want to get paid minimum wage to clean and bathe someone and prepare food. And, you know, it's a pretty intensive amount of work that you have to do, depending on what the client has, you know, that they need help with. So I think that is the biggest barrier is the rate of pay, for sure. And then it's just recruitment and retention of the providers, you know, whether it's, they only want to do certain services, so you can't refer them out to a lot of people. You know, sometimes you have difficult clients, so they're hiring and firing providers regularly. So there's, there's quite a dip, you know, there's quite a number of different barriers and issues. But, you know, just trying to make sure that we're providing as much as we can, you know, as far as the caregiving aspect that was a hard one."]
+[-1.5420626401901245, -0.17318721115589142, "I'm sure there are, you know, but I think with caregiving, I think you run into the same issues. It's barely enough to live on."]
+[-0.37081003189086914, -0.33512362837791443, "I think that's pretty much it. I think it would, I think it would be the same. You know, you'd see the same things across a lot of different cultures, then socioeconomic status, probably."]
+[7.183457374572754, 6.156108379364014, "What do you suggest is the best way to work Just this issue,"]
+[-1.4257311820983887, -0.6324577927589417, "ah, I mean, definitely increasing the the rate of pay for caregivers who are, you know, paid. Well, this is what you're going to be limited to, you know, if you want to stay in your home, whereas if you maybe go to a skilled nursing facility or something, you know, which is the other alternative, you know, then you will have access to all of these things. So, I think, you know, educating people on what their, what their options are, and then also what's, what caregiving entails. Because I don't think a lot of people realize, you know, oh, I've got to take care of my mom or my dad, and then you realize, like, it is a 24/7 job a lot of times and, you know, they may need more help than you originally anticipated."]
+[-3.1762747764587402, -0.004687613341957331, "So that's the end of the sub questions for that. So moving on to the next one. The first one is geriatric care."]
+[-2.3213093280792236, 0.32635924220085144, "Um, I think we're talking about like medical care. Well, sorry."]
+[-3.378530740737915, -0.3521991968154907, "No, perfectly fine. I'll read the definition based on our survey, so geriatrics, the sub branch of health care that focuses on our unique needs as we age. Just as pediatricians specialize in health needs of children. geriatrician, and fellow geriatric health professionals specialize in the health needs of older people. Okay."]
+[4.743701934814453, 8.025888442993164, "Okay,"]
+[-1.7787216901779175, -1.960301399230957, "I think they're fairly accessible. I think, you know, there are a lot of programs that cater to older adults, you know, Cal Optima and some of the other programs that really focus on older adults and getting them the care that they need. So I do think, but I just don't think that a lot of people know what resources are out there for them. So although it's out there, and it's accessible, you know, again, educating people where to go, how to sign up, what services to look for, all of those things are important."]
+[-2.741670608520508, 0.2675084173679352, "Our definition of long term care is a variety of services, which help me both the medical and non medical needs of people with a chronic illness or disability, who cannot care for themselves for long periods. Okay. There are"]
+[-2.1100897789001465, -0.29031023383140564, "different, you know, programs for long term care. They're pretty accessible. I just don't know, you said accessible and adequate, adequate. Okay, I don't know how adequate they are. You know, I think in our experience, we've seen where people are put in long term care and then removed or they're only put there for a certain amount of time until whatever it is that they were put in there. You know, is finished. So I just don't know how adequate it is. Especially when you hear about you know, all the horror stories of different you know, programs and they leave their clients and don't check on them and all of those things so accessible. Yes, adequate. I'm kind of on the fence on that one."]
+[-1.9617688655853271, -1.881338357925415, "I think there's been a lot more focus on behavioral and mental health, you know, especially when you look at kind of like Alzheimer's, dementia, those types of things. So I think, again, it is accessible, I just don't know that a lot of people know where to go, or what to look for, especially older adults, and substance abuse. We have had a lot of clients that have substance abuse, and I haven't really seen a lot of programs that are focused on older adults. So I think that would be an area that could definitely be improved upon. Because I'm not sure how many programs there are that caters specifically to older adults, when it comes to like drug and alcohol addiction."]
+[-2.118899345397949, -1.8595341444015503, "Yeah, so I know that we have, we have Cal Optima who provides a lot of services for our older adults. There's Alzheimer's OC there's trying to think of what else I mean, there's so many different programs that maybe touch on it. Those are the only two that kind of come to me right now. But I know that there are a few other ones that might be Cal Optima related CalAim, and Pace and some of those other programs that are, you know, geared towards older adults, and encompass behavioral and mental health."]
+[2.897132396697998, 6.0891594886779785, "How Sorry, I'm gonna get the question is,"]
+[-0.7137928009033203, -4.045634746551514, "if you could describe how accessible or adequate in Orange County Oh,"]
+[-1.85017991065979, -1.95440673828125, "okay. Accessible again, I think it's very accessible. If you're technology savvy, you know, you can do everything online, and you know, apply online. But again, you have to know how to navigate the technology and how to do that, or have someone help you navigate. So as far as accessibility, you can go into the office, you can do it online, you know, you can call and get services. So I do think it is very accessible, I just don't know that, you know, a lot of times the older adults know what to do, or where to go, they need a little bit more help. And, as far as you know, if they're adequate. I think we could improve upon maybe how we provide services to that older population, again, a lot of times, you know, they're very old school, and they want something in writing, they just want to be able to talk to someone and, you know, so I think, you know, being sensitive to kind of where they're at and navigating them through, I think is important."]
+[-1.781816840171814, -2.0845401287078857, "I think for sure, technology, I think we're already seeing that, you know, technology has posed an issue for a lot of older adults, because pretty much everything is done online now. You know, so if you're used to writing checks and sending in payments, you know, a lot of things are done online now. So you really do have to know how to navigate the computer and do a lot of things online. So I think technology is going to be a big barrier. And then I think that, you know, as the cost of living continues to increase, I do think we're going to continue to see older adults kind of struggle financially, you know, because they're on a set income, and they're not able to really do anything to make more income, you know, especially if they're disabled or they have other issues that prevent them from, you know, doing a lot of things. I think, you know, definitely economic security and technology."]
+[-0.38801079988479614, -2.0784525871276855, "I think the government just really needs to pay attention to what is going on and realizing that our older adult population is increasing. We have continued to see an increase in just the amount of clients that are applying for services for us. So, you know, over the past five years, our applications have increased, like, you know, 20 to 30%. You know, and every year, it's like seven to 9%, that we're seeing an increase."]
+[1.9394042491912842, 3.055161237716675, "Oh, good question, the least amount of attention."]
+[-1.3715075254440308, -1.5144168138504028, "I don't know, that's a good question. Um, you know, I think that people who maybe aren't on social services benefits, or, you know, they, if, if we don't know about you, we can't help you type of mentality. So you know, we know, we can help the people who are on some of the benefits, services, so whether they're getting CalFresh, or they're receiving medical, or, you know, different things like that we know about them. Maybe they don't know that they're eligible for things. So I think you're missing probably a very large population of older adults who really do need assistance and need resources, but they just haven't been able to access them, or nobody's told them about it, they don't know where to go. And so you're missing a whole population."]
+[-2.1919994354248047, -2.1986494064331055, "Um, I think a big issue that is overlooked is, you know, kind of them being able to take care of themselves. I think, you know, you see older adults who are alone in their homes, maybe they don't have any family, they don't have anybody around. And so I think that is probably a big issue."]
+[2.8179104328155518, 6.682990550994873, "I just lost my train of thought. Tell me a question again."]
+[-1.5761191844940186, -1.6997716426849365, "Oh, yeah. Okay. Yeah. So I think, I think really, older adults being able to take care of themselves, you know, as they get older, you know, you think, Oh, well, they can take care of themselves. They've been doing it for this long, you know, and, you know, as you get older, there's less and less things you can do. Or maybe your mobility is not like it used to, you start to forget things. And so I think that a lot of people overlook that, that, you know, yes, my, my mom has been living by herself for you know, however many years, but as they get older, they may need help with more things. Oh, that was a little weird. Like, you know, catching little things that they forget that are, you know, they're repeating things or they're not remembering things. So just being, you know, a little more proactive and seeing what types of help our older adults need because they're change. They're, their needs change, they could change every couple of months, every couple of years, every year, you just don't know depending on you know, what kinds of things they have going on. So I think being really mindful of, you know, their changing needs."]
+[-0.9748409390449524, -3.8618195056915283, "Okay, moving on to our last last section. More questions to go. So, in addition to what we have already talked about, we just want to add dig a little deeper into your area of expertise. So thinking about in home supportive services, right care, care, caregiving, what are some ways that this area is working or not working for older adults in Orange County."]
+[-1.3444668054580688, -1.213633418083191, "Um, so as far as it working, I think that, you know, it does allow older adults to stay in their home, which is where they feel comfortable, they, you know, some of them have been in their home for a long time. And that allows them to do some things for themselves, instead of going into a skilled nursing facility or some type of assisted living, where everything is done for them, they really don't have a whole lot of autonomy in making decisions or doing things for themselves. So I think it provides a really great service for individuals to stay in their home. You know, but I think the other problem is, the problem is, is that being in your own home, if you don't have somebody to help you with the daily functions, like I said, our care, you know, we don't always have caregivers to go out or, you know, they may be in between getting, you know, one quit, and now they need a new one. So I think that is where we see a lot of issues where, you know, there is no nobody providing services. How is their house, all of those questions come into play. And that's usually when we see APS reports is because there's some self neglect, there's few food insecurity, maybe there's, you know, cleanliness issues throughout the house. So although it provides a great service for you to stay in your home, it also provides some challenges to make sure that everything is done the way that it should be done for you to stay safely in your home. And that's like, a big thing is, yes, you're in your home, but are you safe, you know, especially if you don't have a caregiver, which is, you know, an ongoing issue that we've seen,"]
+[2.9496214389801025, 0.05044344440102577, "and what new or revised policies are needed. Um, gosh."]
+[-1.31851327419281, -0.9447664618492126, "I don't I mean, I don't know if there's any new or revised policies that are needed, I think we just need really, you know, if we want to provide the best service to our clients, you know, we really need to get more caregivers, and have adequate staff to go out and see our clients. You know, so I think that is a big problem is, you know, like I said, recruiting caregivers, getting them to stay. And then making sure that we have the staff sufficiently staffed, in order to see the rising number of, you know, clients that we're seeing every month, every year, and being able to assess those clients and make sure that we're going out and visiting the home, you know, within a year, maybe, maybe there needs to be some wellness checks in between those, you know, because like I said, there may not be anybody else, besides the provider coming in and out of the home. So we, you know, we have seen, where, you know, there hasn't been a provider for a long time. And now there are issues, you know, with the client"]
+[-0.5738903284072876, -2.210982084274292, "I think the state, I think the state really has to recognize the need to make sure that our older adults are safe in their home, you know, they obviously created this program for a reason and to keep older adults in their home. But they haven't recognized that, that takes money. That takes staff, you know, across the state we're seeing where, you know, not just Orange County, but every IHSS program is increasing in the amount of clients that they're seeing. And the state is not giving us additional funding to hire new staff. You know, so I think that's a it's a big issue that has to come from the state down to really make it a priority so that we can provide the services that the state wants us to provide sufficiently, you know, not just the minimal but, you know, if they adequately gave us, you know, the funding for staffing, maybe we could do a little bit more so that you know Our clients aren't being referred to APS we're not seeing the issues that we have, you know, and our staff wouldn't be, you know, overwhelmed by their growing case loads."]
+[-1.4677824974060059, -0.12369754165410995, "Yeah. Do you find relevant to your work in the family and friends caregiving arena, um,"]
+[1.6381049156188965, 0.5910632014274597, "we really use a lot of internal data, you know, to see kind of, you know, what, how many, you know, applications were receiving, we have reports that we run to see who hadn't had a caregiver at a certain amount of time. So we use a lot of internal data just to monitor for our own program. But then we also get data from the state that kind of compares us not kind of done. It gives us all the numbers, you know, the case loads, and providers and all of that information for the different IHSS programs across the state. So that you can look at, you know, a large county, which is what we're considered, you know, how are the other programs doing compared to you, you know, what are their caseload looking like, you know, different factors that, you know, obviously contribute to us providing a service. So that is nice, because, you know, we really get to see how we're doing in relation to the other programs across California. Let's call them, you know, some follow up needed. So I think those would probably be the biggest two sources of data or internal, and then, you know, the state data that kind of looks at all the IHSS programs."]
+[4.239375114440918, 4.504863262176514, "Is there anyone else you think that we should talk to,"]
+[-0.8944645524024963, -2.0940377712249756, "um, since this is just for Orange County, I mean, APS, I think APS is a good resource. Adult Protective Services, you know, we, we work a lot together. Like I said, you know, whether they go out to a home visit, and then refer, you know, the person to HSS, or the other way around, we go out to the home, and then we have to make an APS referral, because of, you know, the condition or something's going on. So I think APS has a lot of good insight as well to the needs, in fact, maybe more so than we do, because they have, you know, different criteria that they have to meet. And sometimes they're doing more follow up with their clients than we are with ours, because, you know, we're only state mandated to see them every year, whereas APS may have to go out, you know, 2 3 4 times before the case is closed. So they have a better, you know, better indication of what's going on with the, with their client."]
+[4.826593399047852, 3.3017001152038574, "Sure. All right. I didn't expect you to say no, so at this interview, thank you so much for your time, you have been incredibly helpful to our research. Now. If you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website@www.sec.com and you can leave an anonymous voicemail on our telephone line anytime. And then of course, I tell everyone, you can always reach out to me with any additional to add. Okay, let me just stop the video. Now."]
+[-2.683461904525757, -3.2804603576660156, "Hey, now the primary goal today is to identify what needs you think are most important to the older adult population you serve. Those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Now, I'd like you to take a few minutes to read through this list. And let me know when you are ready to begin. And I'll be asking some follow up questions."]
+[3.6468758583068848, 7.03099250793457, "Oh, there goes."]
+[4.650310516357422, 5.410489082336426, "Like, hit a couple of button. Yeah, let me know if I need to just enlarge this, because that will try to wake up here. But everything on one page, I can also do this. Well, in fact, a little bit better."]
+[3.653254985809326, 7.21516752243042, "A little bit. Okay."]
+[3.010295867919922, 3.8748021125793457, "Because it seems like it's missing a lot of big stuff. It's not a good list."]
+[3.0283303260803223, 5.654215335845947, "We'll get there,"]
+[5.578719615936279, 8.803226470947266, "okay."]
+[4.749339580535889, 8.029814720153809, "Okay,"]
+[3.5887248516082764, 4.931786060333252, "well. I haven't memorized it, but I've read it."]
+[3.535501480102539, 8.037149429321289, "No, no, no."]
+[3.7813057899475098, 6.906872272491455, "No, I'm just gonna leave it up here. So we can refer to that."]
+[-0.6239751577377319, -2.0018913745880127, "Sure, in a couple of ways, our primary mission is access to legal services, particularly focused on vulnerable communities that need a different type of legal services than the traditional one because we're able to go to them in a way that traditional ones aren't. So that ends up meaning a lot of communities that are unhoused and older adults, people with disabilities. And so kind of in our work through providing legal services, we really do kind of a wraparound, a wraparound perspective on how to do that. So we're helping with everything from end of life planning type legal services, estate planning for lower income families, we do have an income limit. But But estate planning for lower income families to help ensure they can keep their home that's not recovered by Medicaid, to disputes with shelters if a older adult is being exited from a shelter, to access to mental health or substance use programs. A lot of assisting individuals with challenges with their vehicle and their license. So kind of with a wide range of ways in which seniors need assistance from lawyers. Often it's kind of more of a wraparound perspective."]
+[-0.9721512198448181, 0.9482658505439758, "Yeah, parts of this list seem to be more like a list of conditions than concerns. But I think in terms of resources that are needed, though, so housing and homelessness is certainly number one, and it says housing and homelessness, but then it goes on to define housing as affordability and options and care which what seems so there's also like, safe and stable right that like habitability conditions. So we have a lot of and and I'm not sure how much whether you mean for that housing to include facilities. So if"]
+[2.3511669635772705, 5.485783576965332, "I can interject, so on the right hand side, the right column, right, these are examples. Yeah. So we're, you know, not I totally understand more of like a broader right. Yeah."]
+[-1.062404990196228, -1.5159715414047241, "Yeah. So that like as recently as this morning, I got a call about people being evicted from an assisted living, so couldn't get a lawyer. And so kind of the big picture of like housing and homelessness, legal services is clearly missing from this list. And there's certainly particularly leading into a lot of the things on this list that impact health that impact capacity. There's a huge amount of autonomy that people can have by being empowered to make their own decisions by having powers of attorney and medical directives and kind of having the support they can get from lawyers. Before these things happen to ensure that they have control over the choices that come up in their life. Stuff as simple. If you offer psychiatric health care directives, like those are all pieces that fall under legal services, which are not listed here at all."]
+[-2.0512306690216064, 1.2293567657470703, "I think there's let's see you have behavioral mental health, which is certainly a component"]
+[2.3812124729156494, 5.19990348815918, "I'm not sure if that would, because, like stuff like IHSS"]
+[-1.545072317123413, 0.0030561729799956083, "probably fall on falling under the fourth one caregiving, right."]
+[-0.5177286267280579, -2.664710283279419, "But once you get approved for that county program, getting a person who's able to take the job is nearly impossible, if you don't have a family member who's willing to do it. Yeah."]
+[2.029846429824829, 5.52744197845459, "I know, there's a lot more out a lot more"]
+[0.7896738052368164, -0.03705232962965965, "I don't see anything related to finances."]
+[-0.34966063499450684, 1.240303874015808, "There's economic security. And I see what you're saying,"]
+[-0.033656053245067596, -0.6461864113807678, "in terms of like, yeah, I guess, I guess for me, that's definitely part of what I think it was finances, economic security, and the rest, just kind of like the support and avoiding scams and financial management and financial planning and kind of, for older adults who are kind of on the cusp of being our clients or not, there's places where that kind of financial support can help with preventing the economic security need."]
+[3.6858787536621094, 5.986693859100342, "I'm just gonna write"]
+[3.537381649017334, 7.680124282836914, "this down. Yeah."]
+[1.1140217781066895, 1.7563058137893677, "I'm not sure if it's meant to be in one of them, but just kind of so you like, you know, the data centers or whatever, like the social component."]
+[-1.3548457622528076, 1.4739165306091309, "emotional well being right. We have loneliness, inclusion and quality of life."]
+[-0.25053566694259644, 0.028587397187948227, "Yes, that's probably falls in there. Okay. Yeah, I think that's I think they all kind of fall under those kind of like the financial independence, the living independence, like the stability and housing, and then the biggest one that is not there. It's obviously the one that I see, which is legal."]
+[2.5667805671691895, 3.8738508224487305, "Okay, so, so of all attorneys on this on this list, including those that you have suggested, Please rank the top three that you feel are the most important."]
+[-0.9468215703964233, 0.5156501531600952, "I think it would be housing, health care, and legal"]
+[3.130558967590332, 4.510784149169922, "aid. So I am going to ask you a set of questions based on each of the three that you just mentioned. Alright."]
+[0.332256942987442, -1.25681734085083, "The there's kind of two, two pieces of that. One is just the simply the cost of housing or that, particularly in Orange County, we have a lot of tenants and the cost of rent is going up exponentially. And then there's homeowners who are kind of over housed but can't reduce their housing because the cost of housing has gone up exponentially. So they're left in a precarious place where they can't quite cover their costs and they also can't quite move. And then the other of course, is it income and assets that people are outliving their planned retirement savings, particularly women. And this is why women older women are the fastest growing homeless population is they cannot maintain housing off their Social Security, it's less than their husbands was their, you know, partner passes away. And then they have lower social security, whether that's because they were paid less or worked less or took time off for breast cancer. But whatever series of activities led to it, their income has gone down. And they plan to live to 70 or 80. And that's really young now. But at the time when they started planning that didn't sound so young. And so now they're, you know, 85, and could easily live to 100, except that they would need a place to do it. So they get the kind of two of the biggest drivers are that that the availability of affordable housing and the availability of funding for it. And the third is that as, as our community particularly in Orange County is really shifting more and more toward significant rentals, particularly the housing that's available to older adults is often rentals like mobile homes, the lower cost apartments, the access to legal services that when there are bad actor landlords when there are facilities, like the one I got a call about this morning, that are improperly evicting people that are creating not habitable conditions, that whether it's because of their assets, or because of fear of scams, that that often those older adults are less able to get lawyers to step in and prevent the bad actor landlords from pushing them out of their housing."]
+[1.4888874292373657, 7.447688102722168, "I"]
+[0.6378386616706848, -2.613295316696167, "think the number one is political will, that in order to build how they're built housing, there will always be some community pushback. I mean, things as simple as you know, the ongoing situation in Anaheim where they wouldn't let Grandma's House of Hope expand. It's literally grandma's house of hope it's for older women who are seeking help for their mental health needs who are living in a community. And yet still, the neighbor said, We don't want that hear so loudly that the city listened. And so I think that kind of the political will to simply approve the developments and to approve the programs and to ensure that when funding is available, because there is state and federal funding available right now for particularly for vulnerable groups, like older adults, to ensure that every time that money is available, that Orange County is taking the money and using it and building and not letting money pass us by and go to other counties because we didn't ask for it if we didn't have the political will to use it."]
+[-0.4624939262866974, -1.4876173734664917, "Definitely, I mean, particularly language, right, there's language barriers. 100%. with Santa Ana, which has significant older adults, Vietnamese speaking population was not translating their meetings to Vietnamese until very, very recently. And only then it was because someone who organized the community to show up to the meeting and to call in to the meetings to get public comments, and they brought their own translator who clearly was a person who was bilingual, but not a translator, and really struggled to adequately convey the message that we should the seniors, he was fighting to get rent control for their community. So I think we, you know, we see very clearly that, particularly for older adults, particularly in non English speaking communities, it's very easy to be left out of the decision making process completely. But yeah, when it comes to, you know, disability access when it comes to immigration status, right, that even as we have some of these, we, Orange County has, regardless of how you feel about it, Orange County has a large community of older adults who are undocumented. And unless we want to lead these folks to die in our streets, we have to provide support. And they're less, you know, the lot of the federal programs are not going to qualify for. And so ensuring that we're coming up with some type of plan to make sure that inside of our community that everyone has access to kind of safe and stable housing can age in the community they're in, definitely requires looking at the needs of each group based on you know, income based on immigration status based on language based on disability. Like there's, there are a lot of buildings in Orange County where there may be available units, but they're on the second or third floor and the elevator doesn't work. We have we have we have one right now we've been working on for a long time where the building is used by the county funded by HUD, permanent supportive housing for people with disabilities, but the elevator hasn't worked in 10 years. So people who get placed on the second or third floor have to be mobile, and if they have an accident or as they're aging, they just lose some mobility and they can't walk the stairs anymore, then they can't carry their groceries up the stairs. So I think that definitely each of the things you listed plus them are factors and access"]
+[1.0824599266052246, -1.3886256217956543, "It's really simple. Like there's not, like, I know, like we act like it's very complicated. But it's really not complicated. Like we know, there just needs to be the political will to just decide to build the housing. You know, we built 1000s of units every year in Orange County, we build high end, you know, million dollar condos. I see buildings go up in a matter of months. The fact that we're not putting up buildings that are affordable and accessible for older adults is a choice, not a necessity."]
+[-1.8001422882080078, 0.5650463700294495, "We on to the second issue oh, gosh, I can't read my own writing. Well, wait a second. Wait. The Yeah, yes, yes. Yes. Yes. Healthcare."]
+[-1.4410276412963867, -1.1070016622543335, "Right part of part of it is, is the housing and the transportation that you know, housing and health care are pretty inextricably intertwined. And so when you don't have housing, it's hard to take care of your health care when you don't have stable housing, that when older adults have to choose between paying for their medication or paying their rent, they pay their rent. And that means they're not taking their medication. That there's, this is kind of another one of those. It sounds complicated, but it's not that complicated. People need more money to pay their rent and their medicine, people need transportation to get to their doctors, people need, you know, adequate access to communicate with, you know, even when there are transportation programs, they're not super reliable. They don't always show up on time, they don't always show up at all. And so really kind of just the physical and geographic access, and the impact of not having enough finances or housing to get it."]
+[-0.7355402708053589, 2.2679901123046875, "And what barriers exist to see improvements in this area."]
+[-1.2255988121032715, -1.4584307670593262, "It's expensive, taking care of people costs money. And so in order to increase access to have reliable transportation to ensure that everyone who's trying to get health care, can engage in the best way possible, which includes having stable housing, we would have to invest in infrastructure and housing and resources, we'd have to make sure that if you know, a 65 year old who's been on house for years with seeking mental health or substance use treatment, that when they walk in that there is a door they can walk in, because right now there's not the only door is the ER, and that when they walk in the door that we have those services available. And at the same time, if there's a 85 year old, who's about to lose their housing and can't get to the doctor's appointment today, because the sheriff is coming to lock them out that there is a phone number, they can call of someone who's going to help make sure they have a lawyer to prevent the lockout, and that they have the money to pay the rent to stay there and that they can get to the doctor's appointment today. Right. But like, those pieces are just so intertwined, that the barriers that they all require investment. And while they would save money in other areas, that we wouldn't be paying the sheriff to go lock the senior out of their apartment, if we prevented the lockout, we wouldn't be paying the sheriff's to go pick people up off the park bench where they, you know, often died if we kept them inside in the first place. So it's different. I don't know, it's not more expensive, but it's different expensive, and it would require restructuring how we're spending our money on the front end."]
+[-0.5242952704429626, -1.5820106267929077, "Definitely, I think that's a lot of the same answers as to the housing one that you know, coming into healthcare in general that that there's that healthcare as a as a whole is kind of reckoning over the past decade with its long history of bias and racism and you know, assuming that older adults don't know what they're talking about, so ageism. And so I think that is a thing that healthcare is just kind of starting to look at and think, Okay, how can we get appropriate diversity of age, race, language, all of these things so that we can provide better health care, but we're not there now. So there's definitely disparate treatment and where do they end up and what type of service they get. And even things as simple as what health insurance they have. There are some resources like we know, the Orange County, I think is the largest county in California that doesn't have a county health care like kind of hospital we don't there is no county hospital, like LA has a county hospitals in Orange County kind of sort of acts like UCI is supposed to be the county hospital but UCI is very clear that it does not view itself as the county hospital. And so we don't have kind of that place of last resort that is government funded to ensure access to health care."]
+[7.2073073387146, 6.131854057312012, "What do you suggest is the best way to address this issue or need"]
+[-1.3802798986434937, -1.1690813302993774, "Like, even if your phone is already turned off, that there should be a door in every city, we only have 34 cities, it's not that many doors that someone can go knock on and say, hey, you know, I need help today with these things, and a structure in place that they don't walk out without a plan about where they're going to sleep that night, and how they're gonna get to the doctor that day, and how they're going to make sure that they're Medicare's in place."]
+[-2.5189950466156006, -1.8110121488571167, "Um, the third area you mentioned, which is legal services, so how and why are older adults struggling with this issue."]
+[-0.5688546895980835, -1.889495849609375, "When the legal services - that for older adults who can afford legal services, there's a fear of the scams of lawyers can't be trusted if not knowing where and how to find a lawyer who's going to do the things that they want. And for those who don't have the resources to hire lawyer is the thought that they can't get a lawyer, they can't hire a lawyer, therefore, they can't have things like an estate plan, like someone to represent them, when their landlord is speaking about after so many of like these HOA problems. So people who, you know, hoard everything they had into their mobile home or their condo, and now the HOA is coming for them. And HOAs can be aggressive and expensive. And so there's their kind of access to lawyers for everything from the pre crisis planning to the mid crisis solutions, you know, when they're, if they're CalFresh, that their food stamps is being reduced, that they are much more likely to be successful, appealing that if they have a lawyer to help them. And that is unfortunate, it'd be great if we had a system where people didn't need a lawyer for those things. But between here and there, access, you know, adequate access to get legal advice for everything they need, even if they can't afford it is is kind of banned by the combination of fear from the private bar and funding for the public bar."]
+[-0.6418631076812744, -1.892878770828247, "Mostly money, which I said to answer most of these, but it's you know that we have four different legal service providers in Orange County. So there's the Community Legal Aid of SoCal, the Public Law Center, our office, the elder law and Disability Rights Center, and the Veterans legal Institute. And between the four of us, we cover most of the areas of law that older adults need. We do estate planning, others don't. Vets legal does VA benefits, Others don't. ya know. Legal Aid does eviction defense, I think really the biggest thing that is not covered it all is a lot more support in licensed facilities, whether it's room and boards or assisted livings, but there's almost no no free support in assisted livings. The problem is that even though we all cover these areas of law, we're also underfunded that we don't have enough staff to help the majority of calls we get. So Community Legal Aid runs a whole hotline, where they have a roomful of people who are answering phones and giving the most kind of triage style crisis advice that they can, because only a tiny fraction of those cases are going to make it through to having a lawyer represent them, not because they don't need it not because the other side isn't doing something wrong. Simply because there just aren't the resources to meet the need."]
+[-4.0132856369018555, -1.987318515777588, "And other different experiences for different groups of older adults from different backgrounds."]
+[-0.45033860206604004, -1.3440001010894775, "Definitely, I think that the kind of again, one of the biggest discrepancies is is language and culture that having kind of culturally appropriate responses people, especially when it comes to folks who can afford to hire attorneys, being able to find someone who they trust who speaks the same language they speak, is often a barrier because because they there's often, you know, like, cultural needs that not every, you know, Orange County, white man will be prepared to respond to. And most of the lawyers are white men, just the reality of who the lawyers are. And so I think there's both kind of all the disparities we talked about in the other categories with financial access and economic and age and kind of race, gender language, citizenships status, but also because it is that you know, the housing and healthcare definitely have some of the components of it, but legal services are like 100% service from the person and so the kind of culturally appropriate response is even more important when it comes to legally legal services."]
+[7.188775539398193, 6.134162902832031, "Oh, no, what do you suggest is the best way to address this issue or need"]
+[-0.7765557765960693, -1.8256858587265015, "Yeah, there's always my wish I had a different I wish there was an answer that was not more money. I mean, a little bit of it as community education right. If we had like, for for all three of these, if we had, you know, more education, maybe there'd be more access to landlords more, you know, trust in lawyers through certain referral services, maybe more senior center referrals to help that some senior centers do clinics for legal services which do quick advice, which at least gives people like when we do a clinic at the Huntington Beach Senior Center, it's often folks who wouldn't necessarily qualify to retain us, maybe over income. But by having this 20 minute consult with us, they're empowered with the language. They know what they're asking for. They feel confident, they know like what the range of cost should be. And so when they go and talk to private lawyers, they're not as worried about being, you know, victim of a scam, because they know what they're asking for and what words they should expect to hear. A little bit of education, but a lot of it is just, it just costs money to take care of our community."]
+[3.292146921157837, 5.322942733764648, "Right, thank you. Moving on to the next set of questions."]
+[-2.2285780906677246, 0.3385503888130188, "I simply meant health care. But if you mean something different than"]
+[-1.2700586318969727, -4.124640464782715, "I'll just read it anyway. So geriatric is the branch of health care that focuses on our unique needs as we age, just as pediatricians specialize in the health needs of children, geriatrician, and valid geriatric health professionals specialized in the health needs of older people. So the question is, if you could describe how accessible and adequate this care is in Orange County,"]
+[-1.94587242603302, -0.08996481448411942, "for the groups of people that have higher level insurance and can afford it, it seems like it is relatively accessible and adequate. for the group of people that are on Cal optima and cannot afford it. It seems to be much less accessible and adequate. for uninsured people aren't for people are uninsured. It's also Yeah, leaving out the uninsured."]
+[-2.6970760822296143, 0.2725599408149719, "And I'll just read that off. So long term care is the variety of services which helped me both the medical and non medical needs of people with a chronic illness or disability who cannot care for themselves for long periods."]
+[-2.491997003555298, 0.16524219512939453, "Insurance about the same that for those who have the means to pay for it. Those who have long term care insurance, that that is often accessible and effective. And for those who don't, there is no long term care."]
+[-2.144848585128784, 1.3383852243423462, "Next one, is mental behavior, health, substance use treatment."]
+[-2.183910369873047, 0.43855956196784973, "This, that for the people who have better insurance, and that means that it's kind of medium level, I wouldn't say it's as accessible as the other two. But there is some of those things available for those who have the insurance. And that means for those who have, you know, medicaid Cal Optima or no insurance, I would say mental health and substance use treatment is completely unavailable, like not just inadequate, just like barely there at all."]
+[-0.762267529964447, -1.7823817729949951, "So yeah, there's there's a few there's, you know, the I think the primary one that works with the folks we work with, that is focused only on older adults is Oasis, because they get the FSP contract from the state. But I wouldn't necessarily say their level of care is adequate, then there's a few that focus on people with HIV and AIDS. And they have, they also keep older adults. And so they're they're probably a little better at services. And then there's some of the kind of broader mental health programs countywide that are not focused on older adults. And so they don't necessarily prioritize the special needs of older adults, but they do provide services. And then the net with this with the HomeSafe funding is kind of a unclear lot like the way HomeSafe funding has funneled through adult protective services. They're basically funding mercy house to act as case managers for older adults who qualifies engaged in self neglect, who, who need assistance, Mercy house as a generic homeless service provider, this is their first time doing a project that was focused on older adults and so far, I have no reason to think they have developed necessarily the specialized experience, but maybe they'll get there"]
+[-0.3217959403991699, 0.5178658962249756, "and the last one is human or social services. You know, such as, you know, basic needs, shelter, food, things like that. And"]
+[0.9462440013885498, -2.7340056896209717, "I think for people who are housed with income, certainly there's like, increasingly accessible kind of delivery services in different programs for people are housed and low income, there's kind of moderately accessible, kind of companionship programs and, and food services, usually not quite enough to meet the full needs. But more than for people who are unhoused are kind of on the risk of being unhoused or who are in congregate settings, that there's really not there is there is no emergency shelter that's exclusively for older adults in Orange County that doesn't exist. There, you know, they're sent to the same congregate shelters as the 20 year olds, which often for older adults who feel more vulnerable is too scary, so then they just don't go. Um, so in terms of kind of like emergency wraparound services of case management, shelter, housing for folks who are either unhoused or living in their car or at risk of being unhoused, there's very, very little that is particularly focused on this population and accessible to this population."]
+[-0.030448278412222862, -3.928877830505371, "All right, moving on to our last set of question. So we're almost done. Now. So in addition to what we have already talked about, let's dig a little deeper into your area of expertise. So thinking about your area, which we have listed under protection from abuse, neglect, or exploitation in one way, or what are some ways that this area is working or not working for older adults in Orange County."]
+[-0.20020534098148346, -2.3934450149536133, "So I think right in this year, in Orange County, probably the biggest thing that is both working and not working is the HomeSafe program, that the state sent $4 million of 2022 money to be passed through APS to serve those that that population that was APS qualified, because of self neglect or abuse. But usually it's self neglect. That was kind of a wraparound whatever it takes funding to pay for motels, housing, food, case management, and that it took us until nearly 2023 To start using it at all. And so we are using it now. And in some ways our program is way ahead of what other counties are doing with that pot of state money. In other ways, our program is still so non responsive that when a person calls in with an emergency and asks to be matched with home safe, that they are told local, they'll get an interview in a couple of weeks from an APS worker, who will then determine if they qualify, and who will then send them over to Mercy house who will call back in a month or two and three or four months from now, when they've already been evicted, there will be rental assistance available. And so it is like there are some ways in which it is doing great work. Once a person gets enrolled in it, I think our Home Safe Program is ahead of those counties who are getting getting access to kind of this like well functioning wraparound program. But getting enrolled in it is really a barrier. And for our most vulnerable older adults, when we have this pot of millions of dollars that's intended to catch these catch those people and to keep them home safe, that sort of thing, right to keep them safe and stablely homed, we're really struggling to get get it out. And sure like it's not that much money, it'll be gone at some point. But hopefully that will put us in a position to go back to the state and say, Hey, we helped all these seniors, we need another pot home safe money."]
+[1.84849214553833, 7.245150566101074, "How"]
+[-0.2807753384113312, -2.536879062652588, "Okay, yeah, so it's 4 million allocated for 2022. That is still being spent. So there hasn't been any new 2023 money because we haven't gone back because we haven't spent the 2022 money. And so the Yeah, I think that's kind of an area where there's both great success and great failure in different pieces of the same program. I think overall that the you know that we have a pretty robust system of like senior centers that are there and available. And some of them have like really amazing resources and connecting people with different programs and having a lot of city specific things. But we really don't have the cohesiveness as a county. So if you know, if a person, you know, who particularly an unhoused person walks into one senior center, they only know what's happening in the, you know, the four mile radius of them. They can't tell you anything beyond that. So if that person, you know, happens to actually be from the next town over and just couldn't find the right city or something, they didn't have a phone, they didn't have a car, they went where the bus took them, that there really is no cohesive system of care to connect people with resources county wide and really is this kind of like every city for themselves. And, you know, either the city does it or doesn't and some cities do and some cities don't. And that just is how it is. And kind of forget that people cross City Lines every day for every you know, for lunch for work, and that we can't pretend that older adults, particularly those who have needs like medical and housing and food are not going cross the city line. So we need to come up with some way to be more cohesive in kind of a system of care where if a person walks in, that it doesn't matter if they , you know, are a San Clemente resident who walked into a Mission Viejo door that they're still a way to communicate with each other and find a place to make sure they can still get to their doctor in San Clemente, but that they get to sleep inside tonight"]
+[2.9912524223327637, 0.06442880630493164, "know what new or revised policies are needed."]
+[0.7489537596702576, -1.882320523262024, "I mean, I think the two, at least in the main priorities that would make a really big difference would be more housing protection. Whether that's extending some form of, of rent control, or rent stabilization, whatever people want to call it. But we see in like, San, I think it's in San Juan, they have a senior mobile home park, and they have rent control for this senior mobile home park. And people there thrive like they've been people have lived there forever, their houses, their their house values maintain, they're able to continue to live out their lives there. For the rest of the county, where there's no protections for mobile homes, they're kind of the place where seniors dump all their money thinking they're going to live the rest of their life and suddenly find themselves dying, trying to hold on to their home. And so we saw, you know, we saw it up in Anaheim, Fullerton, and that Park was bought, and they went all the way to the state begging for help and came back with basically nothing. And so we see kind of over and over where there's the lack of protections for tenants, particularly older adults, and puts them in a really vulnerable position. And so having some type of whether it's county wide, or every city, even mobile home specific, but broadly kind of housing wide, right to counsel or protection on rental increases would definitely go right, because the right to counsel piece, which is a really a national movement that is happening in a lot of states has a right to counsel and housing related things where attorneys are funded to provide services for housing related things. Or, you know, rental assistance, like all the kind of the range of policies that could from like, right to counsel to rental assistance to protections that could keep keep people stablely housed. And it would all go a long way toward letting us work on the healthcare and everything else."]
+[2.703599214553833, 6.008183002471924, "That's a tough question."]
+[1.4699269533157349, 6.77771520614624, "Maybe you guys."]
+[-0.20771659910678864, -2.360136032104492, "But you know, I think the challenge is that when we put local, we put cities in charge of doing it, the political will problem comes up. And so having really having a county wide response, but when we have a county with five supervisors, or each very tied to their own district, you have kind of similarly challenges spending the money in each of the districts. And so having, you know, passing policies that would require some minimal housing that would require protections, like putting money into funds that could be split between rental protection, or, you know, right to counsel attorneys to help people putting money into funds to help people do their end of life planning and kind of empowering them with a medical directives and kind of stop people having to go get conservatorships in the house, in the court system. All of that would would kind of trickle down to having the frontline decision making being the providers. And instead, some some of the hospitals are in a position to help with there's some some of the treatment components that if the hospitals had the adequate funding, they would expand. We saw how the county's attempt to try and expand services by creating be well didn't really pan out the way it was intended. We'll see how the next site goes. But the current site doesn't seem to actually be offering quite the level of service that was promised for all those millions of dollars. So I think kind of the how to get past that political will and who, who is able to get past that political will is really tough in a county that structured the way it is. And that's probably part of why this kind of all 34 cities are saying, oh, that's the one next door. And the county is saying, Oh, we don't want to step on the city's toes. And the cities are saying, Oh, but that's the county's decision. That in some ways, like one of those entities, whether it's, you know, the cities or the county, someone has to kind of take ownership and step up and decide they're going to change the policies, they're gonna put money into solutions. It's going to anger some voters now. And when there are less people dying in the streets, hopefully those voters won't be angry anymore. But how to get from here to there, other than, you know, people just decide to do it. I don't have a good answer for"]
+[1.596174955368042, 7.09714412689209, "me."]
+[-0.03452572226524353, -1.5891371965408325, "So we really haven't. But it's just data we've never sought out because we're so unable to meet the need, and that being able to show that need is more than we can imagine, isn't gonna get us any closer to meeting the need. Even stuff like the special needs trust beneficiaries don't have access to any lawyers. But having having the numbers just wasn't, it's just sad when you know, there's no money to apply for. There's no work to"]
+[4.191484451293945, 6.077287197113037, "do about it."]
+[-0.6602638363838196, -2.118144989013672, "Linda is certainly on kind of like the social services and legal services side, if you haven't already talked to people in the there's there are elder law units at Legal Aid and Health Law Center. Veterans legal doesn't necessarily have an elder law unit, but they work a lot with Vietnam veterans are all older adults. So I think all three of those on kind of the legal services side. And then well, while I'm frustrated with the way in which the HomeSafe program is being administered, I can see there that they are, right that to the county has chosen to put on the front lines right now is that the call comes to APS, if yes, eventually gets the call to Mercy house and mercy house isthe ones out in the street, matching up with the people APS chose as deserving of the program and trying to figure out what it's going to take to get them into housing. And so they're the ones reporting up to the state, hey, we don't have enough training on the housing services and benefits services and how to get so it might be useful to talk to the Department of Mercy house specifically that's working on HomeSafe to hear kind of what are the things that they're seeing and when people do make it to them through APs and when they are trying to get those folks back into or maintaining stable housing."]
+[4.73367977142334, 3.2178587913513184, "Sure. Well, this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research. If you find that you have more to share, please feel free to reach out to us. You know, our contact information is available on our website www.fsoc.com And you can leave an anonymous voicemail and our telephone line anytime and as I tell everyone of course you can reach out to me and you have anything that you thought of afterwards which you stop the sharing"]
+[-2.660146713256836, -3.172149896621704, "Now the primary goal today is to identify what needs you think are most important to the older adult population that you serve those who are 60 and older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. And I liked you to take a few minutes to read through this list. And let me know when you are ready to begin as I kept some follow up questions for you."]
+[4.655791282653809, 5.429765701293945, "I am attacking a let me know if I need to enlarge or move up and down but this is the entire page that I'm showing you."]
+[-2.671985387802124, -1.151838779449463, "Alzheimer's cancer caregiving caregiving is a big one for us. communicable diseases, big one and the veteran community."]
+[3.627138376235962, 4.3068366050720215, "It's okay. I'm trying to add to that for now. Just go ahead and read through it because I want to ask questions about about this list. Yeah."]
+[-1.0743063688278198, 1.2316181659698486, "Digital Divide Yes. Yes. Absolutely. Not security. Yes. social wellbeing. Yes, environmental. Health healthcare acts almost as housing. Tobacco use transportation. Okay, I got it. Okay."]
+[-0.07809628546237946, -3.23561692237854, "Okay, so I'm the executive director and co founder of veterans legal Institute, and we provide free legal services to low income and homeless veterans. As you know, Orange County has a large population of veterans. And specifically, when it comes to low income and homeless veterans, there's a contingent of those who served in Vietnam, Korea and world war two that are all over 60 years of age. So we provide very specific services to that population. And it's a population I feel very passionate about serving."]
+[2.7648847103118896, 6.791477680206299, "Think about that one for a second."]
+[-0.7010292410850525, -2.1290013790130615, "I definitely yes. I think that their legal is missing from the list. I think a lot of older adults need access to low low cost low Bono or pro bono legal specifically when it comes to their estate planning and also their benefits. A lot of elderly people apply for veteran benefits, Social Security, Social Security, disability income, and they have issues they have issues filing for their Medicare, and things of that nature. There's a lot of financial elder abuse that's taking place and regular elder abuse and oftentimes the older adult population cannot afford an attorney."]
+[2.4832375049591064, 3.795041084289551, "Now of the of the, the needs on this list, including those that you just suggested, Please rank the top three that you feel are the most important."]
+[-1.3352800607681274, -0.22750386595726013, "I think caregiver assistance is very important."]
+[2.1421053409576416, 4.47199010848999, "Three altogether, please. Okay,"]
+[-0.8111852407455444, -0.003566203871741891, "so I would say caregiver housing."]
+[-1.954742193222046, 1.4272056818008423, "Yes. The second one behavior, behavior mental health."]
+[3.2670841217041016, 7.072690010070801, "Oh, I would do that. Yes."]
+[3.1858015060424805, 4.590381622314453, "Okay. Now. So I'm going to ask you a set of questions about each one of these."]
+[-1.1744080781936646, -0.8306844830513, "I think specifically in Orange County, we do not have a lot of affordable options for caregivers. And especially like this includes the homes. I forgot the name of those types of homes. Skilled Nursing. Yeah, nursing homes and in homes where they can really kind of like end of life type of planning folks. There, the semi decent ones are extremely expensive, and unaffordable, only the wealthy can afford them. And so and having a caregiver, first of all it, a lot of elderly need the caregiver, and it's just beyond their financial needs. There are I know, county programs for the super low income, but oftentimes people don't know how to access that program, and how to find a caregiver. And many times also people need 24 hour care. And they're only getting appointed caregivers for like eight hours or 10 hours or 12 hours, it doesn't, you know, match the the amount of care that they need. And so there, they have to rely on their children, if they have some and if they don't, they're kind of on their own in terms of taking care of themselves."]
+[-1.013981580734253, -0.7058283686637878, "I think we have a lack of affordable skilled caregivers, a lack of affordable nursing homes. And I think there's barriers to information about how to access programs where they can get low cost or subsidized caregivers."]
+[4.204748630523682, 6.445306777954102, "Aarthi Oh, definitely. Oh, sorry, go ahead."]
+[0.5817983746528625, -3.2109313011169434, "I would also say that a lot of Orange County residents are asset rich and cash poor, meaning they live in their homes, or, you know, 50 years and the home is worth you know, they bought the home for 50,000, the home is now worth 800,000. And that works against them in terms of eligibility for certain benefits. So even though they live off of their social security, which is like $1,200 A month or some minimal amount, so their cash for because they live in that home, they often don't qualify for certain benefits, which is unfair, because it forces the older adult either to put the home in a trust with like a loophole in that system it is borderline fraud and also costs them money, or it forces them to bankrupt the value of the home in order to qualify for services. So makes no sense. No. Sorry."]
+[4.168292045593262, 6.305200576782227, "Sorry. Go ahead. Sorry, I didn't know you were not finished. Go ahead."]
+[-1.0839874744415283, -0.7164783477783203, "I mean, I feel very bad about this. Because, you know, I have, like my grandma died. But this was an issue for that. And you know, a lot of people have like moderate income, but it's a fixed income, and they still they can't afford caregivers. But they don't qualify and ----- on federal guidelines, where people who live in North Carolina, have a significantly less cost of living. So our eligibility has to match, not state guidelines, but county specific guidelines."]
+[-1.1104012727737427, -1.1006308794021606, "Absolutely. I mean, you can separate it, even by veteran versus civilian status. Oftentimes, veterans have different mental health issues than their civilian counterparts due in part to traumatic experiences, from their military experience, so they might have issues, for example, with post traumatic stress, that give them you know, paranoia, or depression or other things that, you know, make them need a different level of care than someone who might not have these issues. Obviously, somebody who is a high wage earner and has money is going to have easier access to a caregiver as well as a caregiving facility because they can afford it. Low income seniors are the ones who really struggle, I think, to access the care that they need, because they're poor."]
+[-0.8585951328277588, -3.642512321472168, "I suggest that we should have more programs for caregivers as well as skilled nursing facilities. And it should be income based based on an income criteria that suits the median income of Orange County residents. So we shouldn't have to make our seniors go broke to qualify for services."]
+[0.5873400568962097, -3.2328379154205322, "Housing. Okay, this is there's so much to say on this. This could be like a 30 hour call, by the way, Tammy, I know. Primarily, we have two things with housing in Orange County, because we have a low supply of affordable housing, and lots of demand to live here. And what that causes is people to, you know, either have several people in one house or in one room, which is unhealthy. Or people have to move away and older adults don't want to move away from their children or from where they grew up. It's very difficult or from their health care provider. So the main thing, the main issue when it comes to housing is we lack affordable housing. And there's there's so many other things that tie into this, for example, the social, the rate of Social Security is so low that most people can't survive off of their social security income alone, as well, they have to done some significant planning and have other investments in order to survive and live in Orange County. Right."]
+[3.669661283493042, 3.614523410797119, "I have my PhD dissertation all here for you right now."]
+[1.621775507926941, 6.705291748046875, "I bet."]
+[1.2831324338912964, -1.1494626998901367, "Well, that's a very complex question. And one of the barriers is that our local cities don't want to build affordable housing, because they don't want to attract low income people. Because they want to maintain their property values, and they want to keep out low income people that they view as undesirable."]
+[3.0601253509521484, 7.567173004150391, "That's putting it very bluntly, right."]
+[0.5238758325576782, -1.5094358921051025, "Yes, low income people struggle to access safe and healthy housing and secure housing more than people that have money. People with mental health, like elderly with mental health issues, struggle to maintain safe and secure housing, because they have mental health issues that create barriers towards rational and healthy living. For example, if you have Alzheimer's and you are living in your home, you may forget to pay your mortgage and that can lead to foreclosure. If you're on a fixed income, you can't hire an attorney to help prevent that foreclosure. But if you can't afford to go into a skilled nursing home because you live off your fixed income, and your home is, you know, you're only paying $400 A month your mortgage, does it make sense to go to a skilled nursing facility so you really need someone to come in and help manage your affairs. So I would say that people with mental health issues also are at greater risk to be housing insecure."]
+[4.734602928161621, 5.018534183502197, "Jesus Christ Tammy."]
+[1.0058414936065674, -1.9227294921875, "Vote for me. I can only say this stuff because that you said no one else was gonna listen to it. And it's anonymous. Okay. We can resolve the complex housing issue in our county at 30 minutes, let's talk about that. We would need to have better requirements for cities to have to build affordable housing specifically for seniors. Cities would and the county or the state would have to enforce consequences for cities who don't want to comply with those rules. So oftentimes we have rules in place where cities need to allocate a certain number of units for vulnerable populations, the city then tells the state to go pound sand, and they just don't do it. And then the state doesn't have a lot of teeth. Really behind their their order. So we really need to provide better incentives for cities to provide housing for the elderly, and skilled nursing facilities, things of that nature"]
+[0.8143371343612671, 0.44299161434173584, "at an affordable rate."]
+[4.142810821533203, 7.692410945892334, "All right."]
+[-2.1838181018829346, -1.5316041707992554, "So mental health, the decline of mental health post pandemic in the United States is something evident in all ages. But specifically with older adults, there was a lot of isolation alienation during that time. And as a result, they're mental health, a lot of elderly people, there was visible degradation in their mental health, higher levels of depression, people were not getting the treatment they needed for other mental health issues that they may have had."]
+[3.9847733974456787, 7.1224589347839355, "So I will leave it at that for now."]
+[-2.252819776535034, -1.5429507493972778, "I think mental health is very taboo. And there's not a lot of education out there on mental health. And I think we need to do a lot conduct a lot of outreach to older adults in need of mental health services. And I think that should should span, you know, lower levels, per se, of mental health issues like depression, anxiety, and go all the way to extreme levels like schizophrenia. And we need to allocate funds and take mental health seriously in older adults, as well as the rest of the American population."]
+[-1.9375391006469727, -1.5852233171463013, "Yes, the key factor here is money. People who don't have money, don't access resources. So, you know, people can pay $250 an hour to see their therapists, or people might have great insurance where they only have to pay $50 an hour to see their therapist. But if you're poor, and you don't have insurance, you might not access those mental health services. If you have to work an incredible amount of hours just to pay your rent, you might not have accessibility based on the hours that you work to access mental health services. So And oftentimes, older adults are so isolated within their own home. They don't have an advocate who lets them know what's available. So they're not even familiar with the resources available to them to assist them with their mental health."]
+[-1.2411963939666748, -2.2628214359283447, "I think there needs to be a stronger campaign. Out there in the forms of media that that older adults tend to use, which I think is print media as well as TV versus just the internet, where, you know, they're not as savvy as their younger counterparts. I think we need to put the education out there. I think we need to, I think older adults that are in more severe situations should be assigned social workers or some sort of advocate to help them navigate what can be very complex and bureaucratic systems so that they are able to access the resources and the benefits out there that they're eligible for. I think we have barriers to transportation for a lot of the elderly, a lot of them are unable to drive because whether it's they don't own a car or they are no longer eligible to carry a driver's license because they might be blind or hard of hearing, or whatever it is. We need to really reach out and find And those older adults and seniors so that they're they don't fall between the cracks."]
+[3.3248751163482666, 5.706980228424072, "Right, I'm moving on to the next question."]
+[2.7962486743927, 5.48228645324707, "I don't know if I'm best qualified to answer that question, to be honest with you. I don't want to criticize something that I don't have a full understanding about."]
+[-3.396622657775879, -0.34339120984077454, "Let me just, if it's helpful, let me just read you the definition we're using for geriatric care. And you know, you can answer or not perfectly fine. So geriatrics is the branch of health care that focuses on our unique needs as we age, just as pediatricians specialize in the health needs of children, geriatricians and fellow geriatric health professionals specialize in the health needs of older"]
+[1.861811876296997, 1.458482027053833, "people. I don't know if that's helpful at all. But I mean, so the question is, how"]
+[-0.6777063608169556, -4.051738262176514, "accessible and adequate these services are in in Orange County."]
+[-2.702239990234375, -0.8077142834663391, "I'm gonna say that they're accessible to people who have money and are of a reasonable mental health. I'd say Geriatric Care is far more difficult for those who lack mental stability, as well as to those who are low income and can't afford, you know, to see a doctor. Also people that are more vulnerable, even if they have their own different, you know, state based insurance systems where they have more accessible health care, they it's so like, the bureaucracy is so complex to navigate, you know, that they they have to go for see a general and then be sent somewhere else. And that the medical system in and of itself, and the insurance system is very broken. So it makes it you really have to fight for your health care, I think in our state, especially if you're poor. And I think that makes it even harder for the elderly."]
+[-2.6182076930999756, 0.279156893491745, "The next one is long term care. And I will just read to you. Long Term Care is a variety of services, which helped meet both the medical and non medical needs of people with a chronic illness or disability who cannot care for themselves for long periods."]
+[-2.6577484607696533, 0.2959647476673126, "I will say the same answer, I think, long term care for people who have planned ahead or of reasonable mental health or have children or a partner or spouse"]
+[1.0894335508346558, 5.616860866546631, "-------"]
+[-0.2228710949420929, -0.6775160431861877, "don't speak good English, have barriers to transportation, don't understand modern day technology are dyslexic and struggle reading are have poor eyesight and struggle reading I think people that are, you know, like that are more vulnerable struggle to access long term care, and most specifically the poor because they simply can't afford it."]
+[1.0642778873443604, 2.6571574211120605, "Again, how adequate and accessable inadequate you think."]
+[0.6005659699440002, 0.7707845568656921, "I believe there there are programs out there but I believe it's it's inadequate, compared to the demand for these types of services."]
+[-2.492729663848877, -0.36580273509025574, "Yes, I. And I'm sorry that it's gonna have to be veteran specific since the field I work in but the Vet Center, there's one in Garden Grove as well as one in Mission Viejo. They are a subsidy of the VA hospital, and they provide free mental health counseling for veterans, as well as if their veteran has a partner they will do group counseling as well with partner. So that's the one that's the That's the program I'm most familiar with."]
+[3.574558973312378, 15.5736083984375, "Pretty."]
+[-0.3266488313674927, -2.9304380416870117, "I think that that's probably our strongest, okay. I it's inadequate given the demand. However, I really do believe that the, the void left by government in Orange County has been relatively well filled by nonprofits as well as, you know, civilian volunteers, churches, and other groups that are community minded. I do believe that Orange County is very philanthropic and nonprofit minded, and we do have lots of programs in place. No. Partly because there's such a great demand. But also, some of the services needed simply social services, whether it's like going to Social Security, or, you know, the county or the processes are so long and drawn out, it takes up so many hours of someone's time, it's hard to find an advocate for everybody to help each person and."]
+[3.7996597290039062, 7.907650470733643, "Right,"]
+[3.3621621131896973, 6.025174617767334, "next question, yeah."]
+[-0.2978486120700836, -4.122915744781494, "In Orange County."]
+[0.2619936168193817, -1.1974256038665771, "I think cost of living. I mean, I just think I think economic viability, I think that social security is, you know, there's always been this constant threat that Social Security is gonna go away. And I think that's most older adults, that's their main form of income as they get older. And I think that without that, along with the increased cost of living in Orange County, it's very hard for them to survive, we have a affordable housing shortage, you know, the cost of health care is going up. And so for somebody who's not working, it becomes very difficult for them to, you know, access to really thrive the way somebody who's young and works and has money."]
+[-0.8130167722702026, -2.8596324920654297, "I think the government has an obligation to keep our streets safe and our communities healthy. And part of that is ensuring that older adults Americans needs are met. And that includes making sure that"]
+[2.1045055389404297, 6.7555623054504395, "they have"]
+[-1.258931279182434, 0.326219379901886, "proper health care that they have, if they have barriers to transportation that they have an advocate who can assist them in accessing the resources that are available to them."]
+[-0.009745309129357338, -4.885595798492432, "Thinking about all the older adult residents in Orange County, who is getting the least amount of attention"]
+[-3.172445297241211, -2.2569754123687744, "out of older adults or out of everybody,"]
+[-3.139465570449829, -2.2185816764831543, "older adults,"]
+[1.9339371919631958, 3.0119400024414062, "gets the least amount of attention."]
+[-2.3455092906951904, -2.255500316619873, "I think all older adults, I think the elderly are are in General ignored. It's not a it's not a gender thing. It's not a citizen status thing. The people who need it more are in terms of accessing resources. No, I think I would say I would actually say all older adults are are ignored. They don't seem to take priority"]
+[-0.22247086465358734, -3.8322665691375732, "in our county."]
+[0.07014725357294083, -1.690662145614624, "It's like, oh, protect our elderly, none of them. I mean, it's you look at it. The commercials it's protect immigrants, protect LGBTQ plus, protect veterans, protect cancer survivors protect children. I mean, they're all worthy causes. I'm not saying they're not. But I don't think I've ever seen anything that was like, oh, old people that don't have children like they have nobody visit them. They're alone. What about the suicide rate Amongst the elderly is pretty high."]
+[1.293197512626648, -0.8643622398376465, "I would say housing for for, for older adults to make any big one."]
+[2.9489850997924805, 4.829562187194824, "Right. So moving on to the last set of questions. Yeah. So, in addition to what we have already talked about, let's dig a little deeper into your area of expertise."]
+[-1.9478548765182495, -2.7708120346069336, "Sure. Well, let me just go back. So in addition to what we've already talked about, let's deep dig a little deeper into your area of expertise in, in this case, inclusion and equity in aging."]
+[2.6767983436584473, 5.893833160400391, "Don't know if I fully understand that. Yes."]
+[-0.3355520963668823, -1.6382008790969849, "I would just say that low income and moderate income older adults need more resources. And in general, because of their I'm not I don't I don't I truly believe it's not like you can break it down by like race and ethnicity. But it really comes down to money, those with more money, regardless of whatever shade of you know, skin that they have. If you have money, you're accessing resources. If you don't, you're not. And I would say that we really need to be more inclusive of older adults that have mental health issues and older adults that are low and moderate income to be able to access safe and secure housing."]
+[3.0060811042785645, 0.06149782985448837, "What new or revised policies are needed."]
+[3.594111204147339, 4.344868183135986, "I can't believe this phone call me like, Gee, I could write like a 300 page novel on this."]
+[2.998060703277588, 0.07255107164382935, "I know what what policies let me give you"]
+[1.0120816230773926, -1.6011865139007568, "a one line answer to that. We need to have I'm going to stick with this we need to have more affordable living space for the elderly in every single city. It should be a requirement that each city allocates a certain amount of units to the elderly."]
+[4.5786004066467285, 5.391308307647705, "Like to expand, it's completely up to you."]
+[1.1267086267471313, -1.5629674196243286, "Do I want to expand that. Yeah, and I think that cities that fail to comply and fail to provide affordable housing to seniors. I feel that there should be a consequence. Or let's not even say more positive city, you should be motivated to be in compliance with these these rules."]
+[0.9510442614555359, 0.19303414225578308, "Okay, well, I guess I kind of know the answer to your next our next question. Again, we're talking about really, either by the inclusion equity agent"]
+[1.9090065956115723, 5.399218559265137, "who's best suited"]
+[4.5962934494018555, 7.845539093017578, "Okay, well,"]
+[1.1126917600631714, -2.0366358757019043, "I mean, in terms I think each city should be addressing the issues within their city because every city has a different demographic, and also has different you know, some cities have more resources, some cities have less. So I would, I would, I would say that ultimately, state lawmakers should be creating blanket policies that can be tailored to each city to make it feasible for cities to comply. But the cities also have to take it upon themselves"]
+[3.339970350265503, 5.870077133178711, "to want to, you know, help out in this way."]
+[5.56494140625, 8.787738800048828, "Okay."]
+[1.6987268924713135, 0.6527490615844727, "So I collect a lot of on every client, I collect all their demographic data, their age, their income, whether or not they're disabled, their military service, and I believe all of that is is relevant. But I would say primarily, it's really important to gather data on people about their income, if they are disabled, their household size because if somebody has other people in the house, it means they're more likely to be taken care of their military service because if they are a veteran, then they may have they may have issues related to that military service. So those are some of the types of data that I would suggest people"]
+[1.357884407043457, 5.28064489364624, "collect."]
+[2.310495376586914, 9.501255989074707, "Yes, I"]
+[4.240463733673096, 4.509404182434082, "think you should talk to chase Wickersham."]
+[1.5833381414413452, 5.087795734405518, "W i c k, e r, s H, A M"]
+[4.621902942657471, 4.151391983032227, "M, like Mary."]
+[-0.7015092372894287, -3.6901557445526123, "Chase is a I don't know how to put it. But let's say he's a leader in Orange County when it comes to veteran and older adult issues and mental health. He's 77 years old. He's a military veteran. He's helped put together large projects mhsa funding programs for for the elderly and veterans and he's very well versed in what older adults need."]
+[4.157742977142334, 4.326009750366211, "And I'm gonna follow up with you later about getting in contact with him if it's okay. Yeah, of course, I assume he's retired. He's not, you know, quote, unquote."]
+[-0.09689013659954071, -0.7289769649505615, "He's retired but yeah, he he basically volunteers full time. Okay, on these exact issues. Okay. Okay."]
+[3.3309032917022705, 5.986349582672119, "Great. Last question. Now."]
+[3.607537031173706, 7.068441390991211, "Sure. Yes. Okay, now,"]
+[4.695278167724609, 3.1692469120025635, "this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our our research. Now. If you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website www.sz.com And you can leave an anonymous voicemail on our telephone line anytime. But as I tell everyone, please reach out to me."]
+[4.526384353637695, 7.567057132720947, "Okay, I know how to find you."]
+[5.360034465789795, 3.58638858795166, "I know Hold on. Let me just um, there we go. Recording"]
+[-2.7307846546173096, -3.1039791107177734, "Before we go over the questions, I'm going to explain a little bit of like a goal, which a primary goal today is to identify the needs that you think are the most important to the older adult population that you serve with those who are 60 and older. So we want you to think as broadly as possible. So thinking into consideration the older adults, caregivers, families and their communities. So um, first, I'm gonna go ahead and share my screen. So you can see a list of common concerns and issues of for the older adults. Yes. Just please take a few minutes and go over the list. Based on the list, I'm going to ask the following questions."]
+[3.9754464626312256, 5.409889221191406, "And please let me know when you're done."]
+[-0.2521577477455139, -4.282282829284668, "Okay, okay, so thinking specifically about older adults in Orange County. Yeah. So"]
+[-1.065516710281372, -2.968471050262451, "my role I work for the University of California, Irvine, as the director of the Sustainability Resource Center, so I work with a large array of folks. The first primary population, our students, which includes traditional and non traditional students, UCI has a large population of non traditional, which essentially means, you know, not your graduating high school and immediately coming into college. So we have folks from, you know, a wide array of ages below 18, all the way, you know, and 98, right. So, I serve a large array of those students, but then we also work with staff and faculty for a lot of sustainability related issues. So that's, again, a large array of folks and then our primary mission with Irvine. And then the community is doing a lot of that outreach work in order to connect students to community organizations to populations in need of service or needs of some kind in order to work with them and provide what we can provide as a university. So again, that's a large array of folks to including, you know, small infants all the way up to older populations of folks, too. So that's a little bit about my role in what we do."]
+[5.218873500823975, 6.809813976287842, "Thank you. No. So"]
+[-2.2911460399627686, 0.7382200956344604, "Including, again, the one that's above it, have respiratory conditions and other illnesses and ailments."]
+[1.32869291305542, -0.42776989936828613, "housing,"]
+[1.7101874351501465, -1.8001667261123657, "homelessness, house lessness, heart disease, all of this is on there. The one thing that I will say as I was reading, right, is that when we talk about sustainability with folks, and especially if we're looking at our older population, there's a lot of crossover that comes with environmental injustices and environmental concerns. Right. So you're looking at the environmental concerns piece and you see drought and wildfires, pollution, right. So a lot of those ailments that are correlated with our environmental concerns. So that's the one thing I'll say is that, even though they're listed as standalone, right, they do correlate and compound with each other, especially for our older population."]
+[7.173612117767334, 4.643739223480225, "Thank you for sharing. Oh,"]
+[2.3963804244995117, 3.912968873977661, "well, it's gonna be different for me right then someone else. So what I feel are the most important."]
+[1.1204451322555542, 6.454660415649414, "I think"]
+[2.448352813720703, 3.8386032581329346, "most important for me on this list in terms of trying to address in my work is one the environmental concerns peace, transportation, and mobility. And then well that's hard."]
+[-0.03066406585276127, 0.8060140609741211, "So many of these rights are so interconnected and interweaved."]
+[4.610886573791504, 8.035053253173828, "What I'll"]
+[-0.9917532205581665, 0.9503949880599976, "say, though, is is that how we view our work, too, and I'm seeing Community and Family Safety. If we view, like a family unit and our community as priority, then we're gonna pay attention to a lot of these other things, right, and take more care and attention to things like our transportation issues, like older populations, and having access to certain things, right, like infant care. So I'll say that even though I'm hard pressed to name top three, but that's what I say."]
+[2.9169416427612305, 4.355707168579102, "Thank you. For the next question, I'm going to ask, ask you the same questions for each of the needs that you listed. So what like, I'm going to start with the number one that you like mentioned, which is environmental concerns. Yeah."]
+[1.958168625831604, -1.7151790857315063, "So what you have listed with environmental concerns, right of drought, wildfires, pollution, emergency preparedness, that list could go on with a whole bunch of other kinds of environmental concerns. What we talked about with vulnerable, vulnerable populations, which, when we're talking about environmental injustice is older populations would fall under, just as right, folks of color or low socio economic status, folks would fall under vulnerable populations. We know that environmental injustice is such as, like, where landfills are placed, where waste treatment facilities are a place where, you know, lower income housing is placed are more commonly correlated for areas that don't have enough services to fight against those don't have enough public services, public goods, right. And then also, with that comes less preparedness to respond to some of these issues like if a wildfire were to happen. Like if drought were to happen, right, there's less public good, less public will towards addressing that need urgently. We're less likely to need to respond with, you know, large campaigns for the rich, commonly white family neighborhoods because they're going to have more resources in order to respond themselves. Right. And so just with that, you can see that when we're looking at an older population, maybe there's less resources in order to respond to those emergencies or to those environmental injustices"]
+[1.231136441230774, 7.7201948165893555, "Well,"]
+[2.0001885890960693, -1.588605523109436, "the biggest barrier, right is climate change, as the climate continues to change. And as we see more and more intensified natural disasters and natural occurrences, these correlations that I mentioned right are going to intensify as well. So our vulnerable populations are going to continue to experience intensified natural occurrences that impact them. And all we have to do is look at last summer with our two heat waves, right, that lasted a pretty long time when we see things like that vulnerable populations, such as older populations"]
+[1.9664267301559448, 6.887319564819336, "are,"]
+[2.0384902954101562, -1.719835638999939, "again, not always equipped with all of the resources in order to respond to that. And so we see that with our students, when we're working with them, we see that with our local nonprofits that are working with vulnerable populations, right. That's Eric, like, how do we respond to that kind of thing. And those natural phenomena and are going to intensify, are intensifying with climate change. And so it's going to be more and more of a concern for our vulnerable populations, as well as it should be for, you know, folks that don't fall under that umbrella."]
+[-4.041007041931152, -2.0380237102508545, "Thank you, are there different experiences for different groups of older adults from different backgrounds. Yeah,"]
+[1.9131261110305786, -1.659082055091858, "so like I mentioned to right, environmental injustices correlate with so many other socially constructed identities and communities. And that's because of our history of in this country, right of, you know, colonialism, of racism, of capitalism, all of these things compounding in and of itself to create the vulnerable populations, and then vulnerable populations that correlate with even more environmental injustice is, and so it's not necessarily that it's like if you are of a certain like vulnerable population, and you identify as someone who falls under the umbrella, you're going to experience this, that's not what it means. It just means historically, within this country, at least, right because of these different compounding historical happenings, and social constructions that these natural phenomena, like the intensification of certain natural phenomena from climate change, correlate with impacting more vulnerable populations. So we see a higher percentage right of folks of color, and specifically, our Black and African American are indigenous native american folks experiencing more intensification from these natural phenomenon due to climate change, because of that historical context. And then because of the disenfranchisement, by construction of these compounding narratives and social constructions often have less resources in order to combat them. So I mentioned earlier too, that environmental injustice is can include things like where landfills are placed, where we waste treatment facilities or place right. And we see often that gets placed, the burden of those kinds of facilities get placed in predominantly communities of color, predominantly low socio economic status communities, because they have less resources often in terms of time, energy and money in order to fight that. Whereas, you know, more often white higher income communities have more time, money, energy in order to fight that. So all of these things compounds so that are vulnerable populations."]
+[2.06172513961792, 6.889654636383057, "Feel it more."]
+[2.030961036682129, -1.6349633932113647, "And so that needs to be talked about when we talk about environmental concerns with our vulnerable populations is that communities may feel it more, even within those vulnerable populations."]
+[7.174947261810303, 4.642065048217773, "Thank you for sharing the next one, as the news suggests."]
+[2.0705819129943848, -1.8041479587554932, "Oh, that's a big question. There's so many things to do. And if we're looking at large, grand scale solutions, right, there's a lot of ways to address climate change that are out there. Right, eliminating greenhouse gas emissions and encouraging, you know, our state, our federal facilities, our municipalities to rapidly start addressing and cutting their greenhouse gas emissions, right, we only have a certain amount of time to bend the curve and our greenhouse gas emissions before we reach higher than 1.5 degrees Celsius in our global warming, which will further intensify climate change. And so we need all governmental units addressing that. But we also need our corporations and businesses to address them as well. And that also will involve right our government to be involved in some way of incentivizing that or, you know, actually putting limitations and restrictions. And, but that's on the grand scale. So on the community scale, right, with something like looking at vulnerable populations in Orange County. One, it means providing the resources to the populations of folks that correlate with these intensified environmental phenomenon concerns, through the form of right, like I said, cooling centers during those times of extreme heat, or like transportation to and from, like, all of these things that are on this list go together in order to help address some of these issues. But really, we're not going to be able to address the local issue of climate change without those larger ones as well. All we can do right now is look at how we can help within our community to provide resources for vulnerable populations, and even like folks that don't fall under that umbrella of vulnerable populations."]
+[1.6995742321014404, -0.6205922365188599, "Thank you, and now we're gonna move on to the second neighborhood you identified and I'm gonna go ahead and ask the same questions. Yeah,"]
+[0.5596017837524414, -3.1789960861206055, "I think transportation. One is an issue in every region. Honestly, I don't think anyone really loves their public transportation and mobility options. However, here in Orange County, there is a lot of issues that come with that the idea of transportation and mobility. And older folks more susceptible to things like COVID, right. We don't want to put ourselves in that position to be in a crowded bus for over an hour. So that safety concern but then also public transportation is not widely available to everyone in Orange County. Right. And even when it is available, right, you then have to spend maybe two hours or more to get somewhere that's further than 10 miles, right. So that barrier to access public transportation is very high here in Orange County, which is an issue. And public transportation, really the only option to do daily transport is through the bus system, right, we don't have a large scale Metro in Orange County that can get you to those. Like I call them daily errands, right, or to workplace or whatever, we do have a metro that can get you to other cities, right, but there's only one stop. So you have to transport there, you have to transport over to the other city, then you have to get onto transport bus to get wherever you're going. That can be a whole, like, a whole day thing. No one really has kind of time to do that, in fact, so public transportation is a big issue. Right, we have, I'm in Irvine. So here in Irvine, we have big wide three lane roads, sometimes four lane roads. And what we see with road design is that the bigger you design the roads, the more lanes you have, the faster people go, that's just a fact. Right. But the smaller roads that you have, the less roads that you have, like mentally, we go slower. And so that makes roads safer, that makes folks want to actually go out and maybe bike or walk somewhere. And then when you also have these wide big lanes, like we have a lot in the Orange County cities, there's also more lights that couples with that, right, so then people are stopping at higher frequencies while they're going 50 miles per hour or more. That's very dangerous. And you potentially get hurt or even worse killed, right. And so all of these things kind of compound. Sometimes, older populations of folks no longer have a license or never drove in the first place. And so are reliant upon some of those public modes of transportation. So then we go back to the first issues. Hours of operation i see is another one on here, which is a big issue and not, oh, sell frequency of local transit services. That's a great thing. Right. That's again, a lot of time. ADA accessible stations, yeah, and buses, right. So all of that is very big, and then compounds with a lot of the other issues that vulnerable populations, including older populations face that are on this list."]
+[0.6110823750495911, -2.5880777835845947, "I mean, the biggest one for public transportation, at least is investment by individual communities, and then the valuation from our communities. Right. And a lot of that goes into like what do our local municipalities What do our our state government place investment in valuation in and here, it doesn't appear right that public transportation is seen as a public good, right otherwise it would be heavily invested in would be a priority to make happen."]
+[2.349599599838257, 7.06679630279541, "But then we also get"]
+[0.684822142124176, -2.5518505573272705, "members of our communities, often the more privileged members of the community against more public transportation, because it is seen to some privileged folks right as against the values that they hold of increased profit and businesses and increased privacy and neighborhoods and all of this other stuff that goes against the valuation of public transportation for All right, everyone can use it. And so I would say the barrier to entry is that valuation by members of our community and by local municipalities and our state government. And then, for the other piece of it of like safe roads, and all of that jazz is, again, going back to valuation is like, a we value getting somewhere fast, by ourselves as more important than how we invest in safe roads. And so it's kind of a change of the culture, which is the barrier, I believe."]
+[7.1673359870910645, 4.670417785644531, "Thank you. Thank you for sharing that."]
+[0.29732123017311096, -2.549093008041382, "Yes. Yes, always. There's a lot of issues with public transportation and how it seemed for some populations, how it's used for some populations of folks."]
+[-0.15796788036823273, 2.4162678718566895, "And the barrier"]
+[0.09010561555624008, -1.1330716609954834, "for entry goes into that as well. So payment, right, like, public transportation here isn't free. If you have to have a car, you have to pay for a lot of things in order to have a car. And all of those kinds of things correlate with again, our our older population and some issues that they face, right. Some of the things that are on here, like economic security and like financial wellness, right, some older populations lose a lot of economic security as they age. All of these things correlate with our different populations."]
+[1.6118046045303345, 6.201165199279785, "Yeah, I think I think a lot"]
+[0.8157157301902771, -2.413109302520752, "of it plays into what we're asking of our local municipalities, our city council members, our mayors, our counties, right, what we're asking them to invest in in terms of transportation, instead of asking them to invest in, you know, widening lanes, right, maybe we can ask them to spend that money on taking a lane away and putting in more bike infrastructure protected lanes, or improving right our public transportation, or increasing routes. Right. I think a lot of that goes to what we as a community demand of our, our local governments."]
+[-1.225008487701416, 0.6702873110771179, "Thank you. And now we're going to address the third thing that you mentioned, which is Community and Family Safety. And I'll go ahead and go over the same questions again with you. Yeah, I think the lack of that,"]
+[0.5866595506668091, -2.928179979324341, "yeah, I think in Orange County, and I'll I'll broaden it to for our, you know, our US context, right. But in terms of our culture here, we're very less reliant on the community and family like sphere. That's not for me to say, but I can see how it plays out right, in impacting a lot of the other things. So when we look at our older populations, because the community sphere is less valued, right, there's less care on the community of individuals to care about a lot of these public goods that service a lot of our older populations, right. So the same thing as investment for public transportation, if we were to care more about the community sphere as a culture, we would see more public transportation, because we would understand that like the ability for all to get anywhere, with, you know, safe, transportation is really important for the safety of all and for the care of all and then family safety. So I think it's also important to note that when you look at things like gender based violence, sexual based violence, and a lot of these things, it correlates with a lot of issues of that, or it correlates with that idea that we don't necessarily care as a culture about this. Community sphere, right."]
+[1.7385305166244507, 5.562255382537842, "A lot of love,"]
+[-0.7196642756462097, -0.36524009704589844, "a lot of issues to lack of access for gender based care for sexual violence based care, right comes because we're not placing investment in those offerings for all people, right. And a lot of the work is put on nonprofits is put on, you know, individual organizations to do that work versus a community based system. And so I would say, I kind of lost what the first question is for all of these a little bit. But I would say that, like this idea of community and family safety is an issue within our region, because there's less"]
+[1.0258479118347168, -0.524976909160614, "valuation in it. Yes, I think you mentioned that. Yes. communities."]
+[0.7808521389961243, -2.17859148979187, "Yeah, I'm gonna see the same thing, I think, an investment within a lot of these services, right preventive, and, you know, you know, after the fact, is really the barrier, and then how we provide these services and offer them. Yeah, that's, that's what I would say is really the barrier is how we are offering them what the valuation is by our local municipalities and state government, and then how they're offered and publicized. And, you know, the response."]
+[-4.130774974822998, -1.8510088920593262, "Are there different experiences for different groups of older adults."]
+[0.06637156754732132, -0.6201863884925842, "Yeah, of course. Different cultures care differently within these community and family spheres. Because that's ingrained in what the values of that family unit are and what that community unit are. No. And are providing this Family and Community Unit and safety and valuation, then the broader community is placing maybe and more negative valuation on that. And so the resources that are being provided from our local cities and region are less so for those folks than they are for the ones that are placing the negative valuation on it."]
+[5.639804363250732, 6.5137553215026855, "Thank you. Again, I'm"]
+[1.0009795427322388, -2.055464029312134, "gonna say right, what we demand of our local cities and our state government through both our vote right, but also what we're demanding of them to place investment in, in budget, right yearly budget, in terms of services, is the one thing I would say that we can do. But what I'd also say is that and I'm going to go back to how like a lot of these things quarterly, right is what our housing looks like for vulnerable populations. What our transportation looks like for these vulnerable populations, what our services are as public goods, as public resources is really important to providing that community and family safety. Because if your only option, right, is that one bus, or if your only option for housing is to live, right with six other folks in this one unit. Then a lot of these other things are going to negatively correlate."]
+[3.344601631164551, 5.580411434173584, "Thank you for the answers. Now we're gonna move to the next question. Sorry, can"]
+[-3.1596412658691406, -0.19784307479858398, "Yeah. Yeah, take care. geriatric care."]
+[-0.5770213007926941, -3.804713010787964, "Okay. I think it depends on which community in OC and then you know, where you live. So overall, I would say, for the region, not very accessible."]
+[1.0074806213378906, 2.3909502029418945, "play into the fact of who can access it and who can't. So that in and of itself makes it not accessible for our"]
+[0.9144700765609741, 1.4147740602493286, "region."]
+[-1.6738331317901611, -0.4773271977901459, "I would say the same thing. If you're able to access those on a more frequent basis. And again, you're in the right area, it can be very, very good. But if you're reliant upon other folks to help you do that, if you require services in order to help you access more long term care, right, get on a waiting list or have to schedule something out a month in advance, right, that takes a lot of time and energy. And then if you're not in an area that has access to that on a quick basis, right, then it can be very inaccessible. So that and again, and and of itself means that for our region, it's not very accessible."]
+[-2.15583872795105, 1.325116515159607, "What about mental, mental behavior, health, and substance abuse treatment. what was The last part of that, oh, substance abuse treatment."]
+[-1.3006192445755005, -1.7459088563919067, "Okay. So that one is also interesting, because we're looking at our older populations too. And so within the context of, at least the US, right, mental health and substance abuse have both been seen negatively. And services have only really grown in the last like 20 years in that barrier of our social constructions of what it means to have mental health issues or what it means to have substance abuse issues, right, has only been starting to deconstruct like in those last years. So then when you look at access for it, one, we have to look at what kind of barriers exist for folks in terms of that social construction of those issues. First Mmm. And then that also plays into what are our local cities, what our county is providing in terms of those resources because of those social constructions of what it means, right, and the valuation that's placed on them. And then if our cities habit which I work with a population of folks that can have immediate access, right, our students no matter if they're traditional, or non traditional, have access to substance abuse, prevention kids, training groups, all of that mental health facilities. We want to be increasing that. So luckily, for me, it's a conversation always in the accesses there. Which then parlaying out into the wider OC region, I would say the same as that there is access but again, it couples with a lot of those issues of what the investment is, from our local cities, what the investment is from our county, how, how widely communicated, that is what the access to long term healthcare is. So in and of itself for that, I would say not very good."]
+[3.6790931224823, 15.139763832092285, "Yes."]
+[1.3494617938995361, 0.9077259302139282, "I don't, I only know of our programs for UCI in the surrounding communities. So that in of itself is an issue. Right, but"]
+[2.2191317081451416, 6.189898490905762, "I don't."]
+[1.373300552368164, 2.5152080059051514, "Because there's a whole bunch of different things falling underneath that category. But in and of itself, I would say not very well, in terms of access for folks, but it does exist."]
+[0.1677859127521515, 3.493532657623291, "Thank you. We'll get on to the next question as what do you think would be the biggest challenges older adults will face the next thing is"]
+[1.139483094215393, -1.8445943593978882, "I think some of the biggest challenges in our region, right are a lot of the same issues a lot of folks will face in terms of increasing population needs for housing, but low cost housing, right. That's a big, big issue, but especially our older population will face because sometimes there's a greater correlation of need for you know, first floor units for single family homes for like this aging and the idea rate of of no stairs, all of this stuff, right. So greater need of housing. But then coupled with that are some of our environmental concerns for older populations, right of, you know, their access to respond in kind for extreme heat for drought for all of these environmental concerns. So I think those two are really big things that will play a part in the needs of older populations, in addition to the things that are always in need, right in terms of that health care piece. So geriatric care, long term health care, mental health issues, all of that stuff is in addition to what I think in the next 10 years will be a big issue for older populations."]
+[10.575894355773926, 8.508012771606445, "Thank you."]
+[0.8537276387214661, -2.075073480606079, "I think the government's role is placing higher investment into all of these issues that right we talked about and that are on this list of things. If we place more investment as like local governments and as a county then I think the valuation from the community follows right because Community Health is"]
+[-1.8749293088912964, 0.7229729890823364, "health for all."]
+[0.8053973913192749, -2.255680561065674, "And so I think right that investment in All of these things from our local governments is like the most important piece. Or what demands we're making of our city councils of our elected officials."]
+[5.4682488441467285, 6.940857410430908, "Thank you. Yeah,"]
+[2.7236361503601074, 5.869960308074951, "I think that's a good question in terms of like, all of these things."]
+[0.21845275163650513, -4.164521217346191, "For me, like, on my outsider perspective, right. I see a lot of I see a distinguishment, between our older old population of folks who are in North Orange County and have like, a lot of these compounding things that we talked about, right, versus our older old folks that are in South Orange County and get access to a lot of these long term health benefits of environmental beauty and access to a lot of these community care things that we talked about. So that's what I"]
+[1.7087905406951904, 6.66587495803833, "would say."]
+[0.08920346200466156, -4.9281392097473145, "So I would say our North Orange County old old folks"]
+[1.0745518207550049, -1.9784144163131714, "Okay. Well, I think it depends on who is doing the looking right. I think a lot of our local nonprofits, our local organizations that are doing this work, see all of the issues. But I think our local governments, depending on which government and city are overlooking a lot. And you can see that by like what, you know, I'm saying that we need to place investment in by what other folks are saying we need to place investment in things like public transportation, right. But older populations aren't really part of that conversation, environmental concerns as well. But I would say it doesn't necessarily, it's not what issue, it's who is looking at the issues is what determines what's overlooked."]
+[2.9896512031555176, 4.759939670562744, "Thank you. Now moving on. So in addition to what we already talked about, so now we're going to go more specifically to your area of expertise. Yeah, I"]
+[0.4247622489929199, -3.2536773681640625, "think a lot of what I already said, right, of how folks are aging in is really hurt by a lot of the investment that isn't being placed in our communities in Orange County. Like I mean, it's a problem for everyone, but especially our older populations that have lacks access to some of the ways to respond to these things. That's an issue for everyone. Right. And so that compounds itself with a lot of the things we talked about with like public transportation, with roads with access to care, and all of that stuff."]
+[10.588282585144043, 8.498685836791992, "Thank you."]
+[2.1206746101379395, -1.8606308698654175, "Yeah, honestly, I would just say a lot. Maybe let me give you a good answer for that first, though, is that a lot of our Orange County cities don't even have climate action plans. Right. And so that is first needed in order for us to even know what problems each city in Orange County needs to address in order to respond to climate change. Right. So I would say, like for revised policy, or new policy, right, is start with a Climate Action Plan. And actually, you know, commit to it as cities."]
+[10.679217338562012, 8.430309295654297, "Thank you."]
+[2.0413312911987305, -1.8474310636520386, "Yeah, that's a good question. So a lot again, there's so much data about populations of folks and how it correlates with different things to do with sustainability issues, including climate change. One really big one that we talk about with a lot of students is how like food insecurity, how health concerns and community concerns, compound with sustainability issues, like climate change intensification in certain areas of Orange County. By like, what access folks have to respond to a lot of those issues, right. So when you see these maps, like put next to each other, it's like North Orange County areas, and then pockets of like the middle of Orange County. And so it's, it's super important to be able to look at how these issues correlate, because they're interrelated. But that data is important to have in order to uplift and highlight those narratives so that we can continue to do this work."]
+[3.7146944999694824, 4.104846000671387, "Yeah, let me after this, I can send you a student did a project a couple of years ago at the start of COVID. And it's my favorite thing that I had a student do here of like an ArcGIS story map of all of those concerns. So I'll find it after this, and I'll send it to you. Oh, that'd"]
+[4.5037641525268555, 3.7617106437683105, "be amazing. Thank you so much. And I guess that yeah, that's the last question. The other question is just like, I can like, follow up with you. If anything's Oh, you can also contact me if you missed something or if you want to share something else. And I mean, sharing those like sources will be amazing as well. So yeah, it's like very, very like helpful like information you provided and helpful so it's great like yeah, very helpful to our research. And also sort of like I mentioned like, you can also contact like information or go on our website and leave a message like emails to our general email that we have so you know this email me Yes, sir thanks for Sharing."]
+[4.39000129699707, 7.141039848327637, "Okay, great."]
+[2.9659392833709717, 4.895919322967529, "No, I think we just like go right into the questions."]
+[-2.6512348651885986, -3.1660025119781494, "Okay, great. So the primary goal of today is to identify what needs do you think are most important to older adults. The older adult population you serve specifically, and that's defined as 60 years and older, we want you to think as broadly as possible taking into consideration the older adults, caregivers, families and their communities. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. And please take a few minutes just to read through the list or let me know when you're ready to begin that I'll share my screen now."]
+[4.326900482177734, 7.16972541809082, "Yes, great."]
+[3.3997108936309814, 5.451213836669922, "Okay, I think we're ready to start."]
+[5.579196453094482, 8.806556701660156, "Okay."]
+[-0.956218957901001, -3.3066766262054443, "So I am administrative assistant at hope Community Services and I help within I'm like a program assistant with I'm a program assistant within the senior programs. So I usually help in providing services regarding our ESL and citizenship classes. And I also do I also help and coordinate part of the food pantry that we operate as well. And I also, I also assist in our community committee, haircuts which we when we provide free committee haircuts for all the seniors on like, the third Monday of each month."]
+[3.6532695293426514, 10.998733520507812, "Um,"]
+[-2.7816812992095947, -2.516188383102417, "I think overall, the list is pretty thorough, these are the ones that I would consider like to be the main issues that older adults do face."]
+[2.4556150436401367, 3.812542676925659, "Thank you. And of the needs on the list, Please rank the top three that you feel are most important."]
+[-1.1735605001449585, 1.0941530466079712, "Um, I think the first one would have to be economic security. The second one would have to be transportation and mobility. And the third one would probably have to be behavioral and mental health."]
+[0.07320891320705414, -0.6724513173103333, "Okay, thank you. Okay, so for the next few questions, I'll be going, we'll be going through each of the three needs that you have identified. So first thinking about economic security, how or why are older adults struggling with this issue."]
+[-0.8187965154647827, -2.1794004440307617, "So a majority of the older adult I serve they are on SSI and SSA, and are like not SSA. Sorry, it's just like us like Social Security and like the SSI, but even then, because of the cost of living has been rising California, it's been very hard for them to like, just budget everything to you know, to just like accommodate to their basic needs. So one of the major things that they face is that they don't really have food insecurity. And so that's where a lot of our food pantry programs like does come in to help with them because, at least for them, or I can only speak for the Vietnamese seniors, like and Asian American seniors that I do help. Because these seniors, well, Majority of the ones that I've been talking to, they're, it's hard for them to cook with things that they're not used to. Right, so we for our food pantry, we serve them like culturally appropriate ones. Spam, something easy for them to cook and that they know that they can consume. Because like if you you know have like meal prep for them. And also, like, just any, like, employment wise there are, most of them are because they're 60 and older, they aren't healthy enough or like not like in the best condition for them to work. There are some of the seniors that do work, but even then it would be like they would they're retired, they're like, retired, but they would do like, you know, meager like side jobs where just to cover like a little bit of rent because you know, rent has been increasing for them as well. Oh, Um, yeah. And they also because of their background, a lot of them are like immigrants and refugees, they haven't had education at all. So like, they're not very literate. A lot of them they do come to office whenever they get mail, whether it's like an English predominately, it's usually English like letters or Vietnamese letters they come in, they don't understand because they just some of them like, are like literate at all some of them they have they're like, partially literate. So it is hard for them to like obtain, or just it's been hard for them throughout their lifetime to obtain, like employment opportunities that can provide like a living wage for them. But even now, like in California, like nothing's a living wage, unless you're making like, at least 80k. And they don't make that."]
+[7.090994358062744, 4.6628570556640625, "Yeah, thank you for sharing. Yeah."]
+[3.408097267150879, 9.000831604003906, "Oh, yeah."]
+[-0.6732250452041626, -1.710574746131897, "The biggest one, I would say is like, culturally competent services. And that's what a lot of our organization aims to do. We provide like, you know, for our food pantry provide that cultural competency and like, you know, food staples, but we also provide our ESL and are in our citizenship classes, because we make sure that these are in languages. And I guess for like other seniors, as far as like they, a lot of like minorities, they don't really have a safe space where they can just like come in and gain access to the resources. So like, it's nice to think that our organization does provide that but as well as like other organization like Asian American Senior Service seniors, Senior Center Service, seniors, oh, my God, I literally don't know their name. It's called ASCSC though. But they're one of our partners, and they provide that for the Chinese American seniors. So that was one of the barriers, um, literacy is also a big barrier that I have seen. Yeah, probably like, if I could like break down like cultural competent, like resources, and language access to resources as well. So probably those two."]
+[10.71230697631836, 8.368857383728027, "Thank you."]
+[-0.6336862444877625, -1.4904563426971436, "I would say yes. But again, like I can only talk for like, at least the Vietnamese, American seniors. And it's just like, mainly, like, there are at least like Southeast Asian seniors that are background, you know, they're from war torn countries, like come here without nothing. So and that would definitely have to be different than maybe seniors are South Asian instead. But also seniors that are also maybe the East Asian, for any, like other non Asian minority group. I can't talk too much about that. But I would assume they would be different."]
+[10.542435646057129, 8.4700288772583, "Thank you."]
+[-0.5447424054145813, -2.3861277103424072, "I would say because it maybe this is like a very biased point of view. Because a lot of the services are given within community based organizations, because a lot of these community based organizations and I can name like, a lot of the ones that we worked with, within the API Task Force, is that and they predominantly do serve seniors, is that we, we have the people with the lived experience in the neighborhood, or at least in these communities that understand like, Okay, why do these backgrounds, so I think one thing that could help this is like to fund more towards these community based organizations and like, improve their capacity, because a lot of them are operating in like low capacity, like our team is relatively small, so we can't increase capacity for a lot of our programs, as well. So I think like the biggest one would have to be like capacity building for like, community based organizations."]
+[10.560736656188965, 8.513666152954102, "Thank you."]
+[0.13162557780742645, -2.6950855255126953, "Yeah, um, so I, because like California is, so it's like a commuter state, it's very hard for them to get anywhere, because one, a lot of them, they don't, they can't afford cars. They're also in a condition where they shouldn't be driving cars because it's dangerous for them. Secondly, most of them they do take public transportation, but even then, like, there's so few bus stops and even if there is a bus stop, like it does, it may be dangerous in dangerous areas for them. Right or it's like not like assessable like, because of like, this also ties into a lot of issues but then like the homeless population as well like and like how the city government governance like take care of that like a lot of it seniors, they can't stand for a while a lot of them like that I do serve they use they do use like some sort of like walkers or like canes. So like, they have to wait at bus stops that aren't like that don't have like no benches for them for like long periods of time. And sometimes like the bus transportation schedule isn't like it is sometimes like there's like, it's like a leave like a gap between like when they get picked up and everything. So I think like, that's probably like a major issue with them. And then again, like affordability, like there are senior passes, but I don't think that the at least Octa they do promote the fact that there are senior passes, and that a lot of seniors do know how to enroll into that, or at least get to obtain this in your past out of like a lower rate for them."]
+[-0.7876503467559814, 2.339115858078003, "Okay, thank you, and what barriers exist to see improvement in this area."]
+[-0.5328303575515747, -1.531087875366211, "Again, it would probably be like in language, accessibility, like, cuz Octa, they usually promote all their things in English. And a lot of the seniors that I work with, like are only like, our, like, low English proficiency. And they only speak like Vietnamese, or like, again, like some of them might not even be literate in Vietnamese as well. So that that's like a major barrier."]
+[0.5386621356010437, -2.9836173057556152, "I would also say like it would probably will be because like, again, like the geographical areas and where many of these communities are based, like for example, a lot of Vietnamese seniors are based in like Westminster garden grove. So like the bus stop areas around there may vary from like, Irvine where it might be a little safer for like, Chinese American seniors or like Southeast Asian seniors as well. So I think it just depends on like the geographical area that might be like facing that I think commuting wise but like regarding cars, it might be the same."]
+[7.117424964904785, 6.180051326751709, "Okay, thank you. And would you suggest is the best way to address this issue and"]
+[0.25512269139289856, -2.701748847961426, "probably prioritize safety and like making sure that like the resources that are offered by like transportation companies like Octa, like maybe like even like Uber like these, like, you know, ride sharing companies that like, it is in language, and they do make it like accessible, and they provide accessibility by reaching out towards community partners."]
+[-2.707808017730713, -1.6143784523010254, "Thank you. And thinking about now, behavioral and mental health, our wire, older adults are struggling with this issue."]
+[-0.8895992040634155, -1.2970569133758545, "It also ties into respect as well, because that's like, just like my background as a kid growing up in like the community. But I guess like mental health is like a very, it definitely is a taboo thing and like the Vietnamese American community, like they just don't like really, they tend to, they don't understand the concept. It's something new for them. And then a lot of the seniors that like, you know, immigrated here, like, they have so much trauma from like, the war and they haven't, or like they never learned or, you know, had resources to you know, cope with like, they're you maybe some of them, they do have PTSD, some do have depression and also as well as like, it doesn't even like stem from more trauma there could also be trauma like family generational trauma that they face, like back in Vietnam, and so or as well as like, the struggles like assimilating into America as well to make sure that like, Oh, they're forced to like you know, work so hard without like with nothing to you know, have a better life. Yeah. I feel like there's a lot of like aspects to consider when it talks to like behavioral mental health for older adults because they don't have like a I guess they don't have the background in it or like they weren't you know, they unfortunately didn't have the opportunities to like understand mental health. One, like, like Yeah, within like, like behavioral mental health because there's like, I think like the examples like listed like there's a lot and just like depends on like, each one"]
+[1.7770905494689941, 5.841916561126709, "ya know, not, not really maybe whichever one you think is most prevalent or most pressing"]
+[-2.1263298988342285, -1.4571187496185303, "thing. Yeah, I think right now it probably be forgetfulness, either like forgetfulness and anxiety. Those are probably like the top two that I would prioritize in my experience, since like, you know, as you go older, like you're bound to like forget a lot of things and Does like impact their daily their daily activities because like, one of the things that we do is that in order to us to, you know, continue to be in contact with a lot of our clients, and to make sure that they're okay is that, you know, we need their phone number, but even then a lot of them are like, Oops, like, I forgot my phone number, we're like, oh, that's not good. Like you, we can't forget our phone number because we need to make sure like, we contact you and have your contact information to make sure like, we can do like, you know, these checkups with you. With like, our Senior Program Manager. with anxiety, I've seen it stem from there's a lot of different factors stems in predominantly like, it could be like, you know, from war, from, you know, being in America. And lucky enough, I'm very glad that our seniors do live in like a Vietnamese enclave where they're able to have, you know, these in language resources available to them. But then when it gets to situations where they have to contact some form of like, you know, government social services that, you know, do predominately operate in English, like they get some anxiety about that. So, like, they like, refer to us, and they get scared, and they're like, can you please call us and we're, like, as much as we can call them for you. Like, there's only like, a limited amount that we can do. And then like, they're like, just do everything for me. I'm like, and I can't do everything for you. Like, I can't like, like, Thank you for trusting me with your social security number, but I don't even like feel comfortable, like handling social security number. I was like, That is like one of the major things that at least, like when I provide the services, like something I see often, when I you know, have like, meet up with the seniors."]
+[-0.7917128801345825, 2.3536884784698486, "Thank you for sharing. Yeah, and what barriers exist to seeing improvements in this area."]
+[-0.9416594505310059, -1.273641586303711, "Um, I guess the top one is, like the fact that mental health is like, or, like mental health is like a very taboo thing, in Asian American community. And that's something that we just like, had to accept and like, you know, develop ways to, like, address them culturally, and competently. And as well as like, you know, do it in language. And because some of the terms that when you translate mental health, like, doesn't get translated like properly, like, it's hard, translating, like, emotional boundries, for example, into Vietnamese, because there is no concept of that behavioral health as well, like, you know, stress, like they just like, like, you know, in order to promote these ways to have like coping as well as these resources, like they have to be done ways that are like in language, and like, try at least try to mitigate the gap between that translation for the seniors who make sure it's as close as possible to what we understand in English to what they understand in their native language."]
+[3.790848970413208, 15.416419982910156, "Yeah."]
+[-2.098503351211548, 0.7092212438583374, "I would say in some of the topics, it might be the same, for example, like needing a caregiver like, and that might be the same within like, across all Asian American community, like older adults. But definitely like for Southeast Asians, like their anxiety and depression is going to vary from like, you know, like a South Asian, older adult, or a East Asian or adult or even like Hispanic, Latino, older adults. Yeah, so I think like in those aspects, like more of like, the mental health-wise the background that or at least like the background for factors acting into whatever goes on mental health is probably going to be very different. Because like, varied experience from like, the home country."]
+[10.602542877197266, 8.484541893005371, "Thank you."]
+[-1.2191072702407837, -1.4631597995758057, "Definitely in language resources, and make sure like, they're culturally competent to make sure like, okay, they understand like, oh, like, what is it emotional boundary or like, what is like depression and was like, oh, it's depression, okay. And making sure like, you convey that to them. Slowly. I think, if you just like, go out there with programs be like, bam, here's depression, and why it's okay. That may, you know, actually have like the opposite impact of what you were expecting. When you're like, talking to a senior, be like depression, or like, I don't wanna talk about depression. So you have to, like, slowly ease into it and make sure like, they're comfortable with the idea of mental health first before like, addressing, like your specific topics like anxiety, depression, stress, like that."]
+[3.6488800048828125, 4.2626190185546875, "Thank you. Yeah. So that's it for the these, the list that we're using what we have a couple more questions, but I will stop screen sharing for now."]
+[-3.3590891361236572, -0.3734865188598633, "Yeah, geriatric. So geriatrics is a branch of health care that focuses on unique needs as we age. So, just as pediatricians specialize in children, geriatricians specialize in the needs of older adults."]
+[-1.4356998205184937, -3.503358840942383, "Or should I just like to say, I would say it's like a product of, at least for the Vietnamese seniors, I know, I would say around it was five or six. So like, probably like average, they do have a lot of access down here to providers that are Vietnamese, and that they are family doctors, they tend to have, like, a lot of providers that like are very like that overlap with each other as well, when I look at my clients. So geriatrics for them is not the provider to at least their system is not too bad down here."]
+[-0.9425039291381836, 0.00457112118601799, "Are you referring in terms of like nursing homes,"]
+[-2.6226348876953125, 0.27141234278678894, "or long term care, it can be a variety. So it's just it just defined as services that helped meet the needs of medical and non medical needs of people with chronic illnesses or disabilities who can't care for themselves."]
+[-1.2322431802749634, -0.8188312649726868, "I would say what ---, it just depends on your insurance, actually. So a lot of our, a lot of our seniors are on Medi-cal or Medicaid, well most of them are. So if they are on a plan that does allow for it, and I would say like, probably it'd be like a seven, like they are allowed, and they are happily, they do have the opportunity to have that care. But for our non insured, or, you know, for our clients that don't really have it, it's very hard for them to gain access to that care. In Orange County, or at least down down in the areas of like Westminster, Huntington Beach, Garden Grove, we do have a lot of nursing homes, because I think lately, like a lot of people have been seeing the needs, and they have like, and, all these nursing homes are pretty good around the hospitals. Like, can they do it long term, because in my own personal experience, like I had both my both my grandparents, I had prospects and both my grandparents have to go into nursing homes, and like, the care there is great, it's just that there's a lot of issues with like health insurance, because everything's like, you know, for profit, unfortunately. Um, but yeah, like I, I would say, like, it definitely is hard for, it just depends on like, the health insurance plan that the senior has, but I would say like, it really isn't accessable if they don't have insurance at all. And even if they did have insurance, at best, it would probably be like four months of like coverage, and they would have to find ways to like, cover it out of pocket."]
+[3.6893813610076904, 15.555525779724121, "Yeah."]
+[-1.8386038541793823, -1.6769973039627075, "I think in terms of having the resources out there, it is out there. I was like, a decent amount. I'm actually I'm gonna not that's not sorry. I just need to think about this for a little bit. I think in terms of having the resources out there, there's not a lot because again, in the area that I serve, mental health is very taboo. So like, even like therapy is like a hard one. But even having like the in language therapists, and like culturally competent therapists, like those are very rare. In terms of the seniors outreaching for these services. I would say like they don't it's very rare for them to seek out like behavioral mental health resources, even like substance use abuse as well. Because I guess the dynamic in the community that I've seen is that they don't tend to rely on providers they just tend to rely on like family or like they tend to rely on like their friends instead to like, I guess, like, help them because they don't have they don't really understand like mental health is like is like a field within health that needs like actual professionals."]
+[10.592432975769043, 8.463791847229004, "Thank you."]
+[-0.8043997883796692, -2.9248321056365967, "Oh, there's a lot I think it's very great down here like cuz because we live. We live I literally live in little Saigon. And like, they automatically like, they're usually yes, there's usually someone or in the office, there usually is someone that can help have a Vietnamese person, so it's not too bad. And then also, a lot of the community organizations down here, we do partner up with SSA if needed under a contract to provide like, um, you know, fairs and opportunities to provide like to help register and refer a lot of the Vietnamese seniors as well. And this also doesn't go for like Vietnamese seniors. Like there's a lot of nonprofits out there that help for like, Hispanic Latino seniors because at least in Santa Ana like, it's very strong down here. So the um around like the civic center plaza, there is like a lot of like Hispanic speaking um providers that can help for like referrals."]
+[10.580862998962402, 8.497072219848633, "Thank you."]
+[-0.09191776067018509, -1.3329269886016846, "I would say if I could limit it, to like the top two or three, it would probably be like economic security. Because the SSA that a lot of these seniors get are the Social Security and uh and the SSI, if they are elected eligible for it, it's not sustainable at all. Because you know, like, next 10 years, like, we're the, I guess, like, the economics down here is was like really bad. So hopefully, they don't, it doesn't hit them too hard, but I would assume it's not sustainable. And there's, they're going to have to find ways to make sure like they are able to afford the cost of living. And also mental health like, I would say, like, more like behavioral health wise for like dementia, because it is, a lot of our seniors are much older, and they're the aging population down here, is very vast. So I think a lot of seniors are going to have to be facing dementia, as well as like the mental health, mental health illnesses that are tied to that. So like depression and like, feeling like, you know, worthy feeling like, they have a purpose in life, because a lot of them they do, at least the seniors here, like they struggle with having a sense of purpose, because they're like, Oh, I'm older now, I don't really feel that I have a role to play. And so maybe those are probably the top two that I would addressed. Or like, those are the challenges that they would face."]
+[-0.4783168137073517, -3.0748040676116943, "And in your opinion, what do you think the government's role should be in meeting the needs of older adults in Orange County."]
+[-0.6082221865653992, -2.1932156085968018, "Um, I would definitely say, firstly, making sure that they can provide resources and when I mean, provide resources, it means investing into organizations that can provide these resources. So like, you know, again, like earlier, I said, capacity building for community based organizations because as much as like the government knows, like, they have the resources to help, they just don't know how to distribute it out, like properly, they don't, they can't connect it, because a lot of what the seniors need is that they need a connection. And like, whether it's like an emotional connection, most of it has to be a more open and emotional connection, as well as like just like any, like physical like maybe like, like any type of relationship because that's what they've been needing. So, if like, the government can like provide funding towards community based organizations down here, that you know, allows them to obtain culturally competent and culturally appropriate resources and provide this shoot that down towards the seniors and making sure that these community based organizations have the capacity to to need that will be like amazing, because that's what I've been seeing within like at least the role of community based organizations in language, I would I would also say more appropriate in language translations. I because as much as like they can distribute out so many flyers and like the translate it, most of the time these translations aren't accurate. They don't make sense. For example, and this isn't to like name drop anyone, I guess one of those because of the redetermination, redetermination process that's been going on for like medi-cal They've translated some fliers regarding like, okay, medi-cal, make sure you keep your information updated. Here's what's going to happen because the COVID-19 public health emergency ending the translations on that wasn't, or at least in Vietnamese, it wasn't like, it didn't make sense. Like, if you read it, you wouldn't like understand it. So it was kind of like all over the place. So if they could just like, you know, take a little bit more time, instead of just putting everything into Google Translate and making sure that it's appropriate for the language and for the seniors, and making sure that because like, there are certain words like, again, like, even in like medical, or like, even like medical, like basic, like everyday usage, like, it's, that word may not exist in English, or that word may not even exist in Vietnamese. So one of the things that, like, our office tries to do is like, we take these translations, we go with our senior program manager, and then we go over it in order to make sure like, okay, can the seniors understand this, because if you can't convey the information properly, then there's no point no one's going to understand, and they're not even going to be able to get the resources that they need. So I think that would be like a second priority if the government could just like do anything, like maybe just invest into translators."]
+[0.11545233428478241, -4.722833156585693, "Yeah, thank you. And thinking about the thing about all the older adult residents in Orange County, who is getting the least amount of attention"]
+[1.7058764696121216, 6.669406414031982, "I would have to say"]
+[-0.5183343291282654, -1.3855868577957153, "I'm thinking broadly in terms of like ethnic minority, but even then, like, my knowledge between that is very was lacking, I would definitely with say any Southeast Asian group besides Vietnamese, as well as South Asian groups, they typically are groups that are very forgotten. It's lucky enough that, its fortunate enough that the Vietnamese community population down here is so like large that a lot of services are being provided. Or, you know, Southeast Asian groups, such as Cambodian, Thai, Hmong, Laotian, they don't -, their community is so small, that they don't tend there tend to be for lack of a better word forgotten, since they don't have or, like, they don't also, like have, like, for example, like, I think an issue is that a lot of things like our like data, like database and log number driven, that because like, they don't have so many people, it's hard for them to like, even, like, get resources or like, you know, even get translation, like there, I see, it's very rare for them, um, as well as for, like, South Asians, like they, they, because they're so little like, they just, nor combined into just like South Asians as a group but even then, like, the minority, like the groups, they're like, different, like, Pakistan, the Pakistani community is different than the Indian community. And like, even then, like the Indian communities, like here was so huge, as well as Native Hawaiian Pacific Islander groups, they, I think, like mentioned, like, they definitely are, like, very forgotten. And because, like, there are also so like, all these groups are so like, combined into Asian American, I think, like, it's like, a good thing that there's, there's like a big need to like disaggregate all the data, because like, even then when you like, Major, when you put everything up to Native Hawaiian Pacific Islander, okay, that encompasses so many groups, there's like Tang group Chamorros like those communities, like like, even like groups that I still don't even know my by myself, because like, the information like just passes over their head, like there's no focus on them. So I would say, like those, I guess, like those three categories, or like, like those groups that often like are forgotten, for lack of a better word forgotten."]
+[10.68852710723877, 8.408185958862305, "Thank you."]
+[-0.6152045130729675, -1.437270164489746, "That's a good question. Because if it's overlooked and I probably don't even remember myself. I would have to say literacy. They just I think, because like when you assume that, you know, at least in the American system down here, you assume that okay, they Then they're educated, they're older, maybe they can read, some of these seniors can't read, they are not literate, whether it would be in their native language or in English. So even then, like, you have to figure out ways to if you have information to provide that information in a way that they can understand. So like, I think, luckily for us, we have connections to ethnic ethnic radios, like ethnic media, where the TV stations are, you know, very, there's a lot of Vietnamese TV stations down here that can provide the news. But sometimes even that can be mixed in or literacy can also sorry, literacy can also be mixed in with disinformation that is a very big one within I guess, like the Asian American community, because you can like provide information. But if they can't comprehend that, again, like, then that what they really understand from that is going to be different than will most likely be different than what you are trying to convey. So like, because I think you can see from COVID Like disinformation and misinformation was a really big thing. And even with like the political elections have been going on, that has been like a major thing as well. So probably like those are probably like overlooked. I think they're just like, not, there's no like concrete plan to address them."]
+[2.9308524131774902, 4.730944633483887, "Thank you. So in addition to what we've already talked about, let's dive a little deeper into your area of expertise."]
+[1.6770025491714478, 6.590100288391113, "I would assume so."]
+[-0.8437215685844421, -2.102184534072876, "Um, I would have to say that I think there's a more, there's an easier focus on hunger, because that's something more tangible that you can impact. Or like, at least address, because I know that there are a lot of community based organizations that are providing a lot of food banks, a lot of food programs, like we are one of them, we provide our pantry that happens like every third Sunday of the month. And at least on our capacity, we can serve like 120 to 150 people and like. So I think hunger is something that's being addressed at a better rate, because again, like there's, for example, Community Action Partnership OC, they also have food banks, and they also extend it towards like low income families and seniors. I think our partners, ASCSC, and the Vietnamese American Cancer Foundation, they also provide these food banks as well. And they those two, they definitely predominately serve seniors. So I think hunger is something because it's easier, because you're just making sure like, okay, the seniors need food, and here's how we provide food. In terms of poverty, it's something that it is harder to address. And at least on our part, it's hard for us to address that as well, because I think it's just more based on the systems like you have money, we just can't like give free money. So like all them are, like, you know, social social security and SSI if they're eligible for it. And so, I think like, even for poverty, like the best thing you can do, off the top of my head is like providing like, financial workshops, but even when you even when you provide them the knowledge, it's like, they can't use that knowledge if you don't have anything. Yeah."]
+[3.0777578353881836, 0.12732277810573578, "Yeah, thank you, and what newer revised policies are needed"]
+[-0.6469422578811646, -2.0695974826812744, "I think, in regards to poverty a policy that off the top of my head, would probably just be lowering or at least, like expanding the eligibility for the seniors or just making like, having like, economic safety nets is also something that, you know, governments can like make that like, really that have our policy for and invest in, and as well like, expand that eligibility. So safety nets is something that that can be like made a policy but also it is difficult because you need funding for that. So, as much as I would want that as policy, I think realistically, that is something hard for at least, you know, governments to do. If they could, that'd be amazing. In terms of hunger, I think a policy that could probably be helpful is just, I guess, like capacity building. And this is because I predominantly sort of like ethnic minorities, and like, specifically Vietnamese American ones. Culturally competency is, is what drives our food program. Will it be nutritious that those are like, there's a lot of things that we think of when we provide and we make our pantry food staples staples. So I think like, probably like more investing, and I think, maybe having funding to fund more of a, rather than like a pantry staple program, a hot meals distribution program, because I think last year, we were lucky enough to obtain funding for three months to provide 50 hot meals a week for our seniors, and like the waiting list, like we sold up the 50 the 50 limit capacity real fast. Unfortunately, there was like a long waiting list because some of these seniors, like maybe they can't cook, they're not in condition to cook. And they also don't have caregivers. So they're going to have to, you know, like resort on eating, like going to restaurants, but even then, like maybe even access to the restaurants is something that is difficult for them. So I think maybe, you know you know, be able to contracting, like community based organizations to you know, you know, work with, you know, a culturally appropriate restaurant, that provide like, at least cuisines that the seniors are, at least the seniors like know of, or they're comfortable with, that would be really good too. Because that can address like issues to access or resources, because if you're going to be based organization, you're going to be located at one spot, and they're going to typically know this spot, and it's going to be possible for them. Secondly, they're going to have that in language access. And thirdly, the food's gonna be culturally competent, because it will be contracted from like a restaurant that they usually are familiar with, like the cuisine that they're familiar with. So I think I also don't really see a lot of these programs, where they provide on like hot meals, most of the food banks are just providing basic staples."]
+[-0.39047396183013916, -2.4960880279541016, "Ooh. Like, off the top of my head, I would just say like community based organizations, as long as they, and this is like a very necessary thing have the funding for it. In the nonprofit world, I mean, because you know, we're both a nonprofit, it is very difficult to find funding, it's such a competitive field out there. Like people always say, like, oh, there's money everywhere, there is not money, there is money everywhere. But are you you're the one allowed to, like touch the money. So I think that would providing the direct services through the committee based organization as long as they have the capacity and the funding to do so are usually the people that I would assume are like the best people to address this. As far as like backing with the government, like offices and like programs as well."]
+[0.8738194108009338, -1.3694610595703125, "We also like to use age as well. And that is hard, though, because some of them I guess, in the Vietnamese community, like some of them like they do renting and like, they get scared of like when renters go out and ask for like their housing data. But I think those are like usually the ones that we usually use."]
+[4.285012722015381, 4.52660608291626, "Thank you. And is there anyone else you think we should talk to,"]
+[-0.871455192565918, -2.87168288230896, "um, I can refer you guys to our partners, Asian American Senior Center Service Center, man I literally like I just call them by the acronyms. I can't remember the full name, but I can get you into contact if you haven't yet I can get into into contact with one of them because they serve because we use our predominant the Vietnamese community, they serve  predominantly Chinese American community. So maybe there's like a different expertise for that as well."]
+[4.340827941894531, 4.094004154205322, "Sure, yeah, I think we do have them as a contact. But I will definitely reach out if we do not get to talk to them as well."]
+[3.1815185546875, 8.04693603515625, "Yeah, of course."]
+[4.841041088104248, 3.2719359397888184, "Great. Thank you. So this concludes our interview. Thank you so much for your time, and you've been incredibly helpful to our research. And if you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website, and that's just www dot events. oc.com or you can leave an anonymous voicemail on our telephone line at any time. So I will stop recording now."]
+[4.389392852783203, 7.140401840209961, "Okay, great."]
+[2.6344687938690186, 3.136735439300537, "In a minute, I'm going to share with you a list of common issues and concerns on my screen."]
+[-2.7917253971099854, -3.0265512466430664, "These are common issues and concerns impacting older adults. And they're listed in alphabetical order. So no ranking or no prioritization, just a list. And so I'd really like you to review the list. And whenever you're ready, let me know when you're ready to begin."]
+[-2.5121705532073975, -3.3568103313446045, "And for the context of today's interview, we're going to be asking you questions about older adults. And our definition of an older adult, uh, pertaining to the California master plan for aging is 60 years and older, okay. But when you ask you this questions, we want you to think as broadly as possible. So taking into consideration the older adults, their caregivers, their families, and the community at large. Okay, so I'm gonna go ahead and share my screen. And once again, take your time to review this list. And whenever you're ready, let me know the list is going to stay on the screen so you don't have to memorize anything."]
+[3.7488951683044434, 5.067328929901123, "But please take a moment to read it through."]
+[4.319045066833496, 7.256114959716797, "Okay, Okay, wonderful."]
+[-0.8165780305862427, -3.7460875511169434, "Oh, currently, I am retired. So, um, but I have 32 years of Social Services Human Services experience. I was the previous Social Services Director for approximately three years, I had a total of 27 years of senior management position, within SSA, serving cross, basically all populations of Orange County and both the public assistance programs, Adult Protective Services in home supportive services, child welfare, etc. Thank you. And thinking about Orange County and looking at this list of common issues and concerns."]
+[-1.2158594131469727, 1.087496280670166, "We've got the housing in here. And you've also got economic security, you've got behavioral mental health, you have"]
+[-3.6173672676086426, -2.2421553134918213, "the big ones that in my experience have been direct. You've got elder abuse on this list. overall safety isolation."]
+[-1.1640232801437378, 1.0578564405441284, "I think the list is pretty encompassing, at least in general terms. Okay, great. There are some that I believe are higher than others. But yes. Oh, good. I'm just about to ask you that. I think economic security, behavioral mental health, because to me, that encompasses self isolation, anxiety, those kinds of things. I also think housing and homelessness should be combined into one because there is housing insecurity, not necessarily homelessness. And I believe that there is some preventative work that can be done to maintain stable housing for those that are currently housed. As well as finding more permanent sustainable housing for those that are currently in an on House status. I also think in that sort of housing, homelessness, there is the concept of safely maintaining in your home, not just it may be there may not be an economic factor, but that there may be some supportive services that are needed in order to maintain safety in that home environment."]
+[-1.1658859252929688, 1.1080501079559326, "Okay, great falls into the sort of, I put that in the health care sort of access. Okay, so just to repeat, you, you would say economic security is number one, followed by behavioral mental health. And number three, a very broad and encompassing housing and homelessness category. My past experience in my direct interaction with this population, those would be the three top ones that we would have responded to. Okay, wonderful. Okay. So I'm going to start asking you a series of questions and we're going to take them into under these categories one at a time. So first, let's start with economic security."]
+[0.2472728192806244, -1.3234485387802124, "Say it's a fixed income issue. Most of the majority of most older adults are"]
+[0.2768971920013428, -1.1601452827453613, "As we age, you know and retire, you're on a fixed income, and that that the cost of living increases you may receive through that process is outpaced by inflation, and the general cost of living. So I think that's the issue, it's when you see that more, so, you know, we're talking 60 and older, right. And so a new retiree who's receiving their Social Security, their cost their pension, and they're living we hope or sort of aligned, right. But as that pension remains fixed and grows out of sequential amount, it comes to a point where that pension no longer meets cost of living. And so you see this really more broadly in the much older population that have been receiving Social Security for many years. And you know, at one point that 1600 a month, may have been sufficient to live on but that 1600 A month today is nearly impossible to live on. And so it's a progression of, I think, a challenge with fixed income, that does not keep pace with general cost of living and needs the cost of basic needs. Yep. Yeah, absolutely. That's,"]
+[3.753037929534912, 15.526695251464844, "yeah."]
+[2.776261329650879, -0.016931142657995224, "Well, I think there's, there's a couple of things, you know, we worked with United Way who sort of did a, they use the public policy group to sort of do a"]
+[-0.7663638591766357, -2.3630149364471436, "an evaluation of economic factors of our seniors, but also to do a deeper dive of what's why some of our seniors were not taking advantage of SNAP or food stamps, as we call it in California. And when we looked at that percentages, we saw that there's a couple of things, the biggest one, why seniors weren't taking advantage of some of the economic supports that they may be entitled to was a lack of information about those economic supports. So they didn't even know they existed. They didn't know that there was a food assistance program. Right. Yeah. And what that means. Yep."]
+[-1.0725597143173218, -2.241285562515259, "So I think there's a couple of barriers, lack of information about what economic supports are available to them, then you add in the stigma and perceptions of these programs, I think we have a branding issue. And I think that's a state that's a federal branding issue, as well as the state and local. But then there's also the complexity of just applying for these programs. Or you going to do it online, then you have the digital divide, and the fact that most seniors,"]
+[2.8757095336914062, 0.059653766453266144, "You're dealing with a high regulatory environment."]
+[0.6728293895721436, -0.08555158227682114, "In a population that"]
+[-2.4984021186828613, -1.8142296075820923, "may struggle in understanding and navigating that bureaucracy, I can tell you a 21 year old would never struggle to navigate."]
+[0.5211650133132935, 1.9226903915405273, "We put them through right. Yeah. Yeah. So you add Stig, lack of information, stigma and nav difficult navigation. And that's like a perfect storm for why someone won't even won't access the supports that may be available to them. Yeah, yeah. No, I hear you."]
+[0.21478663384914398, -1.4381957054138184, "There's a segment of the older adults that may never have an issue with their financial security or housing costs. And then there's a segment of population that are okay. They may not be doing really well, but they're sustaining right. And then you have the segment of you can't do a one size fits all for our older population. Because not every 60 year old is in the same situation. Not every 90 year old is in the same situation."]
+[3.769974708557129, 15.467438697814941, "Yeah."]
+[-2.2968428134918213, -2.2826995849609375, "So and then there's family dynamics. And so you can't compartmentalize this, this population know, the same way. You can't compartmentalize an 18 year old. There's not 118 year old, that's the same as another 18 year old, right. And so I think that's a big mistake that we make in implementing programs. We like to do this one size fits all model. And I don't think that works in any population, but it definitely doesn't work in an aging population. Okay."]
+[0.15860730409622192, -0.5893768072128296, "Yes. We've got our lowest socio economic, we got persons of color, right. So the disparities are there, and we can ignore them. So this population does not differ than any other population as far as the additional barriers that those disparities add to their day to day, right. But if you look at"]
+[0.5079989433288574, -2.9134814739227295, "Laguna Woods is a great example. Laguna Woods is considered higher affluent area, right. But there is a high level of food insecurity in Laguna Woods."]
+[0.5302026271820068, -0.31798192858695984, "Right. So their disparity, this, this population suffers with disparities, just like any other population. And"]
+[1.35737144947052, 2.247345447540283, "but the need is across all spectrums. And so I want to make sure that"]
+[-0.5618297457695007, -1.8223973512649536, "what I'm trying to say is, is that there are going to be population segments in this aging group that have a higher need, because they're already coming into their aging process with disparities, you know, low socio economic racism, whatever, you know, those aspects. So they were already struggling before hitting the age of 60. Right, with those societal barriers. But then you've got these other areas of population that are also experiencing the same hardships that are new to experiencing hardships. Yeah, absolutely. And that's why i That's why serving this population can't be a one size fits all. Yeah. Because whatever programs are designed, or whatever interventions are designed, it has to be individualized to the specific need of that aging person that we're coming in contact with. Yeah, yeah. Yeah. Yeah, yeah. Yeah. No, it has to be culturally sensitive. And it has to be customized, to what that particular individual needs. Like my mom, like, as an example. She is 79 years old. If it wasn't for me, and having her in my home, my mom would not be able to live in California at all. She has a very small fixed income. She's Hispanic in origin. So it I think there's a cross what my needs and my mother are offset by the fact that I am as a supportive family member able to intervene, right."]
+[0.009000265039503574, -0.5824790596961975, "In other words, you know, like being recently retired,"]
+[-2.638179063796997, -2.9975342750549316, "Well, I think a lot of my responses to you was the, the aspects of the system of care that we needed to develop, but as a adult, who cares for an Senior mom who's a single parent, right."]
+[-1.9945062398910522, -0.25452908873558044, "As a child, who is caring for a parent, a lot of the areas that are pain points"]
+[2.3953747749328613, 6.465768814086914, "are probably more visible as I've, you know,"]
+[-1.7520067691802979, 0.36446714401245117, "been more involved in things like her health care or you know, making sure she's eating nutritional right physical ailments, as her mobility deteriorates, you know, all of those things a"]
+[-2.64399790763855, -0.7010644674301147, "little bit of, you know, memory loss, nothing diagnosed but so"]
+[-2.0141797065734863, -0.8828927874565125, "And I have a lot of friends who are caring for their aging parents. And their pain points may be similar in some ways, very different in other ways, depending on the individualized circumstances."]
+[-1.6042207479476929, -0.25225627422332764, "If you're caring for a parent, you're gonna understand the perspective of the caregiver. That's just the way it's going to be. Yeah. And I do believe there is some that are generic, and then there are some that are very specific."]
+[-0.7494946718215942, -1.2343424558639526, "I think there's got to be a couple of factors. It's not a one, one answer to solve it. I think one, we need to look at how we share information on economic supports that may exist that someone doesn't. So I think there needs to be a branding educational issue. But then there needs to be trust, because someone may know a program. We see this a lot in the undocumented population, they know the programs are out there, but they fear the programs, or they don't believe they should, or they, you know, because they don't, there's fear. There's, you know, immigration concerns, right. So they don't always take advantage of the programs that are available to them out of that fear. So when you do fear and stigma, I think you need to look at access points. And we need to look at first points of contact."]
+[4.5920610427856445, 4.604174613952637, "So having a strange social worker show up at your door saying, hey, I want to talk to you about your eating, you know, you know, we've got to"]
+[-1.1925337314605713, -1.899568796157837, "report it. And we want to do that. It's not uncommon, where they won't let the the individual in, but you know, who they really know is their meals on wheels provider, because every time that provider shows up with their meals, they spend an extra few minutes. They talk to them, they they know them, right. So there's a trust built. And I think the"]
+[-0.41621845960617065, -2.2320077419281006, "best option is to create individualized pathways for ease of access and navigation"]
+[1.9147131443023682, 4.610725402832031, "through that first point of contact. Yeah. That's multifaceted."]
+[0.8841686844825745, 2.2660160064697266, "It doesn't matter who reaches out to them first, but there is an access point. Yeah. That's all I'm trying to say is I think there's"]
+[0.3749786615371704, 0.45799577236175537, "I think there's some key stakeholders, that could be navigators, like, for example, in the you know, the public assistance side is a good example. That Home Health Network, who also makes connections, because they see that there's some economic families in the family."]
+[1.6111558675765991, 6.437714576721191, "I think you"]
+[-1.540282130241394, -2.499887466430664, "again, I hate to say this, Katie, but it's not a one, one solution. Because also, let's face it, not every senior not every aging adult older adult who goes to a senior center needs me."]
+[-1.469680905342102, -2.359462022781372, "Because they're going to a senior center for different aspects. They're going there for socialization and their friends. They play cards every day, you know, those kinds of things. They don't need an intervention. They're doing fine."]
+[-2.285876512527466, -1.5457189083099365, "Yeah, yeah. Okay, so I'm like making this much more complicated than it needs to be. No, no, no, you're doing great, you're doing great. And you know what, you probably above all have the wealth of knowledge and experience and touch points across this with a whole system of care that we really need to hear from. So I'm just grateful to you for sharing that today. So now I'm gonna move on to your second topic. You talked about behavioral mental health as your number two ranked priority for this population. And I will ask you the same questions that we just went through. I think the issue is, you've got a couple of things. Some of them are medically driven, you know, so you may have some dementia, starting sensibilities, you know, dementia, senility, Alzheimer's, so there's a maybe a physical aspect, but seniors tend to, there are some older adult population with self we know, we know, the study show self isolation is a problem for older adults."]
+[0.33574602007865906, -1.8350231647491455, "Lack of transportation is an issue for that socialization, aspect."]
+[-1.3799865245819092, -1.7813442945480347, "cleaning your house, all of those things that some older adults, as they progress in their their aging process their aging process becomes a little bit more and more difficult for them. Right. Are there creative ways to build trust with his, with his population that may need us again, there are some older older adults that have a strong support network, who are very active in their community very close to their support systems, that this may not be an issue. But as their support systems begin to not be there, or for those who do not have a support system, then how do we"]
+[-0.15506386756896973, 2.2819206714630127, "Yeah. Yeah. Well, I don't know. You know, barriers is such a strong word. I think there's, again, multi factors, I think biggest one is trust and lack a lack of, of"]
+[-1.4373160600662231, -0.8983728885650635, "trust and connections. That's why we say trusted connections. They don't trust strangers. So are they Oh, you know, will, you know, if there's,"]
+[-2.5317721366882324, -1.8097703456878662, "with anyone who may be struggling in this area doesn't matter your age, you need to trust the person who's intervening for you. Yeah."]
+[-2.466806411743164, -0.2649137079715729, "It's going to be a family member, or it's going to be a doctor."]
+[-2.4552977085113525, -0.42005446553230286, "Because they've gone to this doctor for 20 years, they trust the doctor into their family member is caring for them. Or"]
+[-1.6622083187103271, -1.3358186483383179, "it's going to be an observation made by their other older adults supports their friends, their neighbors, those kinds of things. Just just, I hope I'm articulating what I'm trying to say really clearly. So I think, I think trust is a big one and then connections. For those. There are some I'm going to give you an example."]
+[-1.2660881280899048, -1.3761930465698242, "APS went out on our call one of self neglect and self neglect means that individual is is"]
+[-1.212335228919983, -1.2744266986846924, "is now demonstrating their inability to self care, meaning to take care of themselves, right. So it's a call by neighbors the same we think this person is in crisis. When you reach when we reached the home, here's what we found. We found a"]
+[1.5303574800491333, 7.466457843780518, "He"]
+[-3.163339138031006, -2.2314059734344482, "no adult children. The only family member was a distant niece, right that they don't really talk to regularly."]
+[-1.4207006692886353, 1.109487533569336, "So this gentleman goes into depression over"]
+[-1.3479989767074585, 1.3321713209152222, "the loss of his wife,"]
+[-1.2692844867706299, 0.9944247007369995, "he stops cleaning,"]
+[-1.125593662261963, 0.7997641563415527, "he can no longer do groceries because in addition to this, his mobility is now deteriorating."]
+[-1.7738566398620605, 1.1053049564361572, "And having trouble bathing."]
+[-1.3169469833374023, 0.9121933579444885, "He's sitting in his house all by himself every day, seven days a week."]
+[-1.2983176708221436, 0.9737975597381592, "And the only way someone knew he was  in crisis was everyday, he used to take his dog out in the patio, and they hadn't seen him in a couple of days."]
+[1.5424394607543945, 4.86769962310791, "That is a prime example of how in some situations, there's an event that triggers"]
+[-1.6187782287597656, -0.9289101958274841, "a need for support. And if there isn't a support system, then we find ourselves with an older adult in crisis. So that's one example. Or has always been,"]
+[-1.5578609704971313, 1.105284333229065, "as my aunt calls it, melancholy, we know he was depressed, right. He's always suffered from depression."]
+[-1.5882846117019653, -0.9989917874336243, "That as they age, now they're by themselves, they're part of their partners die, or their friends start to go, or worse, their sibling start to go, and they're now feeling more and more alone. Their children may not live nearby if they have them. Right."]
+[-0.5083468556404114, -2.0702550411224365, "So I think I think that making the connection and how to introduce new supports into some with someone who doesn't have a support system, the nonprofit's are really good because they have the they understand how to go in and just start having a conversation and building trust with someone. Right. And they're usually the best ones. To do an intervention."]
+[-1.4835460186004639, -0.797758936882019, "Yeah, it's really to me trust and connections. Yeah. Got it. Got it."]
+[-2.0219926834106445, -0.7523472905158997, "Yeah. Yep. do so within the system. That depends. So let's talk about the reality of life. You become retired at 65, you now have to change your Medicare. Now you're on Medicare. And now on Medicare, you have to pick a new insurance plan. For many older adults, that means completely changing their health network."]
+[3.678463935852051, 15.55459213256836, "Yeah."]
+[-1.868698000907898, -0.8806236982345581, "Got it. That's what I mean by continuity of care, or helping with establishing and finding new providers. That's really, when my mom had to when I moved my mom out here from Massachusetts, and we had to put her in a Medicare Advantage plan in California, she had to start with all new doctors, she struggled with that. You know, I had to go with her to make introductions to all our new doctors, so she could build a new comfort for them. But that was very traumatizing for her. Yeah, I'm creating that new connective work. Yeah, yeah. So I'm trying to say that's, you know, it's not about a handoff, it's more about that falls into the health insurance category when their schedules because now, you know, they're either retired or they're on Medicare, and they have to pick a new Medicare Advantage plan. And the other thing that you can't stop is the Medicare Advantage plans. It's not uncommon that you'll get a letter in July saying, Oh, by the way, that group is no longer a Medicare Advantage plan, you need to pick a new group next year, or that doctor you've been going to is no longer available, because they've decided they're leaving the medical group that you're enrolled with. Yeah."]
+[3.8034253120422363, 15.47866439819336, "Yeah."]
+[-2.0910606384277344, 1.0046170949935913, "Yeah, that's very disruptive for sure. Or disruptive in the care. So that's kind of, you know, I'm talking behavioral mental health issues, but that same is through with the, you know, the health care and access. Sure, sure."]
+[-0.5861347913742065, 1.1837780475616455, "I don't know if I'm the right person to answer that question. Honestly. And then how did they maintain"]
+[-1.2104851007461548, -0.3027358651161194, " a provider relationship. But I think that goes back to the connections like"]
+[3.4412918090820312, 9.023700714111328, "Yeah. Yeah."]
+[1.3200023174285889, -1.1443825960159302, "Great. Okay. And I think it's a big issue of rents go up."]
+[0.7301108241081238, -0.31112509965896606, "Income stay stagnant."]
+[1.6538105010986328, 6.063492298126221, "I think that's a big issue, I think."]
+[0.7214531302452087, -0.4764651656150818, "Their costs of living are going up. Their income isn't matching that. And so there is an"]
+[0.8621466755867004, -1.249367356300354, "the other piece that impacts housing instability creates housing instability is if they do own a house, and they have adult children who have decided they want that inheritance early."]
+[2.608978509902954, 7.46836519241333, "Though it comes back to that, you know, that abuse situation."]
+[0.19567205011844635, 0.050681646913290024, "We've had situations where kids have sold a family home park, mom and on the lawn"]
+[-0.7119405269622803, -0.6707510352134705, "and left her for the new owner. So and those are extreme cases. Katie, I don't want to I don't I want to be clear. Those are extreme cases that it happens. It happens. cases. But I think the number one factor,"]
+[0.7520666122436523, -1.27922785282135, "impacting housing instability in our older population is very strict. It's easy math. You have a fixed income, and your expenditures are going up naturally. Yeah. All of your costs are going up your prescription costs. Now, your food costs, your utility costs. All of that impacts your ability, Something's gotta give. And you know, in some cases, it's your rent."]
+[3.429978370666504, 9.077744483947754, "Yeah, yeah."]
+[1.0667409896850586, -1.5524487495422363, "Oh, boy. I think we need more affordable housing. I think that's, again, I don't think these solutions know how about affordable senior housing."]
+[1.1848359107971191, -1.283010721206665, "You know, I don't know if I go that far. I mean, public housing was a failed experiment in the 60s, let's be honest, for the general population and created different techniques. I think, I think affordable housing that's community based with."]
+[1.1340687274932861, -1.3760594129562378, "And when I say community based, I mean, embedded in the community, with other members of other representative members of their community. Yeah, like, we used to have a lot of we used to have a lot of senior affordable apartments, right, was an apartment building, had to  be over 55. And it was, you know, lower, lower rent."]
+[-0.12363685667514801, -1.9066375494003296, "And then they have their own little network in there, right, because it was just a senior apartment. Right. I also think the other issue for those older adults who require more medical support, but are not acute care, there is no asset. There are no board and care facilities that accept an SSI rate."]
+[-1.2241417169570923, -0.2000831663608551, "You know, that that will take a public assistance rate, public assistance, doesn't pay medical doesn't pay for the room and board at a at a boarding care facility."]
+[-0.829237699508667, -3.4955499172210693, "And there are no affordable board and care beds available anywhere, not just in Orange County. That's an issue of boarding care facilities that are willing to take an SSI rate, which is the lower income. Right. Right. So I think lack of affordable senior housing is an issue. I think lack of affordable boarding care facilities for seniors who are in that lower socioeconomic factor. who can't afford the $6,000 a month a private boarding care will cost you. I also think there is a struggle with housing is not just an economic factor, but it's also being there safely. And there is definitely a shortage of viable caregiver options and who's going to pay for those caregivers. So you know, the average going rate for a home health care person is $35 an hour."]
+[1.7728912830352783, 7.70088005065918, "So you do"]
+[1.1379587650299072, 6.408816337585449, "I think the"]
+[0.7466314435005188, 0.3332769274711609, "I don't know what the IHHS provider rate is right now. But it's not not it's not $35 an hour to be assessed."]
+[0.7632454633712769, 0.27851250767707825, "It's about $1 and a half over minimum wage."]
+[-1.2141433954238892, -0.5333829522132874, "But they're not about to do it for others, because it doesn't pay well. And if they weren't going willing to be caregivers, for others, they're gonna go to an agency like Visiting Angels, where they're gonna get $35 an hour."]
+[-0.2327577918767929, -1.388600468635559, "Just, that's a struggle. Yeah, our older population as their needs become higher, the older population that are in that lower socio economic group,"]
+[1.2173722982406616, -0.8644688725471497, "their support systems in their houses are going to continue to increase without an infrastructure there to address those issues."]
+[-1.1313469409942627, -0.8133947253227234, "It's fragmented. That response system is very fragmented. Every agency does the best they can, within the rules. Sure, I can go in, they can apply for IHSS. And if they're eligible, they can get you know, depending on the needs assessment, the hours authorized, but then it's up to that older adult to find their own caregiver and find someone who's willing to take that dollar more than minimum wage."]
+[2.3570985794067383, 8.398819923400879, "Yeah. Or"]
+[1.7118409872055054, 3.8775370121002197, "they need"]
+[-1.2619237899780273, -0.36375370621681213, "the income or family member who's willing to pay for it pay for that caregiver. I have someone right now who has their mom at home who needs care. That's a choice heard her family's made, but she pays she pays almost $5,000 a month in home health care for her mom."]
+[0.9360468983650208, 3.8963663578033447, "Yeah, that's tough. Yeah."]
+[-0.798751175403595, -1.5407814979553223, "Well, there's nothing really there to really provide that support. We can fragmented we can get IHSS. We can get interventions with the nonprofit's we can get meals and wheels to go in that home and make sure they're at least eating right, we can try and find a friend or a family member that's willing to intervene"]
+[-2.0448803901672363, -0.46552619338035583, "but at some point, that person won't, will struggle with medication management. Right, as they progress. And there is no affordable board and care facilities out there. Yeah."]
+[1.3834154605865479, -1.1306935548782349, "It's but it's not an apartment. It's just a single family. Yeah, it's a single home. But you know, it. We I think all solutions should be explored."]
+[-0.7915595173835754, -0.0405641533434391, "Similar to dependent foster care dependent group homes, right."]
+[0.834152340888977, -1.8193433284759521, "There is shared housing that could be explored. There is incentivizing people to build those single family add ons, you know, the grandma, what they used to call grandma flats. Yeah. Yeah. That's something that what LA County does. If you want to Grandma flat, there's, you know, you can get a certain amount. And so there's those things there is working with DHCS to find out why we don't have affordable boarding care facilities in California. Right, maybe encouraging some of those things to be revisited. Yeah."]
+[0.8068060874938965, -1.4425979852676392, "Yeah, I think it's all you know, it's one of the other solutions, I think it was reading about the other day as seniors who own their own home and are struggling with housing insecurity, are actually taking other seniors in as roommate. Yeah, yeah. Right. If there's a senior who owns a three bedroom house, doesn't want to live by themselves, needs some additional funds for their housing, right. How do they"]
+[1.2424777746200562, -1.2250866889953613, "Look at some potential shared housing situations. Yeah, it's kind of like the the optimal Golden Girls episode."]
+[3.9546210765838623, 5.052156925201416, "So I have a couple of friends we've already said when I get there when we get there were two Golden Girls."]
+[-0.19702333211898804, -0.8533414006233215, "Because, one, it helps with a lot of things that helps with isolation. You got companionship, there's someone looking out for you another set of eyes, right. And it lowers your living expenditures. So I think those are I think you need to explore all of the I think there's not one. It always frustrates me that people that we look at these things in these problems with a one size fits all solution, however, I'm going to be honest, government can't be at all, there's no way. You can't."]
+[1.647612452507019, -2.6386303901672363, "Yeah, if it's alright, with you, I'm going to shift this a little bit to the homelessness issue. Right. So we have older adults who are homeless, yeah. What is"]
+[1.2963489294052124, -2.4698166847229004, "what are some barriers to solutions to address seniors who are homeless, same as barriers, distressing, homelessness in general, what we're seeing there, we're seeing lack of transitional housing, lack of permanent supportive housing, it goes back to that lack of transitional housing, lack of permanent supportive housing. Yeah. So the the challenges for this population is very similar to the rest of the population is where we put them."]
+[1.5184093713760376, -2.277617931365967, "As we build out our continuum of care for homelessness, we need to and this is something we've always talked about is we need, we can also just like in homelessness and housing individuals, there's differing needs in there."]
+[3.711791515350342, 15.565515518188477, "Yeah."]
+[3.6815695762634277, 15.550694465637207, "Yeah."]
+[3.236255645751953, 8.579270362854004, "Oh, boy."]
+[-2.692436933517456, -2.220761775970459, "That's a lot. And then one other I wanted to touch on the other thing that you mentioned, which is safely aging in place, I guess, right."]
+[-2.760927438735962, -1.5279499292373657, "Um, you know, as we physically age our body ages with us, right, so at some point, I'm going to need assistance. You know, at some point, I expect my hearing won't be as great as it is today, right. So I think, but I can"]
+[-2.125056028366089, -0.3595573902130127, "I have you know, financially secure, I can maintain my financial economic, but how to, maybe I don't have a doctor, you know, how do I"]
+[2.004981517791748, 7.212884426116943, "how would you Why"]
+[-2.2991905212402344, -0.18364158272743225, "where do I go if if my doctor tells me I probably need to, you know, so example"]
+[2.4970898628234863, 7.409356594085693, "So, you know,"]
+[-2.1128499507904053, -0.38561171293258667, "Or, Hey, I'm struggling with walking, I'm falling a lot. How do I work with my doctor to ensure that I have physical assessment of my gait is done to ensure what level of walking support I need to be done. Right, some of these things, some of these challenges. You know, I realized Katie, I'm Sadie pretty"]
+[1.0376335382461548, 3.0478522777557373, "I think they're just fragmented in nature. So like,"]
+[-1.9315781593322754, -0.42341604828834534, "I'll just use my mom as a great example. I noticed that mom was struggling a little bit with walking. Right. Right. So we go to her doctor and I say, Hey, I think Mom, mom struggling with her knees a little bit. She's having some joint issues. I noticed, I think, I think she may need a cane. And the doctor says to me, You know what, let's send her to physical therapy. Let's do physical therapy. And then we'll have that physical therapist assess her gait. Okay, great. Physical therapy was three times a week, that's me driving her three times a week. Because you have to just have had a medical procedure for anyone that do physical therapy in your home."]
+[-1.9444458484649658, -0.45683565735816956, "Can't get hold in home physical therapy, unless you've had surgery, or you've had a recent medical challenge. Medicare won't approve it. Yeah. So you literally have to get to the physical location to do physical therapy."]
+[3.6758463382720947, 7.8485822677612305, "Right. So again,"]
+[-1.717224359512329, -0.6967459321022034, "it's doable. If I have an older adult who is paying for the cane is not an issue. It's not, it's not about the money. It's about logistics of getting you there."]
+[0.5639985203742981, 1.1776033639907837, "So is it transportation,"]
+[-2.5139079093933105, -1.9331380128860474, "you know, get who's who's going to take this older adults to, you know, do they do they still have their driver's license, great, but that's not an issue."]
+[1.9430676698684692, 8.36317253112793, "But at some point,"]
+[0.3341244161128998, 3.549959659576416, "these new challenges come in."]
+[-1.9084583520889282, -2.6522860527038574, "And that senior may find themselves"]
+[-1.65422523021698, -0.7253255844116211, "struggling to get to where they need to go in order to get the things they need to stay safely in the home. But then the progression of if you have a medical condition, or a you know, higher in need, who makes those connections for you. If I'm dying, I get to go to hospice."]
+[-1.6617119312286377, -0.5831832885742188, "Hospice comes in and they do an amazing job. They make the connections they get they order, you know, the hospital bed, the portable potty, if I need it, right, the oxygen if I need it, my medications come to me, that's because someone has determined that I'm going to pass away in six months."]
+[-0.6180227994918823, -3.847755193710327, "I think that's, and that's not an Orange County ability to fix that's going to be that's, that's a whole healthcare system revamp, which is what the MPAA was hoping to do on the healthcare side."]
+[-2.2281455993652344, -1.159737229347229, "And, oh, that's gonna take them up to somewhat there. But that takes a lot. You've got your managed care providers having to work with your medical group providers having to work with your pharmacy, with with older adults wanting to maintain their own control, privacy being a very specific issue for these population and fear. So and then, you know, this is"]
+[0.2904880940914154, 3.492316484451294, "this, this is a challenge. Here's where it's funny. This is a challenge, that people's perspective is very much shaped on their personal experiences. Yeah, yeah."]
+[0.27150171995162964, 3.4504683017730713, "It's the challenges I've experienced with my mom's care, right. It's the challenges my friend"]
+[-1.727856993675232, -0.4866911470890045, "experienced trying to make sure her mom didn't have to go into a skilled nursing facility because her culture, her culture is very much about you take care of your seniors at home, right. And so the idea of putting her mom in a sniff was, was not something she was even going to consider"]
+[-1.5634452104568481, -0.3475778102874756, "the financial burden it's placed on her and her family to make sure Mom is there with a caregiver, because she needs it. So she's gonna tell you if you were asking her these questions, she told us health care and access, because that's her struggle."]
+[4.296677112579346, 4.222068786621094, "That's what she's gonna tell you. I told"]
+[-1.612433671951294, -0.37139031291007996, "Um, you know, when when I told them, I wasn't going to put mom in a sniff, but I needed the supports the moment mom came home, they said, well, she's home, she doesn't need sniff level care. So all of that in house support went out the window. There is no financial support from the healthcare. Your insurances don't pay for that stuff."]
+[-1.3872661590576172, -0.16863366961479187, "They don't, they don't pay for home health care."]
+[2.724940061569214, 0.21346549689769745, "So those are the planning that has to happen. So you know, that's, that's what I'm saying. It's,"]
+[1.6669124364852905, 3.6858317852020264, "it's making sure that there's an assessment of need"]
+[-2.29583477973938, -2.2864251136779785, "But when a senior is being abused, that senior has the right as an adult to remain with the abuser. Hmm."]
+[-2.2997395992279053, -1.900366187095642, "So the negotiation that happens to get that senior to agree to a safety plan is very different. Because an old, a senior has the ability to make their choices, right. And they, they really want control of their care. So that's the other piece too."]
+[-0.7521077990531921, -2.6507885456085205, "To have general navigators, uh, you know, I would love to see, you know, one of the things that happens really good with our low economic families is that pro matoro model, you know, because there's so good about going in the home, building trust, building relationships, making connections to the need, ensuring the family is, you know, doing that assessment, it would be great if we had a promontory model to go into to be available to specific aging populations, that can also make those connections in the older adult community."]
+[-1.0187302827835083, 0.1102864071726799, "And it would be good, it would be also to encourage key access points to want to have their own navigators, right. And the ability to assess, it would be great. If we worked with our medical community, like we've done so much in our child's community of ensuring that they understand socio economic, and there's still a lot of work to be done in the medical community as far as educating individual providers. Right. Yeah. What do you think, you know,"]
+[-2.425784111022949, 0.26262450218200684, "mediCAL recently introduced"]
+[-1.281550407409668, 0.25332123041152954, "reimbursements for community health workers. Yeah. AKA could be parameterized as well. I think a carrier advocate would be good. I think anything you do to build those connections is something that needs to happen."]
+[-1.6961643695831299, -0.2436722218990326, "I also think there's a lot of advocacy work that needs to be happen with the insurance companies, right. Some of them are really great about home health, and then others are not. Right. Yeah,"]
+[2.035017728805542, 2.348416566848755, "we're not kind of solve, these major issues that exist in the United States. I think that's not going to happen."]
+[-1.0642889738082886, -2.206145763397217, "But yes, I think any sort of exploring creative navigation models in this population would be a good use of time."]
+[-2.2902514934539795, 0.2121356874704361, "Okay, so what then those three areas that you highlighted, I'm going to ask you some more generic questions around health care, actually, the system of care. And then we're going to go into just a couple more questions after that. Just checking in on your time. I'm good with time I don't know about you. I'm retired, I get nothing."]
+[4.603282451629639, 4.5571980476379395, "That's why I put you at the end of the day because I knew I was gonna have a very fruitful conversation."]
+[-2.963747262954712, -0.5117942690849304, "Okay, so in your capacity now, I'm going to ask you to wear your hat as the former SSA director in your capacity as the director. Can you please describe to me how accessible and adequate the following care"]
+[-1.231813669204712, -4.210297584533691, "or services are in Orange County. So we're going to talk about GE geriatric care."]
+[2.7824506759643555, 5.945701599121094, "Know what, I'm not the right person to answer that question. Okay. That's fair."]
+[3.7575740814208984, 15.456629753112793, "Yeah."]
+[0.5446863770484924, -0.1924704909324646, "I think the overall adequacy of access to that is very similar to the general population."]
+[3.6821327209472656, 15.264116287231445, "Yep."]
+[2.221374273300171, 5.305941104888916, "There may be one, I'm just not directly aware of one. Okay. And"]
+[2.473834276199341, 5.145681858062744, "I'm sure HCA would be able to tell you there's some Yeah, yeah. Okay, so now."]
+[1.5149078369140625, 7.456168174743652, "I"]
+[0.15875232219696045, -1.961033821105957, "think we've done a lot of work to make it more accessible. And I know the department is working even harder to increase that accessibility and pathways. But there's always work to be done in that area. Okay. No, I'll tell you, it's that's true for all our families. I think the snap grant is way too low in California in California. I don't think our public assistance programs have kept up with the pace of inflation. Yeah. Yeah. fair. That's fair. Okay."]
+[0.19510430097579956, 3.4540231227874756, "So I'm trying to think of myself in the next 10 years, and what I think my own challenges will face."]
+[0.47737351059913635, -0.08478178828954697, "I think, again, I think the general cost of day to day living will continue to be an issue, I think, the issue of self self isolation will continue to grow. But I also think we are continuing to move more and more into a digital age. And I think that's going to create some barriers."]
+[2.753127098083496, 6.51539945602417, "That's a general. Yeah, yep."]
+[1.6629644632339478, 0.07290198653936386, "Oh, that's a loaded question, Katie. I know. It's not that it's just I just, you know, it's such a complex question to answer. I think government."]
+[1.607384204864502, 0.06815168261528015, "Oh, I want to say government tries, but we're not always good at it. Um, I think government's role is to,"]
+[-1.834271788597107, -0.6291092038154602, "really, because this is different for everyone. I've, you know, what healthcare can do versus SSA can do versus OCR versus, you know, Medicare versus, you know, these governmental agencies. I think the government's role is really about true program evaluation, coordination, and"]
+[0.2643440365791321, -1.8031237125396729, "individualized services, right. I think government has this is this is confidential, I'm just gonna lay it out because I'm on a soapbox this afternoon. Government has to have the courage to say that program A doesn't work. Or that program aid only works for this population. And then we evaluate if it's a big enough bang for their buck, but what government tends to do is throw money at symptoms versus looking at causal aspects of the true issues. But I think the one thing, the easiest thing for government to do is act as that coordinator point."]
+[1.0998259782791138, -1.385528564453125, "Spoken hub, we can be the center of that. Yeah, we can be the bolt, we can be the bolt that gets that wheel to turn with different spokes. That's what I'm saying. And I think the best thing government can do is sometimes stop thinking they know exactly what the problem is."]
+[1.4440745115280151, 3.490278959274292, "Because they don't know we like to think we do but we don't."]
+[-3.32112455368042, -2.7772066593170166, "My personal aspects of my role as SSA and the challenges I saw my families go through, right."]
+[2.44360089302063, 6.818082332611084, "But I can't tell you I'd be"]
+[-0.14655578136444092, -1.9269204139709473, "Don't want to design a great program, what I'd like to tell you is I'd like to sit around the table and look at an individualized group and look at different segments of my older population and say to what level of interventions does this population need. And I'd like to have the people who actually meet and talk and spend time with these populations to get some ideas of what the end I'd actually like to talk to the population. Because you know, what, that populations got a lot to say, but what they need and feel and the way they want services to be provided. And I'd like government to have the courage to listen. Hmm, yeah."]
+[1.490699291229248, 0.08035561442375183, "Not necessarily be the doers. Government can't do it all. And in fact, if you look at any program where government tries to do it all, it's usually never met its true goal. Yeah."]
+[3.735731601715088, 15.454972267150879, "Yeah."]
+[5.499554634094238, 6.0176682472229, "That was pretty direct. That's powerful. That's powerful. Thank you for that."]
+[4.161874771118164, 7.62998104095459, "Okay. All right."]
+[3.133824586868286, 8.426823616027832, "Oh."]
+[-3.0554747581481934, -2.2139315605163574, "Within the older adult population,"]
+[-0.02508232183754444, -1.2582745552062988, "I'm just gonna say that there's probably disparity in how we looking at this, I suspect that the aging population in the undocumented community has probably never been really looked at and what their needs are. Because guess what they do have needs they age just like the rest of us. You know, we age a like, it doesn't matter who you are we age alike, right."]
+[-2.7493979930877686, -2.1735215187072754, "Some of us just age more"]
+[0.08036845177412033, -1.0188485383987427, "You know, they stopped me from from doing a focus group on the undocumented population, because supposedly, these dollars are dollars from government. And I said, that's impossible for me to do assessment on the aging population without considering that."]
+[0.6572599411010742, -0.1738865077495575, "But then we actually the silent population everywhere. Yeah. Yeah. Yeah, for sure. Okay. All right."]
+[2.3083813190460205, 2.750842571258545, "One issue is being overlooked."]
+[-0.7535843253135681, 0.1352047622203827, "We talked about support systems."]
+[-2.050966501235962, 0.3617503046989441, "We talked about challenges with health care access. We talked about the whole"]
+[2.30591082572937, 2.811711311340332, "issue, this being overlooked."]
+[-2.5101845264434814, -2.5134007930755615, "You I'm here to provide some examples, what other people have said, yeah, what have they said, somebody said, the fact that we don't properly prepare folks to age. So there's no aging plan. The fact that"]
+[-2.820786237716675, -2.119504690170288, "older adults are not provided with respect and dignity."]
+[2.795396089553833, 6.7501983642578125, "Other people have said that"]
+[2.1318774223327637, 4.768728256225586, "we just don't know what we're doing."]
+[3.590242862701416, 7.856285572052002, "Wow, they said it much more directly than I did."]
+[3.01460599899292, 5.052775859832764, "You know, when I think I think all of those statements are true, that there is dignity and respect, that is lacking. I think there's also, you know, again, I'm going to go into a"]
+[2.049785614013672, 7.053238391876221, "I fear."]
+[2.520226001739502, 7.435659408569336, "You know,"]
+[-2.156158685684204, -0.7272811532020569, "you know, I did have some discussions with my mom, when I went through menopause. Like, you didn't tell me this was gonna happen. Right. So it's like,"]
+[2.095320463180542, 4.596462726593018, "we do that we prepare for most things. Yep. Right."]
+[-1.5525590181350708, -0.24076096713542938, "So we she just laughed. She's like, Well, do you think anyone told me and I'm like, I thought so. Yeah. If that's what they're mean by planning, yeah. Then I think there needs to be, oh, you know, what I think is missing. What caregiver support. I think we there's work that needs to be done."]
+[1.0855790376663208, 5.40039587020874, "For"]
+[-1.9381126165390015, 0.717659056186676, "She has a bipolar."]
+[-1.9325881004333496, 0.7059943079948425, "Hospitalized as a teenager, severe bipolarism."]
+[-1.5134475231170654, -0.30660563707351685, "The pressure that care her care put on my family was very hard right this"]
+[-1.703004002571106, 1.4974076747894287, "stresses and attentions."]
+[-0.8925521969795227, -0.3665878176689148, "Right. So we took this families to families class. And it was a six week class, it was one night a week. How to find their own support groups, if they need it."]
+[-1.869486689567566, -0.5906716585159302, "One day you're gonna get, you're gonna think your mom is ignoring you, but it's really a hearing issue that you need to navigate. Right. I don't think they're preparing caregivers. I don't think they're I don't think we're doing enough to prepare family members."]
+[-1.7912876605987549, -0.9597625136375427, "The aging process of their family members. Yep. And the time and care and how to get their own support system. Yeah."]
+[1.5420523881912231, 6.179549694061279, "Yeah. I think that's a that's a big one."]
+[1.49908447265625, 8.811993598937988, "But"]
+[2.946241617202759, 4.682448863983154, "okay, so I just have a couple more questions left for you. And this is now going to be drilling in on your specific expertise as a professional in this field. Okay."]
+[0.18103225529193878, -1.681440830230713, "SSA is doing a great job of getting themselves more involved with the community work and access they've done. They've, you know, it started before I left and and the new directors continued, and in fact expanded that of moving away from these large campuses and starting to look at sort of smaller, smaller satellite offices embedded in the community, the work they're doing with CalOptima. As far as SNAP and access, I think those are all things that they are doing really well. And with the recognition, that expecting the community to continue to come through your brick and mortar, your brick and mortar facilities doesn't work, and that you need to look at your access points, and you need to leverage your partnerships and your stakeholders. I think there's that recognition, and they're creating those infrastructures. And, you know, thing, I think where the agency struggles is the same struggle that I was there is the fact that the amount of resources that are needed to do this work timely and effectively, is challenged by the lack of funding and recognition of how important that work is at the statement."]
+[-0.23739276826381683, -2.9031150341033936, "Not the county. Oh, we had great support of the board. So I think the the the, at the county level, yes. But you know, you want to know what really makes a nonprofit really mad is when they took the time to submit an application. They want to know why you didn't approve it within 45 days, because they don't recognize that there's 20 other 1000 applications that you're also trying to improve. And there's just not enough bodies to get that work done. So that and I don't like hearing that."]
+[0.10434543341398239, -0.1464741975069046, "Yeah, because it doesn't work that way. Because there's significant. So I think there's, I'm sorry, I think the workload, I don't think people recognize how high and big the volume really is. You know, I think that's a challenge. But a lot of addressing that volume, you know, it takes me it takes 10 weeks to train an eligibility technician to do eligibility."]
+[-2.4786715507507324, 0.23531055450439453, "Six of those weeks are just medical. Wow."]
+[1.2549757957458496, 0.9909474849700928, "So it takes 10 weeks, so you're gonna hire 200 people, but it's going to be months before any of those 200 people are going to provide any work relief. And guess what, by the time I get that 200 to the line. There's 200 People that have either been promoted found a job"]
+[-0.3020380437374115, -2.2659964561462402, "I wanted to help people. But this wasn't the scope. I was thinking. Yeah. Right. So you so the department, there's that challenge of this ever evolving rotating door and training and hiring and funding ongoing positions and honestly, and that there's, and that happened. The problem with that is the state has not looked at count the CalFresh methodology and how they fund counties for CalFresh work. So we're still using the methodology from over 10 years ago."]
+[-0.04996524751186371, -2.163602352142334, "doesn't account for the current work, or the current volume. So and the state is never pays you prospectively, they always pay you retroactively. Hmm. They're always playing catch up. Yeah, we look at those things. Those add that resources, I think is going to be an ongoing challenge. And then I think, as the agency has moved into this new culture of community based work, there are some in that the majority of that agency loves it, especially the newbies. Some of the veterans probably struggling a little bit more, because they came from they grew up in that old welfare fraud environment. Right. You know, they're finally starting to leave us because they're retiring. But it's still that constant. And"]
+[0.5142989754676819, 3.57419753074646, "that's all I'm saying. I think that's the biggest challenge for them. Yeah, yeah."]
+[2.9553160667419434, 0.056195348501205444, "So with respect to those things that you just brought up what, what new or revised policies are needed."]
+[0.03520355373620987, -2.9972331523895264, "I think the state needs to do a better job of"]
+[2.0007567405700684, 3.463820457458496, "I think CDSS and DHCS need to do"]
+[2.5337154511362314e-05, -2.9604361057281494, "need to do a better job of working with the counties to really understand that there. But I also think the state also has a tendency, just like I said earlier, to throw money at a symptom and not look at a root cause. And I think the other advocacy work that needs to happen is the"]
+[1.177854299545288, -0.5006868839263916, "flex there is more flexibility in the funding. The funding is very specific to one thing."]
+[1.8953405618667603, 4.161755561828613, "We need to create that single point of entry we all want."]
+[0.7685700058937073, 0.10549210757017136, "That means everybody has to put in at least $1."]
+[5.153625011444092, 8.4641752243042, "I understand. I understand."]
+[-2.3431289196014404, 0.26469385623931885, "And with regards to all of this system of care to continuum of care issue,"]
+[0.17129166424274445, 0.09747126698493958, "No, they don't they you know, start the state. No."]
+[3.6398262977600098, 6.487690448760986, "I can see. But who is who's the right, let me do it. I think"]
+[-0.37549760937690735, -3.176389217376709, "I think the needs are so specific. I think the needs of this population are so specific to the community. Now lay seniors are not gonna, you know, they're gonna have different needs in Orange County, seniors in San Bernardino senior"]
+[0.14122679829597473, -2.8054323196411133, "Riverside seniors, I do think that the county plays a very extensive role in the coordination of that. But I do believe it needs to be fully funded by the state. I think the state says needs to be clear. This is what the state needs to be here. We're just going to advocate right now, the state needs to say, hey, counties, we want you to accomplish these three goals. These three, this is what I want you to do."]
+[0.8345495462417603, 3.8653018474578857, "And each of these goals is going to get you this. Here's your money for these three goals. Take the money, take the goals, show me how you can do it, and then get the heck out of my way."]
+[0.7558079361915588, 3.769418716430664, "And only jump through hoops for that money in those goals."]
+[-2.0536575317382812, -2.452725887298584, "Yeah, create crazy rules. Because someone told you a story about a senior that you now think all seniors struggle with these issues. Yeah. So I think that is"]
+[0.0875229462981224, -3.113898754119873, "I think the coordination has to happen at the community and the county level. Yeah. Not only just the county's responsibility needs to be a community level a level of hurt."]
+[0.544292151927948, 2.991353988647461, "I don't think we're in a crisis. I think we're close to one"]
+[1.5096642971038818, 7.450389385223389, "I"]
+[1.9115066528320312, 2.8031468391418457, "think we're close. I think there are some factors that we talked about today that are more prevalent today than they were yesterday. And if we ignore them, we're going to have a bigger issue."]
+[0.4994816482067108, 2.193263530731201, "You know, stay safe at home big one."]
+[0.997290849685669, -1.050185203552246, "Economic, you know, inability to maintain housing. Huge. I think we, I think we see that is continuing to grow. And if we don't do anything, we're we're going to be responding to the outcome of lack of interventions."]
+[-0.2696623206138611, 0.684195339679718, "Yeah, yeah. So really, we have an opportunity to do prevention. Prevention is a big one. I think we have some a segment of this population that's in crisis today. Yep. Right. So we need to we need to do that while we invest on prevention activities for those who may be in crisis tomorrow. Yeah. But that's not how government that's not how it works. We address those in crisis today. We never want to invest in prevention, because we've given so much money to the symptoms that we think we don't have enough money for prevention, because we don't realize, because you know why everyone wants to come today. When I give you $1, I want to see what you do with $1. Today, yeah, I don't want to invest in prevention, that I may not see the outcome of my results for five years. Yeah."]
+[-0.11503436416387558, 0.6130617260932922, "Yeah. Yeah. Yeah. So they do the intervention work."]
+[-0.15880879759788513, 0.6193885207176208, "Without looking at the prevention work, that has to be done. Yeah. Because what you should be doing is shrinking this population and avoiding this population from becoming this population. So eventually, you you hit a ground zero. It's like, it's like that the housing situation, right. If we had done a lot more in prevention, we wouldn't have a crisis today."]
+[0.8463907837867737, -1.2760376930236816, "We all moved away from supportive housing, because well, no one wanted an affordable apartment building in their neighborhood. Yeah. Right. So yeah, we're a lot of this stuff is very big. Katie. I mean, it's just a big problem. But I don't think I don't think the majority of this population is in crisis. I think there is a segment of this population that is feeling the pain more today than others. Yeah. And we need to intervene in those lives. But I think it's, you know, we need to also start preparing the others as they continue to age and prepare their support systems and how best to support this population."]
+[1.9566792249679565, 6.366357326507568, "I'm just curious. Yeah. I think I think what they're thinking is that"]
+[0.5165391564369202, 2.9547808170318604, "is that we are so far behind the eight ball. Yeah. That a crisis is inevitable, is what they're feeling. Yeah. I don't I don't you know, what, we are falling behind the eight ball. But we're not we're but so is everybody else That's the problem. Yeah. So it's sort of a ticking time bomb, basically. Right. That'd be the title of my report, a ticking time bomb. Let's not do that. That won't make you any friends."]
+[0.29438552260398865, -1.7501003742218018, "Well, hey, leveraging what we do well, and building on the things that we do well, and trying to see where we can customize, and how to be better partners, with the community organizations that do this work more effectively than, you know, like SSA has their piece. They have their piece, but they don't have it all, and then are responsible for it all. Yeah. Which ca has their piece."]
+[1.482917070388794, 0.2883571684360504, "But they don't do it all and are responsible for it all. Yeah. So how do we bring the pieces"]
+[2.07584547996521, 4.63666296005249, "That's really what we need to do. Yeah."]
+[-2.699707508087158, -1.361259937286377, "I'm sure you're talking to like all the big partners, I'm sure you're talking like to the Alzheimer's Association, you talk to United Way. So you got the big players. So I'm sure they've covered the big player ticking, you know, group that we identified when we did the Senate bill for shared information, probably. I'm sure they just gave you that list. So"]
+[4.596634387969971, 3.500284433364868, "they didn't give me that list. But we do have like, we have 100 stakeholder interviews slated."]
+[-2.6821959018707275, -1.4189608097076416, "So I think we have like the big ones United Way calafell Alzheimer's Association, right. All of them. Yeah. Yeah. You're you should be good then. Yeah, yeah, that's a good group. Yeah, yeah. So um, well anyway, if you ever feel the need"]
+[4.781911849975586, 4.189306259155273, "that you're like oh, I didn't tell Katie this please feel free to reach out and call me or send me an email. I'm happy to jump on the phone again with you. Thank you thank you so much for your time you have any no worries and if you have any follow up just give me a call. I will I will and whenever you they make that official I will be the first to welcome you. Back."]
+[2.1762022972106934, 4.858249187469482, "We try let's all keep that you know, because"]
+[4.820064544677734, 5.129299640655518, "I didn't say anything. I didn't say anything. Okay, thank you so much. Okay, take care. Bye bye."]
+[4.421411514282227, 7.164638042449951, "Okay, great."]
+[4.988476753234863, 6.552809238433838, "Um, no, not really. Yeah. Happy to help."]
+[-2.6908557415008545, -3.227489471435547, "Okay, thank you. So the primary goal of today is to identify what needs you think are most important to the older adults population that you serve. So that's defined as 60 or older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. And please take just a few minutes to read through the list. And let me know when you're ready to begin. Sure. So I will share that list right now."]
+[4.1215925216674805, 7.330745220184326, "Sorry, okay."]
+[3.9870424270629883, 6.320642471313477, "Yes. There we go. Great. Okay."]
+[4.023752689361572, 5.259852409362793, "So yes, please take a few minutes to look over and let me know when you're ready."]
+[2.6612372398376465, 3.989837646484375, "Yeah. So a little later on, I will ask you to list the top three. But I have just before that,"]
+[3.4896881580352783, 4.107974052429199, "go over that list, as well. So be able to look at this. Okay. Yeah. Yeah, definitely."]
+[-3.036355972290039, -1.9214107990264893, "Definitely. I'm the regional manager at Braille Institute in Laguna Hills. So we see seniors, our average age of our students are usually 80 to 90 year old."]
+[0.1927722543478012, -2.868582010269165, "Just due to where we are in Laguna right next to Laguna Woods village. Yeah, so we help individuals that are either losing their sight or they've gone totally blind. So we help everyone from, you know, has cataracts, glaucoma to total vision loss."]
+[0.0924937054514885, -4.156528949737549, "Thank you. Thinking about Orange County and looking at the list of common issues and concerns impacting older adults."]
+[2.5161051750183105, 3.855010986328125, "Um, no, everything that I've seen is on this list. Okay, thank you. And of the needs on the list, please rank your top three that you feel are most important."]
+[0.5352237820625305, 1.245818853378296, "Yeah, no particular order. Okay. Definitely transportation would be one of them."]
+[-2.379795551300049, 0.4178175926208496, "from our seniors, I would say personal care management."]
+[10.612702369689941, 8.482519149780273, "Thank you."]
+[3.1236867904663086, 4.474715709686279, "Okay, so the next set of questions will just be going through the three needs that you identified."]
+[0.2414240539073944, -2.385087251663208, "Definitely due to vision loss, so for their safety and the safety of others on the streets, they no longer can drive. So you know, if they're not living in a community, such as like, Laguna Woods village that offers transportation, and they're still living in, you know, a family home and you know, if people are going off to work during the day, and they're there by themselves, they don't have a ride."]
+[2.599787712097168, 8.792015075683594, "Ah, definitely"]
+[-0.25437161326408386, -2.4643044471740723, "COVID. I know that kind of put a kink in things. I know a lot of transportation kind of slowed down, I guess if it's just the lack of drivers being available, and the costs. I know if there's a cost, usually seniors are less likely to take advantage of the service."]
+[10.692209243774414, 8.437131881713867, "Thank you."]
+[1.1634360551834106, 1.8883150815963745, "I would think so. Yeah, if they have the resources and they're able to"]
+[-0.44713354110717773, -1.3739721775054932, "To, you know, look up things on the internet, they have that digital, you know, background, they know how to use technology, then they are more likely to find transportation and see what is available. And like, you know, individuals that are either speaking English that is difficult for them at some time. So if they're not, you know, they don't have a second language is English, it's it's a little difficult."]
+[1.6244680881500244, 6.106125831604004, "I think that's always key."]
+[10.61135482788086, 8.493987083435059, "Thank you."]
+[-1.1466922760009766, -1.3776363134384155, "Um, mostly the lack of wanting to learn new things. It's they see it as being challenging or difficult. And they don't they feel like they don't need it. Or if they don't have the funds to buy technology, that's another one."]
+[2.901010751724243, 8.13764762878418, "Oh, gosh,"]
+[-1.9478247165679932, 0.9751711487770081, "memory issues would be one thing, definitely. So if they have any cognitive issues,"]
+[-1.6957522630691528, -2.068549633026123, "that can always interfere with learning new devices. So that's always a big one."]
+[10.652604103088379, 8.442957878112793, "Thank you."]
+[-1.2644495964050293, -1.8039159774780273, "I think so. I mean, I've seen people that are, you know, in their 90s. And they're better than technology than I am. So if they have the will, and the urge to learn something, and they have that drive, I think it's a little easier on their end to do that."]
+[-0.8424714207649231, -1.8977035284042358, "Offering classes and workshops, I think that's always a good thing and offering it in different languages. And free, of course."]
+[-1.5747991800308228, -1.4114735126495361, "Definitely, for us, since we have individuals that are losing their sight, personal care can be hard at times. We teach independent living skills here. So we're always teaching someone you know how to mark and label their washing machine. So they can actually use the washer. So they have clean clothes. We teach them how to mark and label their clothing. So they, you know, have matching clothes, so they're not wearing mismatched things. Yeah, just not being able to see to like, you know, for females, if they want to do their hair and makeup, it can be challenging at times. So that's always a hard one. But yeah, just self care, being able to, you know, clean up after yourself. You're, you know, cooking in the kitchen and you leave crumbs behind that could be an issue that can cause insects that can come into your house."]
+[-0.8000056743621826, 2.384533166885376, "Thank you for sharing what barriers exist to seeing improvements in this area."]
+[-1.5536022186279297, -1.4340260028839111, "Um just the lack of wanting to learn how to do things differently. I know some people struggle with change. So some people are embarrassed to have they're called bumped dots to like mark their appliances. They feel that if someone sees it, it's embarrassing. And they feel like that. They're, you know, not what they used to be. But yeah, I think it's just"]
+[1.8244768381118774, 6.202329635620117, "a personal choice."]
+[-1.564965009689331, -1.4201490879058838, "I think so I think if you're, you know, you grew up cooking cleaning for someone and you know, you're starting to lose your sight and you're getting older, and you want to continue doing that you want to and you have a passion, usually you will learn the different ways adaptability."]
+[-2.435044765472412, -1.3939965963363647, "Teaching them different ways. Because even you know, when I started working at Braille Institute, I had no idea with all the different ways, you know, we're losing our vision, how to go about, you know, pouring a cup of water when you can't see, you know, how much water you're pouring into something so it doesn't overflow. So just learning different ways and different tools that people can use."]
+[3.684652090072632, 4.303906440734863, "Thank you So that is it for the list. There are some more questions following, but I will stop screen sharing at this point."]
+[-3.2673540115356445, -0.34373024106025696, "Yeah, so geriatric care would just be any doctors that are specifically catered towards older adults."]
+[-0.6986675262451172, -4.114542484283447, "Yeah, I think there's a surplus of that, especially in South Orange County, since it's more of a retirement area. I think that is definitely a specialty down this way."]
+[5.485915184020996, 6.417196750640869, "Okay, thank you."]
+[-0.8450528979301453, -3.8166420459747314, "That can include any, like retirement centers, nursing homes are any services that help medical and non medical needs of those who cannot care for themselves. Gotcha. Yeah, definitely, I would say more in South Orange County, they are, I mean, from what I've seen everywhere, especially down this way. Unfortunately, it does cost more to live down in South Orange County. So that does price a lot of people out from retiring and living down this way. So that's the only downside."]
+[1.7344579696655273, 2.197157144546509, "From what I see, yeah, there's a lot of resources."]
+[-2.7766764163970947, -0.3580062985420227, "Okay, great. Oh, gosh, I would have to look it up. I know that Hoag offers it. I've seen Kaiser, pace, I want to say is another one."]
+[2.213735342025757, 5.331588268280029, "Etna, there's always we have the"]
+[0.5975499153137207, -2.9420909881591797, "VA right here, the Laguna Hills VA. It's like a small branch. So yeah, there's definitely options."]
+[5.444596290588379, 6.4434428215026855, "Okay, thank you."]
+[-0.6872642636299133, -2.7254137992858887, "Um, I, from what I've seen, it's a little bit more difficult. Just due to county issues, I know, there's always you know, a waitlist, or it's kind of hard to actually talk to someone to get a hold of a human in the social service department. So that is a little bit more difficult."]
+[10.678080558776855, 8.352827072143555, "Thank you."]
+[0.7200888991355896, -0.45061370730400085, "Oh, gosh, I would say the cost of living. I mean, everything's gone up. So yeah, just paying for living expenses, food, transportation."]
+[10.712857246398926, 8.380073547363281, "Thank you."]
+[0.43997615575790405, -1.2756767272949219, "Oh, gosh, I would say definitely, you know, price point, making sure that, you know, rent stabilization is there. You know, they're always talking about Social Security won't be there for people that are, you know, younger, so making sure that's going to be available in the future. So, yeah, I would just say, price point of actual actually being able to retire and live somewhere. Especially in California. It's kind of expensive."]
+[0.09397218376398087, -4.950875759124756, "Yeah, and thinking about all the older adult residents in Orange County, who is getting the least amount of attention."]
+[-0.4501611888408661, -1.5042157173156738, "I would say, the individuals that don't speak English or Spanish, I know, you know, there's always you know, Spanish brochures, the English brochures, but I mean, there's so many other languages, especially in southern California that are being spoken. So yeah, I think those individuals. Thank you."]
+[3.127774238586426, 8.403013229370117, "Oh,"]
+[-1.428655982017517, 0.6239102482795715, "I, oh, gosh. I mean, food is always a big one, food insecurities. But I know for a lot of people they don't want to admit to it. So that's always a big one. Especially after the pandemic being lonely and the whole mental health. I think that's been overlooked as"]
+[-2.435288906097412, -1.478894591331482, "You and in addition to what we've already talked about, let's dig a little deeper into your area of expertise. So we have Braille Institute"]
+[-0.9273661375045776, 1.4650070667266846, "under the category of bridging the digital divide, would you say that's pretty accurate to your area of expertise."]
+[4.4066572189331055, 7.150665760040283, "Okay, great."]
+[-0.33231687545776367, -2.4761853218078613, "Definitely, as we've actually been offering more virtual classes and workshops for the past three years, we never offered that before the whole pandemic. But yet individuals are comfortable doing that now from the comfort of their home, they don't have to worry about transportation, since transportation is huge for seniors. It's, you know, to go down the street, 10 miles, it could take an hour. So you know, just to go for a class for an hour's you know, three hours of your day. So, that's definitely been huge."]
+[5.459593772888184, 6.942070484161377, "Thank you. Yeah."]
+[-1.4258592128753662, -2.1173110008239746, "Um, it's been pretty good working, it does take, you know, a few one on one sessions with some students, for them to get a hang of, you know, using technologies such as Skype or Microsoft Teams and getting them logged into the class or the workshop. But yeah, it just, it just takes practice and patience."]
+[5.459516525268555, 6.9439697265625, "Thank you. Yeah."]
+[0.5476032495498657, 0.7070212960243225, "Oh, gosh, I just say, more information on technology and what it can do for an individual."]
+[-0.10576309263706207, -3.6274707317352295, "I would say the county."]
+[-0.9223280549049377, -2.501605749130249, "Being able to offer you know, services or even like cities, local, like senior centers, being able to offer that to the community. I think that's that would be huge."]
+[4.044421672821045, 7.0640177726745605, "Well, what did you I didn't hear you Sorry, you cut out."]
+[3.6406257152557373, 10.964418411254883, "Um"]
+[-1.733520269393921, -2.0999982357025146, "probably just seeing how far the student has come from being able to use, you know, their iPhone independently. I think that's huge. Using different apps on the phone, just showing that not just being able just to make a phone call or send a text actually being able to use all the different apps."]
+[4.167685031890869, 4.6059370040893555, "Thank you. And is there anyone else that you think we should"]
+[3.6840498447418213, 15.2765474319458, "Yup"]
+[1.9431108236312866, 6.287148952484131, "Who else."]
+[4.963003158569336, 3.304935932159424, "Maybe anybody at the VA, they have some great services as well. So yeah, we always recommend those two. Okay. Thank you. And final question. Yeah, definitely. Okay, great. Thank you. So, that concludes our interview. Thank you so much for your time, and you've been incredibly helpful for our research. And if you find that you have anything else that you want to share, feel free to reach out to us. Our contact information will be available on our website, which is www dot advance oc.com. And you can also feel free to leave an anonymous voicemail on our telephone line at anytime. So I will Yeah, and I will stop the recording now."]
+[-2.697715997695923, -4.807415008544922, "Good morning in learning. My name is Ron Barnes, and I'm a part of the research team at advanta, you'll see a local nonprofit conducting the county of oranges older adults needs assessment. Thank you for your willingness to take part in this interview. And the purpose of the interview is to identify the needs of older adults, and to gather insights from your expertise and experience. The information provided will be used for the development of the Orange County Master Plan for aging. This interview will last about an hour and with your permission, our discussion will be recorded only for transcription and note taking purposes, the recording will not be shared with anyone and after the transcription, the recording will be deleted. If you do not feel comfortable being recorded, turn off your camera and change your name attached to the picture. Your responses are confidential, meaning that you will we will remove identifying information in our report. Please note that your participation is voluntary. You may choose to answer any question in part full or not at all. You may also withdraw from the interview at any time. If you're unfamiliar with any of the terms used, please let us know when we'll provide you with a description or example of what we mean."]
+[4.461392879486084, 5.484734535217285, "Yes. And I already I already indicated that with the notation that came up on the on the Zoom."]
+[5.427858829498291, 6.401420593261719, "Great. Thank you."]
+[5.285461902618408, 3.591953754425049, "I don't I think I again, just identifying each other here at the top of the recording is helpful."]
+[-2.546388864517212, -3.063112258911133, "Right. And so again, I'm Turon Varnes, part of the research team at events OC. Excellent. So the primary goal today is to identify the needs of the older adult population, those 60 and older. And we want you to think as broadly as possible taking into consideration the older adults, caregivers, families, and they're coming in to community. I'm going to share my screen. And so you can see a list of common issues and concerns impacting older adults."]
+[3.9245710372924805, 4.954599857330322, "Please take a few minutes to review this list. And let me know when you're ready to begin."]
+[4.02755880355835, 6.563021659851074, "Okay, let me just"]
+[3.637911319732666, 6.390021800994873, "let's take a look at everything here."]
+[4.716378688812256, 5.442111015319824, "It's a little small Mr. T. I mean, I that's what I'm that's what I've been doing is trying to adjust my screen. Oh,"]
+[4.657235145568848, 5.388230800628662, "I think just make the type a little bit bigger that that's gonna help a little bit. I mean, I can see it and read it. But little bit, there's going to be much more helpful. I think"]
+[-2.682698965072632, -2.6984660625457764, "Yeah, and I keep moving my screen as well. So yes, I do see the representative of common issues or concerns impacting older, older adults. So but I only see down you know, right, just about half the page. So go ahead."]
+[3.5168440341949463, 6.855184555053711, "I can. Okay."]
+[-0.5560519099235535, -3.734398603439331, "Sure. So thinking specifically about older adults in Orange County. For the record, could you please tell us your name, role and how you interact or engage with older adults."]
+[-0.3078334927558899, -4.33949089050293, "Hi, my name is Dr. Kathleen Greiner. I'm the director for the Center for Entrepreneurship here at North Orange County Community College District that includes two colleges, Fullerton College and Cypress College, neither of which fall under the older adult moniker. But our third entity or campus is called North Orange continuing education. And that specifically serves a vast array of people returning to upskill, to the workforce, and so forth. And it does include adults over the age of 60, who are gaining skills, maybe acquiring language skills, or updating or re re, regaining language skills, as well as small trade and business programs. So that attention to the plus 60 crowd is something that is a large focus on the North Orange continuing education unit or N. O C. E, all in caps."]
+[0.15597577393054962, -4.193117141723633, "Thank you. And thinking about Orange County and looking at the list of common issues impacting older adults."]
+[4.228201866149902, 8.965545654296875, "No."]
+[4.131088733673096, 7.680246353149414, "All right."]
+[-1.368489384651184, 1.1870452165603638, "I think behavioral mental health certainly comes to the top of my list, as well as healthcare access and delivery. That would be right there at at number two. And then I think I'm just looking at I would say economic security would probably round out the top three."]
+[-2.046257257461548, 1.2704499959945679, "Okay. Thank you. So you can quickly note. Now, when you think about the behavioral health, and I want to say exactly how I was listed here, think."]
+[-2.8052141666412354, -1.6232942342758179, "emotional well being also behavioral mental health. Thank you. So um, when you're thinking about that, how, and why are older adults struggling struggling with this issue of emotional well being no behavioral mental health,"]
+[-1.979248285293579, 1.4056060314178467, "oh behavioral mental"]
+[-1.2061671018600464, 1.1048884391784668, "Because of I think, well, three things, housing security, plus or minus, getting it, keeping it holding on to it, maybe re assessing it as health needs, you know, the downsizing syndrome and those sorts of things. Along with that goes economic security and economic viability. And then I think the third thing is just community engagement, and mental health viability and behavior, mental health, are tied into all three of those housing security, economic security, and personal engagement for mental and physical health."]
+[0.2674207091331482, -2.8260388374328613, "I think just access to services, I mean, many people, you know, 60 Plus, they certainly can drive around, I mean, my gosh, 60 60 is the new 40. Ergo 80 is the new 60s. So most people in Orange County, and certainly in the 60s, their 60s and 70s. Enjoy, you know, broad capacities for everything from shopping, to visiting to traveling and et cetera. So there is that level of engagement. This seems to be focusing kind of on, you know, what are the barriers to continuing that very healthy and positive quality of living. And those barriers do include access to being able to drive I mean, the highways are very, very dense. And I know increasingly of people who are a little bit nervous about getting on the freeways. So as that that circle of access decreases on the alternatively, is I think, a transportation system as well as access to services. That is, is much more, I'll call it boots on the ground that is much more accessible, rather than people going to a central place to get those services that lets use interaction as one of those, how do we bring those services, maybe to a community center so that people don't have to drive as far if that whole little continuum makes sense, transportation, access to services, again, community engagement, but to make that much more local, if you will, as opposed to centralized in larger pockets that requires additional transportation"]
+[-3.928816556930542, -1.8128974437713623, "and other different experiences for different groups of older adults from different backgrounds. That means where they live disability status, income education."]
+[1.8207863569259644, 4.697713851928711, "You about to bring"]
+[3.0620789527893066, 4.930696487426758, "Okay, and just before we begin, I do have to remain as neutral as possible. So I will not be responding to a lot of your answers, although I'm sure they will be very insightful. Yeah."]
+[4.541215419769287, 6.372298717498779, "No, not at the moment. Thank you. Okay."]
+[-2.686164140701294, -3.2652323246002197, "In that case, so the primary goal for today is to identify what needs you think are most important to the older adult population you serve. That's identified as those who are 60 years and older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through the list and let me know when you're ready to begin. I will share that list now."]
+[3.1694157123565674, 8.556200981140137, "Oh, yeah, this"]
+[0.9750718474388123, 2.247058629989624, "would be where it would be helpful to have it on the computer. Oh, oh, yeah, I"]
+[3.3474276065826416, 6.848148822784424, "can. I can"]
+[4.287453651428223, 7.121697902679443, "blow it up enough so that I can make it out. Okay. Great."]
+[3.3869616985321045, 4.562063694000244, "I have a few questions on those later, but for now, you can just read through the list and familiarize yourself with it."]
+[3.95464825630188, 7.9249186515808105, "Right Okay"]
+[5.135221481323242, 3.5143094062805176, "Yes, thank you. Okay. So, starting off for our records."]
+[-0.7934113144874573, -2.73142409324646, "Oh, sure. So, my name is Mark Lowry. I work for the Community Action Partnership of Orange County. Among our other programs, we operate the Orange County Food Bank. I'm director of the Orange County Food Bank. We distributed 26 million pounds of food last year, some of that to the people directly and others to other nonprofit organizations. Many of the customers served by the nonprofit organizations to whom we supply food, our seniors, including a number of senior centers that are food distributors for us. In addition to that, we operate three family resource centers that provide services to seniors. And within the food bank. Our single, single largest direct service program is a senior food box program where we provide food boxes not indirectly, but directly to 1400 people each day on an average workday. So we are a major senior service provider in that regard. And in addition to my professional work, I have helped to care for an aged a grandmother and an aged parents, all three of whom I've lost, but I've certainly saw you know the challenges they faced in in aging."]
+[0.19510631263256073, -4.200735569000244, "Thank you for sharing. Sorry to hear that. Thank you so much. Moving on for the next question. Thinking about Orange County and looking at the list of common issues and concerns impacting older adults."]
+[2.345154285430908, 4.8167595863342285, "Oh, nothing that I see missing. Several are of course interrelated, but I don't see anything missing."]
+[2.4562604427337646, 3.8731818199157715, "Please rank the top three that you feel are most important."]
+[-1.6680337190628052, -2.8312227725982666, "And I think just in terms of how it affects seniors, disability, economic security, and personal care."]
+[3.193239212036133, 4.438196182250977, "Thank you. So the next set of questions will be going through each of these needs that you have identified."]
+[-1.760574460029602, -0.9836679100990295, "Oh, yeah, in, I think probably all of our experiences, we see that seniors not always, but often lose mobility. You know, both the and disability leads to an inability to work and either provide income or supplement their income, disability can affect your transportation, mobility, um, social interactions. I've just, you know, I've certainly experienced it with my grandmother, you know, both parents and any number of seniors that I've known, both professionally and personally, where, you know, that leads lead to isolation that can lead to depression, that can lead to financial challenges if people are unable to work or supplement their incomes. So, you know, just as broad ramifications,"]
+[-2.0510413646698, -1.8479797840118408, "I mean, of course, we want to, you know, see that there's both quality, quantity and quality of life. Prior to COVID, you know, the average age of Americans was increasing. But sometimes the quality of life wasn't keeping pace with that, and it was decreasing. Yeah, that, that we want to, of course, we want people to leave live as long as possible, you know, but to address quality of life issues, along with them. So that any supports we can offer in terms of diet, physical activity, anything to keep, help keep people, seniors mobile, and active and participating members of society, as opposed to simply people that have to be cared for, you know, better for them, and better for all those around them."]
+[10.664619445800781, 8.455814361572266, "Thank you."]
+[-0.05640913173556328, -0.927245557308197, "Oh, I think absolutely. I mean, they say that your zip code in terms of your health outcomes is more important than your, your genetic code. You know, there are certain populations, particularly those living in poverty, that don't have same access to the resources that others do. And that affects, again, both their quality and quantity of life."]
+[10.542352676391602, 8.532073020935059, "Thank you."]
+[-0.13257372379302979, -0.7892460227012634, "Yeah, I mean, you know, the big picture stuff is more economic equality, is that, that, you know, the people that don't have as many resources as those that do, you know, can have comparable life expectancies. And, and, and similar quality of life, that sometimes then gets a little bit away from capitalism and into universal health care and other broader issues."]
+[10.699233055114746, 8.403064727783203, "Thank you."]
+[-0.7347135543823242, -0.8267983794212341, "Many people in part because of the increase life expectancy, outlive their savings. I start with my grandmother, you know, she ran out of money before she ran out of life. And, and the same thing happened with the care of my mother as well, where we did not want to sell the family home. But when she moved into assisted living at $10,000 a month, yeah, we burned through the remainder of my parents life savings, you know, quickly enough, that even though we didn't want to sell the family house, we had to sell the family house, to have the income to for my mother to be able to stay in a $10,000 a month assisted living facility. And in my, my family was the fortunate ones, you know, not everybody owns a home that they can sell, you know, to keep them in assisted living. You know, so, you know, when when people are economically stable, you know, they have the ability to afford for things and care and gravel and indulgences, you know, that that can add to their quality of their lives. And when they lack financial resources. They not only sometimes, you know, struggle for the niceties, but struggle for the basics. We always hear people having to make choices between food or medicine. And you only have to drive around our cities to see that some of the homeless population in our communities are people that have aged"]
+[-0.22298599779605865, -0.9173094630241394, "Economical equality and getting the big social issues about economic equality. And I don't know the actual statistic, but we've heard numbers like see huge number like 64% of all Americans don't have access to $400 in fluid cash to, to help address an emergency. So yeah, a little bit of that is planning, you know, I will meet with my financial planner, you know, June 29. So, you know, some of that is planning. But, but you can't plan to save if you're living paycheck to paycheck and really in subsistence mode. So, it's economic equality, its economic opportunity. And, and for those that are provided, you know, those benefits, it's your good financial planning, you know, I spend an enormous amount of money personally on insurances, including long term care insurance, realizing that that's probably the most likely thing that you know, that we, as seniors need, yeah, will be long term care. And many people don't have long term care insurance or some of those protections, in large part because they see them as unaffordable."]
+[10.531063079833984, 8.544477462768555, "Thank you."]
+[-0.19145524501800537, -0.8887510299682617, "Yeah, we clearly go back to the, your, your quality and quantity of life is often more determined by the zip code in which you live, then you have the genetic code that you inherited. So we know that there are great disparities in any health care and in communities."]
+[-0.35449615120887756, -1.806540608406067, "Again, and those are the big broad social issues, you know, the living wage, affordable housing, universal health care, you know, the really big, expensive social issues that, you know, that we as a country really haven't tackled, aren't willing to address. So we dance around the borders of those issues, and try to make sure that, you know, people are provided some benefits, you know, that, you know, whether it's food assistance through congregate meals, senior centers, or Meals on Wheels, home delivered meals, programs, whether it's Obamacare, you know, we were trying to address those and auxilary ways, yet, because dealing with them directly, just seems too big a bite, too huge issues for us to tackle as a country."]
+[10.576265335083008, 8.501254081726074, "Thank you."]
+[-1.449477195739746, -1.6401125192642212, "Yeah, and, and that's might have picked something different, because that would be related to disability, again, same time, where we're seniors get to a point where they simply can't live independently. And, and, and the sometimes. Again, I keep sharing personal rather than professional stories. But you know, my, my grandmother experienced pretty rapid weight loss. 15-20 years ago, we took her to a doctor fearing that she was ill. And it turned out she had simply lost her mobility. She was unsteady on her feet. So she used to be a big cook. But she didn't feel like she could manage cooking anymore, because cooking required that you use your hands and she needed her hands to hold on to things so she didn't fall. So she had without us knowing because she lived independently, she had gotten in the habit of going to the grocery store, buying things like three burritos, microwave burritos for a buck. And, and she was just microwaving something quick and easy. And instead of sitting at a table and eating a full meal, she was just leaning up against the, you know, the kitchen countertop and eating this microwave burrito. So she was getting some nutrition, but she wasn't getting the nutrition that she had previously. And that was almost all related to her lack of mobility. And you see you don't always, you don't always see the consequences of those little changes in the health of seniors. But things like instability, lack of balance, lack of mobility, you know, can have dramatic effects, you know, you and I just hop on our car and drive wherever we go, want to go wherever we're gonna go there. But, you know, sometimes seniors lose that ability to drive or drive safely as well. And that just wants access to everything."]
+[-1.090896487236023, -0.8771681785583496, "So personal care, you know, part of the family. You know, parents would sometimes have a lot of kids, and for a lot of reasons, but some of those reasons were they needed children to help out on the farm, and they needed children to help take care of them in their older years. So it was the case that just a couple of generations ago, family members took care of one another in their later years. And yet government programs and institutions started to, I'm not sure if it was a chicken or egg, which happened first, you know, but, but government programs and institutions like assisted living facilities have, to some degree taken the place that was once filled with loved ones and family members. I don't know how you do that. But but somehow humankind did that for generations before we had government programs and assisted living facilities."]
+[5.469088554382324, 6.951118469238281, "Thank you. Yeah."]
+[7.1233110427856445, 6.2123799324035645, "Thank you. And I know you already touched on this a little bit, but what do you suggest is the best way to address this issue."]
+[-0.012940263375639915, -0.8357871174812317, "And almost all of that is really related to economic stability. And, and that's, and that starts from, you know, early on quality, education, quality, opportunity, you know, jobs that we value, such that we're willing to pay a living wage, you know, that for people that make a living wage, that they're able to plan and save, and invest in their senior years. So they are not people who wind up homeless or destitute or having to make difficult choices between food and medicine."]
+[3.797185182571411, 4.335690498352051, "Yeah. So there are a few more questions, but that is it for the list. I will stop screen sharing."]
+[3.1217920780181885, 8.716882705688477, "Yeah, essentially."]
+[1.654795527458191, 6.034056186676025, "Yep. Just very or not very, is, is fine."]
+[-1.1725929975509644, -4.014805316925049, "Yes, I think it's very available. I know that your scan is based locally, we have a number of health care providers that actually emphasize care to seniors. And, and there are other providers like Kaiser, which is just huge and Orange County and Cal Optima, that also provide care to seniors. So I would say that, it's very, very good in Orange County."]
+[10.659688949584961, 8.459155082702637, "Thank you."]
+[0.8226483464241028, 0.5997653007507324, "readily available, but very expensive."]
+[10.616623878479004, 8.469487190246582, "Thank you."]
+[-0.5366949439048767, -0.28185534477233887, "Yeah, I think available, you know, but, but stigma on almost all the issues that you addressed, you'll often keep people that need that help away from the help that could be available to them."]
+[10.699653625488281, 8.3831148147583, "Thank you."]
+[-0.7778026461601257, -2.589535713195801, "Yeah, I'd say somewhat available. You know, I work at a food bank. And, and we have, you know, so there's not a lack of food in Orange County. But in a community like ours, hunger is a symptom of poverty. You know, they're just too many people that live here that don't have the necessary resources to meet their basic needs. So whether they struggle with paying rent or mortgage or food or utilities or transportation or health care, whatever it is, again, just too many people with too many bills and too few resources. So It's available, but I can kind of affordable for. So, I'm sorry, back to social services that just often that demand exceeds the available resources. So available, but insufficient resources to meet the full needs of seniors in our community. Thank you."]
+[0.17147664725780487, 3.466630697250366, "So the next question is, what do you think will be the biggest challenge older adults will face in the next 10 years."]
+[-1.808300495147705, -0.9323176145553589, "And, and I clump it but it's probably the is probably those issues about disability which you can clump in together and to personal care and caregiving and transportation and lack of mobility. But, but if I put it under the big umbrella of, of disability, it's, you know, the inability to, to care for themselves physically, and financially, the growing inability for them to independently care for themselves, physically and financially."]
+[10.557228088378906, 8.525334358215332, "Thank you."]
+[-0.09555435180664062, -2.0841991901397705, "I do think and I'm a huge proponent of like, the federal nutrition programs. So I take my Sacramento trips, and my Washington, DC trips, and we do our advocacy work. So I feel very clearly, you know, that government has a role. And, and, and the, I've got some great quotes up on the wall of, you know, leaders from human history that talk about, you know, the, you know, the role of society, in terms of meeting the needs of the less fortunate. And having said that, you know, the government has a major responsibility, and helping support its citizens. Yeah, I do to think that family, and community and faith communities all play a role as well. And it is, and there's personal responsibility, right. So you clump all that together. So I'd say it's a shared responsibility with, with government, you know, playing a major part in that."]
+[0.10154210776090622, -4.970833778381348, "And thinking about all older adult residents in Orange County, who is getting the least amount of attention,"]
+[-0.1655130535364151, -1.5593749284744263, "I would say, the Latino community. And they are underrepresented on the roles of many public assistance programs, largely around the public charge issue and issues related to immigration. You know, at least in our programs, we do not see that in the the AAPI Asian Pacific Islander community that are actually over enrolled in our programs based on, you know, their percentage of the general population in Orange County. But, but fairly consistently, what what we see in a number of the public assistance programs is Latinos are underrepresented in those roles. Again, sometimes, oftentimes, because of immigration issues, whether they're your undocumented, or whether they're even here illegally, but not yet citizens, and worried about concerns about issues related to public charge."]
+[10.678449630737305, 8.400664329528809, "Thank you."]
+[0.6262811422348022, -1.8505688905715942, "Thinking back to your list, wanted to jump to transportation, but there are some transportation programs for seniors. I know that's an issue for our seniors, you know, we have the senior food box program, but you need to come pick up your food. And, and we do though, allow proxies up to, for people to be listed a friend or a neighbor or relative who's willing to pick up your food for you. But you still have to have a friend or neighbor or relative who's willing to pick up your food for you. So I know that for the seniors that we serve, transportation is often an issue. But but there are accommodations, such as us allowing proxies and another Abrazar and several programs out there that help with transportation. So I'm trying to think of the affordable housing. I mean, housing is the single largest expense that any of us experience. And to the degree that housing eats up a larger percentage of the budget of seniors on fixed income, that simply leaves less money available to meet all of their other basic needs. So I'd say from a financial perspective, at least the lack of affordable housing for for low income seniors, you know, probably ranks near the top of the list."]
+[1.3391574621200562, 0.8626629710197449, "Thank you. So in addition to what we've already talked about, we can dig a little deeper into your area of expertise, and that would be protection from poverty and hunger."]
+[-0.6307606101036072, -2.145346164703369, "You know, there are a lot of resources out there, but adequate. And if we and I just had this conversation with a funder a couple of hours ago, if we think of a continuum, right, you've got people in emergency situations, you got people that are stable, you got people that are thriving. And, and there are two different definitions of self sufficiency. One is that you got all the resources you need. So you can live independently, and you don't need help from anybody. The other definition of self sufficiency is that you don't have everything that you need. But we have successfully connected you with all of the resources and commitment to the community for which you're eligible, such that in piecing those together, you are able to meet your basic needs, and you don't find yourself in an emergency situation where you're not able to do so. And, and even though I work for a charity that hands out boxes and bags of groceries to people, that's a really hard way to feed a family or feed a senior on a continuous basis. And that's where often the government programs, again, like the federal nutrition programs, so you know, for seniors, there are things like the congregate meals at senior centers, the home delivered meals for younger homebound. There are our seniors food box program, and the CalFresh, or formerly food stamp program. So, those, so I think, you know that the challenge for us is to make sure that that seniors are are accessing all the resources for which they're eligible. And, and if we're successful in doing that, we're far less likely to find seniors in emergency situations where their basic needs go unmet. And then, but there's just no place you can go, right, it's a hodgepodge. A patchwork."]
+[2.9498164653778076, 0.052895642817020416, "Yeah. And what new or revised policies are needed."]
+[-2.626152515411377, -3.1860263347625732, "Okay, well, and I like what you're doing. Because, you know, if you don't have a goal, you'll What's the expression, you'll hit it 100% of your time, if there's no plans, there's no plans. So I think to have a roadmap that describes how it is that we're going to help, you know, seniors age in place, and age, well, and maintain a quality of life. To describe what success looks like, and a plan for getting there. I think everything kind of starts with having a plan and having a goal. So to add credibility to to the exercise you're involved in"]
+[2.709630012512207, 1.7555949687957764, "you and who or what entity is best suited to address this issue."]
+[-0.024332793429493904, -2.004024028778076, "And unfortunately, fortunately, or unfortunately, the government has far more resources than any of the rest of us, you work for a private charity, I work for private charity, you and I can ask people to consider writing that check to us once a quarter, once a month, once a year. But the government takes 33% of my salary every two weeks, when I get my paycheck. I don't have a lot to say on that, you know, a church can pass a plate, you know, once a week, and people can choose to put something in or not, it's the government takes 33% of my paycheck every two weeks. So the government just has far more resources, you know, then then all of us combined, so that from that perspective, they just have to be a major player in providing services, because they have far more resources than any of us to be able to do so."]
+[1.8524165153503418, 0.8590177893638611, "I work in the hunger fields. So there's some national organizations Feeding America and organization called FRAC Food Research and Action Center, our California Association of Food Banks and nourish California. So when I need data that I don't have, just readily know, you know, those are the sources that I turn to for for information. And oftentimes, it's lagging you know, anecdotal information is readily available, you know, but, but hard in resource data is takes time. So, you know, people are always, I mean, like during COVID. And other times, people are asking, you know, wanting to see hard firm data, but but, you know, harm firm, harm, firm, hard data only comes from your credible sources. And credible sources take a lot of time to collect and analyze, and vet and release data. So, it often trails, you know, two or three years going any of the credible sources that we usually rely on, you know, that data is at least three years old. So it's there's not a lot of good stuff. real time information."]
+[3.7263805866241455, 15.420890808105469, "Yeah."]
+[-0.8510541319847107, -2.42254638671875, "I mean, in the senior space, they're all probably people that you know better than I do. Because they get a lot of those calls from seniors and others that are looking for resources, the senior meal providers, certainly Meals on Wheels in Orange County. And then there's some comparable organization in South Orange County. Yeah, they're providing many of the congregate meals for seniors at the senior centers, as well as the home delivered meals. Orange County Department of Social Services, you know, because they are, they run the CalFresh program. That is, from a food perspective, at least that's America, America's largest anti hunger program, seniors are historically underrepresented in the CalFresh, or food stamp rolls. So what is it that, you know, the federal government, the state of California, in Orange County can do to help address that, and that worsened April 1, because yes, seniors who were receiving 100 or 200, upwards of $283 a month, some had their benefits reduced just April 1 to $23 a month. So that's a public policy that's working contrary to your goals. So you know, I think of some of those big providers Abrazar in Westminster, that does a lot of fine work with with seniors. And I think probably connecting with not just the administrators of some of these programs, but the policymakers. I don't know if she's still around and alive. But there was a and I'm not on social media, but there was a woman, Lynn Boucher. She's from Orange County. She was an assembly woman for a number of years, and then turned out at the California State Assembly. And then, and then she was director of the Department of Aging for the state of California, and Orange County residents. So she came back to Orange County. And last I knew, but even this was six, 8, 10 years ago, she was I think, serving on the board of directors for, you know, for what is now Meals on Wheels, Orange County, but just a real advocate and champion for seniors, and somebody who had been in in substantial roles, and an Orange County resident. So if, if she's still around and accessible, you know, she would be a person that would have a unique perspective. We have a couple state senators, Senators Newman, and Senator men are on the Budget Committee, you know, at the state of California. And so, you know, they decide where they help decide where dollars are spent. So I think, you know, connecting with some elected officials, who, again, set policies and priorities would be helpful and, and helped put this issue helped put this issue on their radar screen as well."]
+[4.923316478729248, 3.322904586791992, "Great, thank you. Oh, sure. Of course. Great. Thank you. So this concludes our interview. Thank you so much for your time, and you've been incredibly helpful to research. And if you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website, which is www dot advanced oc.com and you can leave an anonymous voicemail on our telephone line at any time. So I will stop the recording now."]
+[4.408890724182129, 7.136872291564941, "Okay, great."]
+[3.4288272857666016, 5.5055999755859375, "Let's get started. Okay."]
+[-2.5121679306030273, -3.4359371662139893, "So once again, today's goal is to identify what needs you think are most important to older adults, particularly the ones that you may come across so that you serve at the Apartment Association. And for definition purposes, our definition of an older adult is those are those who are 60 years and older. So we want you to think as broadly as possible, taking into consideration the older adults, their caregivers, families, and as well as the community at large. Okay, so I'm going to share my screen with you now, you're going to see a list of common issues and concerns impacting older adults. Just take as much time as you need to review the list and read it through and then let me know when you're ready, I will be referring to this list in our interview. So take your time, please. Okay."]
+[4.163494110107422, 7.079062461853027, "I see it. Great."]
+[3.6686947345733643, 4.899203300476074, "You don't have to memorize it, I will keep it up."]
+[4.2401227951049805, 7.358180522918701, "Okay, all right, great."]
+[-0.7747994661331177, -3.2837092876434326, "Sure. So I am the executive director of The Apartment Association of Orange County. We're a trade association that represents rental property owners and operators in Orange County and parts of Riverside County as well. As far as my role in interaction with older adults. A lot of our members have been longtime investment property owners and so they have been affiliated with the association throughout their lives and many are retired at this point. And this is a supplemental income for them if not, you know, a business that they look to hand off to their children or grandchildren as they pass away. And then of course, from a service standpoint, our members oftentimes provide housing to older individuals and you know, issues that they deal with with the aging community certainly will impact them in the rental community that they're operating."]
+[5.308738708496094, 6.72155237197876, "Right, thank you."]
+[1.4719715118408203, -1.6509793996810913, "No I think those are pretty much issues that anyone would know make priorities as they look at the area where they live. Great, great,"]
+[2.58134388923645, 3.9346439838409424, "great so of the things that you see here on the list please rank for us the top three things that you feel are most important"]
+[0.5151466727256775, 1.211754322052002, "I think transportation mobility is one this is no no particular order I'm just giving you the top ones I see"]
+[-1.173840880393982, 0.7127946019172668, "housing for sure health care access and delivery economic security."]
+[-1.8084743022918701, 0.7734777927398682, "Disability I think those be the top ones."]
+[2.6428983211517334, 4.077708721160889, "Okay, great. So you name for me five things. Of those five things."]
+[-1.4253486394882202, 0.6528112292289734, "health care access and delivery would be one. Transportation of ability two, and housing three."]
+[3.114616870880127, 4.453144073486328, "Okay, great. Thank you. So for the following questions, I'm going to ask you a series of questions. And I'm going to take them one at a time with three that you listed."]
+[0.2817330062389374, -1.2693086862564087, "Well, I think combination of, you know, people who are either reaching retirement age and either are not in a position to be able to retire, because of, you know, cost of living, as well as just being on fixed incomes moving forward dealing with increasing health costs, in particular, insurance, and certainly, you know, medicine, other things like that. And rising costs of, you know, looking here at the list, you know, in home services, nursing home availability, all that it, there's a major cost consideration. And given the, you know, the wide, wide range of incomes within Orange County and cost being what they are, I think this is certainly one of those things where it can be concerned looking ahead and having some uncertainty about whether or not they're in a position to be able to sustain themselves as costs rise, and they don't have enough long term savings and income to meet those expenses."]
+[-0.23261487483978271, -2.2405288219451904, "God, there's so many possibilities here. I think if you look at the, the immigrant and non English as a primary language, population, you know, you certainly have different health care, you know, you know, third party party providers and advocates, but I think the group, you know, increasingly older population, there's just gonna be an increased demand, and perhaps not enough of those individuals and services that are gonna be available to point them in the right direction and and provide resources they need to access it. I think just the cost of living within Orange County is such that you know, it for many, it will provide some financial barriers, where, you know, choices have to be made, and that that's not a new issue. But I think it is one of those that is an ongoing problem that we need to, you know, to look at and figure out, are there different ways of delivering services, you know, different third party providers or other resources that they can turn to."]
+[5.469717979431152, 6.391669273376465, "Great, thank you."]
+[0.2953701913356781, -0.9545401334762573, "Oh, absolutely. I mean, I think those that have been able to save and put money away for retirement are going to be in a much better position to have access and have choices that other individuals probably would be in a more difficult position to, to access simply because of the actual economics involved in, you know, their own backgrounds leading up to that point as they are reaching 60 years and older."]
+[3.3717262744903564, 9.06982421875, "Yeah, yeah."]
+[-0.9373820424079895, -1.8264212608337402, "Well, I mean, I think, you know, as far as that the county is involved, you know, having a, you know, a primary resource where, you know, older individuals can go for information and, and resources that are available to them and making it in a way where they can, you know, sort of identify what they might qualify for within these different services that are out there. You know, multilingual is certainly going to be important. If there are financial resources that are available to, you know, certain, you know, groups of people that that need maybe financial assistance or other resources, you know, places where they can go to to get that assistance. I think that would be helpful. You know, baby, even, you know, looking at, you know, nursing home availability and in home services, you know, maybe a website where they can go and search for these different types of services that they may need, where it's all in one spot, instead of having to spend the time searching a lot of different places. I think that might be something that can be helpful."]
+[-0.41649100184440613, -3.1376566886901855, "And I think as far as you know, health care, you know, agencies, I know Cal Optima certainly does a lot for certain segments of the Orange County community. I don't know what specifically that they have to offer. But I'm pretty confident that they already have very robust offerings, but maybe just looking at ways that they can, you know, do more outreach to the populations that they serve, and perhaps others who may at some point, be eligible to receive those types of benefits as well. And I think really, that could be all the different health care providers and medical groups that are out there, and, you know, trying to make things more clear when it comes to health insurance and how they can access benefits."]
+[0.5344881415367126, 1.1715357303619385, "Great, great. So now I'm gonna move on to the second thing that you named, transportation, mobility, I'll ask you the same set of questions. But this time, we're going to focus on transportation and mobility."]
+[0.1869320124387741, -2.517690896987915, "Well, again, I think it does come down to economics, and the, the financial resources, they kind of already have available to them for transportation, and if they have their own vehicles, but I know there's obviously still many who as they get older, maybe have never needed a car or had a car previously, and they found other ways to get around. And certainly as their own personal mobility may begin to be impacted, they're gonna have to find new ways to get to the places they need to be medical appointments, or, you know, grocery runs or anything like that. Obviously, we've got a great, you know, public transportation system, but, you know, the the OCTA. I know, at one point, you were seeing a lot more of like, the smaller shuttles that were available to, you know, get people around them, which doesn't seem to be quite as accessible any longer, not maybe the way I perceive it to have once been available. But, you know, it's, I think, having those additional options for people who need to get around, and maybe from an affordability standpoint, having some sort of a program in place to maybe you know, defray some of those out of pocket expenses, maybe could be tied to insurance, you know, to help, you know, allow them to get where they need to be, you know, more often and make it more affordable."]
+[-0.1325148493051529, 2.3761837482452393, "barriers exist."]
+[-1.8453813791275024, -1.364176630973816, "Probably just, there's not going to be enough availability of those resources, when they're going to have the highest amount of need during the day. Yeah, just looking at the aging community having medical appointments or needing to go to the pharmacy or anything like that, you know, as the aging population grows, the demand is going to grow. And if we don't have the bandwidth to accommodate that growing need, it's going to create some significant problems for those people who need the services."]
+[0.3077000677585602, -1.2725715637207031, "Um, prediction options, you know, owning a vehicle of your own, being able to drive still versus not, you know, the public transportation availability, certainly is gonna be important, I think those who, from an economic standpoint, maybe don't have the same flexibility and available resources to them from savings over over time, or, you know, other areas. So, yeah, I think again, it comes down to economics, first and foremost. And, you know, what they've been able to save put towards retirement costs that they would have. Yeah."]
+[3.6342148780822754, 10.958734512329102, "Um"]
+[-0.14877885580062866, -2.242385149002075, "Don't really know, that's not sure what else will help to address the issues. I think it's just, it's having access and flexibility to be responsive to those needs, when they when they have a need. It's just, I don't know how I don't know how you really make a pencil out, it's it's obviously very expensive, and there's only so much money that could be made available to provide support for it. Given all the other, you know, needs that we have here in the county, it's probably that's probably where, you know, a lot of these, you know, charitable organizations and, you know, third party service providers that, you know, exist. And, obviously, they receive, you know, grant funding and support through state and local government budgets, you know, it's just a matter of being smarter in the delivery of services and stretching of those dollars as far as they can go. And and, you know, directing it to where they identified needs really are."]
+[0.3260154724121094, -2.040116310119629, "Yeah. Well, that's an interesting question. As far as for like market rate, apartments that are being built, I haven't heard so much. As far as like medical clinics being on site, or little mini pharmacies or anything like that, I would imagine that senior communities may have those, you know, types of services that are being factored into, you know, current and future development. But I really, I don't have any data to, to know for sure if that's happening, or is being planned. But certainly, as far as I think, you know, maybe mobile services where they can come into a community, that might be something that, you know, could eliminate some of those transportation barriers, in particular, for those that maybe can't get rides or don't have the access on, you know, at the times when they need it."]
+[1.6807156801223755, -0.8218142986297607, "Great, great. So now on to your third chosen topic, which is housing."]
+[0.7512673139572144, -1.5525877475738525, "I'm just, I mean, when you look at from the the rental side of things, you know, rents continue to increase as the demand increases. You do have a lot of individuals, we're now becoming, I'd say, a majority rental County, you certainly see certain cities already that are majority renter cities. And I think yet, that is what you're going to continue to see. But you do also have a lot of, you know, older individuals who are as we're talking about aging in place, they've been in their homes for multiple decades at this point. And, you know, they may not necessarily be planning to, to leave, they want to stay where they're at, and totally understandable. But, you know, the cost for those that rent is going to continue to, I think be an issue, and how they are going to keep up with those rising rents. That's certainly a concern for everybody that's involved. Again, it's the luxury of planning and savings is great if, if you're in that position, but there are a lot of people who have throughout their entire working lives have been, if not paycheck to paycheck, they don't really have much in the way of being able to put money into savings, given all the other expenses they already have. And if they don't have a, you know, a family, the support network, or people that they can live with in the future. Again, you know, they may financially not be able to keep up with with the direction that rents are going. But I will say and this becomes the only argument that we hear a lot of times for rent controls. So how rent control is going to stop that. But, you know, as we have always advocated, you know, when it comes to trying to control, the amount of prints can increase, they're still going to increase and it creates this new barrier or a new obstacle for the housing providers where, where they had flexibility before to not, you know, go for, say a maximum rent increase every year, now they find, well, if I'm only gonna be capped at a very small number, it's going to basically force them each year to do a rent increase, that doesn't serve the interests of the renters, and especially those that are older individuals. It's, you know, it sounds good, until you really started looking at what the actual impacts are. And that's one of the things that, you know, we are trying to always educate, but it becomes a very emotional issue when people are struggling. And I think we need to look at other ways to perhaps bridge those gaps, especially for older individuals, within the communities, and again, you know, charitable groups and others that can provide, you know, gap funding, if you will, for whatever shortfalls may exist now and then down the road."]
+[1.1115400791168213, -1.3067679405212402, "Well, no, it seems like a lot of housing in communities today, or is being faced with, you know, sort of NIMBY opposition, they don't want to see more housing being built in their communities, they don't like change. And whether it's market rate apartment, you know, high density communities or even, you know, trying to get a senior housing community approved, there are hurdles that come because there's community opposition, and they people simply just don't want new stuff being built, because of a fear of, you know, insert, you know, concern at the moment, whether it's traffic or crime, or you name it, it's just they they find something to oppose. And as long as that becomes the default reaction within communities, we're not going to be able to keep up with the demand for additional housing. And for the housing that does exist. You know, again, I think it's just it's, it's highly competitive, and trying to find someplace that's affordable. And, you know, if you're gonna be a long term renter, you've got realities that you're gonna face down the road."]
+[3.4247517585754395, 9.065469741821289, "Yeah. Yeah."]
+[0.6598014235496521, -3.2844109535217285, "Um, yeah, I mean, similar. So I'll do the other things, you know, barriers to housing is I think, just the affordability factor over the long term. And what's going to happen, as these adults aren't able to continue to work, as you know, as much as they once did, as they are starting to deal with, you know, mobility issues, personal mobility issues, physical issues, where they're not able to work any longer. You know, how are they going to sustain themselves financially. And that's what it comes down to when it comes to housing, the cost of housing being what it is. And I mean, it's, I don't think this is a unique issue to to Orange County, it just so happens that the cost of living here is significantly higher than what you might find in you know, other parts of the country."]
+[3.63981294631958, 10.978460311889648, "Um,"]
+[0.6540719866752625, -3.2086527347564697, "it could be, I mean, I think Orange County is getting close to being built out as it is. So it's going to be I think, for new future housing, finding those, you know, those pockets of areas where they can be redeveloped into new housing is probably where you're gonna have the greatest amount of success. And it could, you know, it all depends on sort of the the composition of the city council's because ultimately, they're the ones who have to approve, you know, major new developments, and if, if they're unwilling to approve or they erect barriers or or makes or make it too costly. To do business in the city, you're going to lose that potential to meet the existing or the growing demand within that community."]
+[3.486572742462158, 8.299633026123047, "Gotcha."]
+[0.6274200081825256, -1.6706992387771606, "I think what you need to look at is projecting ahead, you know, looking at your community demographics. Now look at your census data for your city, and project ahead, you know, where you see things headed and identifying what changing housing needs they may have. Probably not. But as their need for care increases, it may you may see, you know, that transition from ownership into, you know, the need for a skilled nursing care facility. And having those types of facilities being built close to where they call home now, I think is going to be important, because I familiarity for, you know, individuals is is important, they don't want to go move someplace that they are unfamiliar with. And if you can build more senior housing, with the ability to expand care as need increases, we hope, I think that will be very important as we look at the future."]
+[-3.0667428970336914, -0.010501042939722538, "Okay, great. Well, we're done with this list. I'm going to move on and continue to ask you questions about other things. So now it's around health. So first is geriatric care. Better Care would be for"]
+[1.2453219890594482, 2.0529613494873047, "I think it is. Oh. I think my my perception would be it's available out there, but probably not at the levels that I I would think are necessary. I think there's more of a demand for and probably not being able to address the needs as quickly as they probably should be. But try to gauge how well I have no, no way of knowing."]
+[-2.6864840984344482, 0.13339069485664368, "What about long term care. And this is care for older adults as they progress in age."]
+[-1.073119878768921, 0.015750154852867126, "I know there are a lot of facilities that are out there, and you know, they quality is going to vary depending on again, how much you have to be able to put into the you know, the rent, or if you're living there. Quality of care, I think at these facilities is going to have a pretty wide range. And having no people who have lived in these facilities, some not so good and some very good. You know, it's it is concerning, because, again, cost living being what it is, I think you're gonna find more individuals who are going to be on the, the lower end financially of what they can afford for these facilities and probably won't get the level of care that is going to keep them you know, at a health level that they probably should be at."]
+[-2.114854335784912, -1.5906565189361572, "Um, I think in general, not even the aging community, but just, you know, all ages, there's probably not enough available out there. Just looking at mental health services that you try to access through your your insurance plans. I know there's a backlog of individuals that are trying to get in for appointments and you know, coverage is going to range depending on the type of health insurance you have. And I don't see that demand diminishing. So I would say the availability and accessibility for mental health services is inadequate."]
+[-1.3118157386779785, -3.735130786895752, "You know, specifically of any services or programs in Orange County that provide mental behavioral health to"]
+[-3.1863515377044678, -2.2138679027557373, "older adults. Um, no I don't"]
+[-0.9809725880622864, 0.34399160742759705, "So these are services unrelated to health, so they'd be services like transportation or housing, food insecurity, that kind of thing."]
+[2.4161064624786377, 5.075994491577148, "What's my familiarity with this"]
+[1.0009899139404297, 2.4944851398468018, "no how, in your opinion, how accessible and adequate are they um,"]
+[-0.5284176468849182, -2.767493724822998, "I mean, I know it's available. And I know that second harvest Foodbank in, for instance, I mean, they've, they have a lot that they make available. And I don't know how broadly, people are being able to tap into that availability and get the resources that they need. I would think like anything else, the demand in Orange County is probably higher than most people would anticipate it to be, myself included. I just I hear anecdotally about, you know, the need increasing, and they're not being enough. But I do know, there's a there are a lot of providers of those types of services that are out there. I just I don't know, if I were just trying to gauge how you know how successful they are in meeting the overall demand. Again, probably, the knee is much higher than what they are just able to do currently. On if they could do more, I'm sure they would."]
+[3.706266164779663, 15.571450233459473, "Yeah."]
+[1.3288450241088867, -0.7611528038978577, "Services for housing as in"]
+[0.5997466444969177, -3.382136583328247, "I think they're accessible. You know, one of the challenges that we face with the housing voucher program is, for the most part, the the amount that they cover in say, rent isn't necessarily realistic of what rents really are going for here in Orange County, the payment standards are there's always a delta between what what's available at the price point that it will cover and you know, where they're located. and things of that sort, I think it's just, again, the cost of living in Orange County is particularly high. And the rental market analysis continues to be very tight. I mean, you've got a lot of demand that you don't necessarily have a lot of availability. And as soon as you have openings, you're getting the double double digit applications within just a matter of a couple of days. And so trying to get a voucher holder into one of these units. There's just down I think the demand is so high that it makes it very challenging."]
+[4.2284440994262695, 8.972088813781738, "No."]
+[3.632215976715088, 10.957819938659668, "um"]
+[-1.7938703298568726, 0.5000702142715454, "health care affordability."]
+[-1.7385845184326172, 0.3347020745277405, "Adequate provision of care, the availability of care for what the demand is at that point."]
+[0.49648094177246094, -3.062925338745117, "Being like in home services, meal deliveries, again, transportation, for those who need it, I think it's just it's Orange County's inability to keep up with the demand that's going to be, you know, be here 10 years, I think it's already a challenge. And I don't know how it's going to improve in 10 years time, unless we really like what you're working on a comprehensive plan identifies and it figures out, you know, funding streams and can tap into funds that are out there and available on top of whatever new funding programs might might be created."]
+[3.6380980014801025, 10.977161407470703, "Um,"]
+[-0.04110335186123848, -2.035900354385376, "primarily, I think the government should be in the role of facilitator and identifying existing available resources and and creating opportunities to meet the demands that we have here locally. And eliminating potential barriers that may exist to getting those types of programs. And the funding up and running and implemented is efficiently as possible. I think as far as the delivery of services for people in different socio socio economic levels, you know, those that, you know, simply cannot afford, I think there needs to be a systematic look at the taxpayer funded programs that exist and figure out how do you improve the delivery of those services and the funding, utilizing that funding is smartly as possible. The problem is what we do maybe here locally, we're dependent on things that are happening at the state and federal levels, too. And I think that this government dysfunction, and inefficiencies that exists at all levels of government, make it hard to really get the most money into the delivery of these programs and services that are really necessary. But I don't, I don't see how we ever really fix that problem. And I think that's then where it is, you know, it's going to fall on to other service providers that are through, you know, again, charitable organizations and, and others that can step in, and maybe fill gaps. And, you know, perhaps do differently at the very least, and maybe better than what government might do, if it was, you know, providing it directly. But ultimately, you know, government is there to help, help direct things, it doesn't necessarily have to be the one doing it themselves, but creating those opportunities and, you know, stepping in where it needs to, but otherwise try to just facilitate other solutions that would meet those needs that exist."]
+[-0.06352454423904419, -2.0143003463745117, "I think you get the political answers that are really intended to justify programs that already exist, but maybe don't deliver services as effectively as they probably could. It's always gonna be the, you know, the the underserved communities. But you look at programs that are already out there. And, you know, whether it's homeless housing up in Los Angeles, and the millions of dollars that have been put meals put through, you know, taxpayer programs that aren't really getting results. It makes, it makes it hard to get behind those programs that do exist, because you have such a level of skepticism. I don't have an answer. You know, it's, for me, personally, it's a lack of confidence in government doing things the right way. Waste, bureaucracy, again, money that if it wasn't being, you know, I don't want to make it too political. But if it wasn't being spent on things that are core to the mission of serving the people that they're trying to serve, you could probably get a lot more out of it. And yeah, I don't know. It's just it's, it's a hard question to really answer. I'm not, I would say, I'm just I'm not a big government guy to begin with. And I don't have high levels of confidence. There's a role to play. But yeah, I just, I don't have solutions that are, I think, going to work unless all the different parties are willing to really examine within themselves and make tough choices to, you know, change. So let me I just in this case, I, you know, I hope this orange county program is one where we're very reflective and we can make recommendations, but there's only so much I think that we can recommend for other governmental entities. The Orange County way and make it as efficient and keep it focused on the people that really need it. And not get caught up in Government speak and characters, the characterizations of situations and"]
+[1.98593008518219, -0.2700675129890442, "trying to get into politically driven decision making. You got to do real assessments have real numbers and report it for what it is."]
+[2.261991024017334, 2.7944533824920654, "Yeah, yeah. And thinking about all the issues that we had covered today, but also other issues that, you know, maybe not one, two or three for you, but you know, maybe further down the road, what issue is being overlooked,"]
+[-1.4535661935806274, -1.9410380125045776, "Lack of connection with the community. I mean, especially those that are in assisted living facilities, a lot of times, their family just sort of checks out. Now, they don't stay connected with their older family members, as regularly as they should. And I think that leads to, you know, you talked about earlier about mental health services and impact on on older communities, I think that contributes to some of that, that mental health issue, you know, they don't have a real strong sense of community, but their family members, and, uh, you know, depending on where they live, they may have a sense of community within the area where they're living. But I think there's a lot that society can still, you know, benefit from having connections with older individuals, and that they have to offer, you know, society today. And I think, giving, giving them purpose, as they may not be, you know, out in the workforce any longer, but connecting them and giving them something that they can contribute. And that will help to make them I think, continue to feel like they're making a difference as well. We can serve them but they can also, you know, stay active and contribute as well. Absolutely."]
+[0.4367314875125885, -3.55910587310791, "Okay. In thinking about your own work, right, and housing, and those that you the members that are part of your association. So on the topic of housing, what do you think is working for Orange County. Um,"]
+[0.6517221331596375, -3.428842544555664, "despite the cost of, of rent in Orange County, we have options, we do have an assortment of available rental housing, that's available to meet differing price points and different segments of our overall county population. It's out there. But again, like I said, demand is high, pretty much across all classes of rental properties. It's highly competitive, but it's there."]
+[4.3439106941223145, 4.245908737182617, "No, oh, sorry. You know, she's a little early. So let me Vitale, hi. I just put her in. She's really"]
+[1.3709430694580078, -0.8512091040611267, "kind of like we're saying I'm saying earlier about having a place where they can access, you know, a compendium of resources available, when it comes to housing, you know, finding a way for individuals who are looking for housing and certain areas to find it, you've got multiple different, you know, rental websites that exist, but it's not always going to be for, you know, the most affordable housing that's out there, it's usually geared more toward, you know, not necessarily luxury apartments, but higher end market rate housing. You know, I think for people who are looking for housing that is more, you know, more affordable, you know, finding a way to connect them with a source or multiple sources focus just on that that might be helpful. And that might be something that we can even as an association, you know, work to facilitate. Down the road."]
+[2.488753080368042, 2.9607315063476562, "Great. Yeah. And what are the some of the things that are not working"]
+[0.6518881916999817, -2.64986515045166, "In general, we're not building enough housing in Orange County. And not only not enough, but not enough variety. And like I was saying a moment ago about, you know, you have what government does here, but it's impacted by what's happening at the state or federal levels. So many of the challenges that we face are the result of what Sacramento is insisting we do. Because of its belief of how housing should be done, and forcing that down on the locals. And the problem is, local government isn't doing its job to facilitate new housing in its communities, the state is forcing things upon local government, which they're bristling at, neither of which is really going to solve our solution, we just need to build and meet that demand, and eliminate some of the more costly steps in the development of new lanpher for housing, you know, nothing unnecessary, in particular, but I mean, you look at just, you know, environmental regulations, and the time, you have to go through all these different studies on time is money. And that drives costs up, the more, the more time you spend, in blood alone, you know, potential lawsuits and dealing with, you know, local opposition, it shows just, nothing moves quickly enough. And I don't know you, again, it's like so many issues where we need to get everyone at the table and really find ways to fix the problem. But no one's doing that. Everyone's got their special interests, and they refuse to, to budge and really talk to each other and work through. So it's just, you know, a battle of wills that we seem to face when it comes to addressing the housing needs we have. And until we get past that, and we find ways to eliminate some of the more costly aspects of getting projects approved and the community opposition that oftentimes, because I think we're going to continue to struggle to really address the overall housing needs that we have."]
+[1.1233068704605103, 6.475038528442383, "I think."]
+[0.4330999553203583, -3.0422167778015137, "I mean, I think the, the conversation has to begin with the cities here in Orange County, first. I think the data is out there, we can do it here. The problem is you invest the time and resources that that may not be something that the state ultimately would accept, and probably wouldn't, because it's not being done in accordance to the mandates through state law. But I think that is where you can begin to tackle future senior housing needs. Affordable housing needs. homeless housing, you know, finding out what types of facilities do need to be built into communities to meet the direction that we're heading demographically. If we start talking just amongst ourselves locally here in Orange County, that might be a step in the right direction to eliminating, you know, the challenge that we're facing here. And I think that's where the county come in, as far as working through the field, the five supervisorial districts with their respective cities to bring them to the table and, you know, have the kind of filter up into a county wide plan. Similar to what you're working in here for the county for the aging situation."]
+[4.664753437042236, 4.496991157531738, "Right. Right. Right. Well, great. Oh my gosh, just there's so much information here you gave me today. I really eloquent I'm sorry. But you know, it's just, it's perfect. It really is. And again, it's really coming from all kinds of different perspectives. So I super appreciate that."]
+[4.631921291351318, 3.2958667278289795, "Okay, great. Okay for the opportunity. And yeah, I will I will get that information on chip for another interview. And then when you're ready for the focus group, let me know and I'll see help to facilitate that as well"]
+[4.8431620597839355, 4.501185417175293, "thank you so much All right Have a great day Thank you Katie you too okay bye"]
+[4.215334415435791, 8.928787231445312, "I know no."]
+[-2.644946813583374, -3.144808769226074, "The primary goal today is to identify what needs do you think are the most important for the older adult population you serve those that are simplified and older, we want you to think as broadly as possible, taking into consideration the older adults, caregiver, family and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults."]
+[3.7208285331726074, 5.055402755737305, "Please take a few minutes to read this through."]
+[3.8332014083862305, 5.277494430541992, "And let me know when you are ready to begin. Okay."]
+[3.3764798641204834, 6.90353536605835, "Oh, yes, I can't."]
+[4.758675575256348, 8.042594909667969, "Okay"]
+[3.576387405395508, 4.993274688720703, "okay, yeah, I've read it now. I understand all those."]
+[-3.117293119430542, -0.39118093252182007, "Well, I am a registered nurse. But I'm also masters prepared gerontologist, I have worked with ah, well Senior Services as a consulting to a grant program, which is a band provided for probably 1617 years with a combination of Monarch health care, and H will senior services grant. So I'm not an employee of AgeWell."]
+[-2.923865795135498, -0.40520039200782776, "I am a private care manager that has a private practice. But I help the care management department at Agewell,"]
+[-1.5105514526367188, -2.715087652206421, "as far is keeping up with the seniors and what's going on and doing some of their home visits for them."]
+[-2.496298313140869, -0.5764992237091064, "Especially when the workload is more than they can get done in a timely fashion, the county. So I do like I say I do home visits for Agewell Senior Services, I have my own private client that I do not only home visits for monarch patients, but private clients that I have, and that I sometimes can't take care of for many years, when they don't have families to look after them."]
+[2.116253137588501, 6.613383769989014, "And I maybe need to take a look at"]
+[5.579432010650635, 8.8020601272583, "okay."]
+[-1.3324161767959595, -0.30247962474823, "So and that happens to be one of my families that I'm working with right now on a private basis. I do sometimes I take care of families"]
+[0.051219355314970016, 0.5943999886512756, "and helping them get through the system, helping them find"]
+[1.0961991548538208, 5.429680824279785, "proper"]
+[-0.7800005674362183, 0.1436564028263092, "living facilities, whether they should be on their own be in"]
+[-1.1982035636901855, -0.5487433671951294, "assisted living be in born care or whatever their needs are. So that that's my primary role. Is those two."]
+[0.13439306616783142, -4.176767826080322, "Oh, pardon. Yes. Thank you for sharing. Thinking about Orange County and looking at the list of common issues and concern impacting older adults."]
+[0.5009777545928955, -3.3091113567352295, "You don't have either I miss misters you Yeah, there's a transportation transportation major issue here in Orange County. But I see you do have it on there."]
+[2.262516736984253, 4.831753253936768, "I think one of the things that is missing"]
+[3.137462854385376, 5.075142860412598, "Hang on I'm looking to make sure I didn't miss it"]
+[2.1450722217559814, 5.740403175354004, "is you don't have anything in relation to some of their senses."]
+[-2.55619215965271, -0.9444037079811096, "says their needs, their hearing aids, their glasses, that kind of thing. There's no reference to that."]
+[-2.778158187866211, -1.4446011781692505, "And that's a major need for our seniors to have help with that. Because if they can't hear they that will follow and cause more increased dementia."]
+[2.439926862716675, 4.628383159637451, "So it's really, really important. But there's, I don't see anywhere on there that you're including that."]
+[7.185526371002197, 4.640589237213135, "It's good. Thank you for letting us know and sharing that."]
+[1.3206895589828491, -1.0808757543563843, "You do have affordable housing. That's the main major issue. I'm sure you know."]
+[2.4730913639068604, 3.7928202152252197, "So of the needs on the list, include those that you have suggested, Please rank the top three that you feel are the most important."]
+[2.524512767791748, 3.8946926593780518, "Top three, I actually have, I can tell you that I actually have more than top three that are equally important. Yeah, it's like share"]
+[-1.0247776508331299, -0.07803858071565628, "affordable housing. I think you've got caregiving, but it's not paid care giving paid in home support."]
+[0.7733011841773987, 0.26014837622642517, "People can't afford it anymore. So almost $40 an hour. So they're going without"]
+[-1.3203867673873901, -0.3904722332954407, "that's a major issue. So there's not enough in home support. I already mentioned the glasses and hearing aids, and reliable transportation, all of those things are the some of the top issues we deal with, as far as going into the homes. And it is not necessarily means tested completely. And other words, it happens to all segments of the population."]
+[10.60008430480957, 8.482945442199707, "Thank you."]
+[1.2578946352005005, -1.0547631978988647, "When you think about affordable housing."]
+[1.035054087638855, -1.2762086391448975, "I'm sorry, I didn't understand the question. So you mentioned affordable housing as one of the top issues that you feel are the most important. So when you think of affordable housing, how or Why are older adults struggling with this issue, because they don't have the money to pay for it."]
+[0.237724170088768, -0.9389521479606628, "It's as simple as that. Their unit they cannot they're on limited incomes, the income, many, many of the ones that are alone are single women who have the smaller amount of Social Security coming in that does not meet"]
+[1.2646825313568115, -1.0493139028549194, "affordable housing at all. And there's just not enough housing for these people to move to they can't afford $7,000 a month. So they stay in their homes, and and struggle."]
+[2.5811614990234375, 6.790355205535889, "Yes. Well, I think that's obvious."]
+[-0.15683585405349731, 2.241779088973999, "The barriers is financial, whether the the the"]
+[0.9986077547073364, -1.6790722608566284, "county wants to build more senior living in affordable homes or not, whether there's locations for them."]
+[2.0985958576202393, 7.260295391082764, "It's"]
+[0.7557277083396912, 0.5292115211486816, "it's money."]
+[-4.158991813659668, -1.9447365999221802, "Are there different experiences for different groups of older adult from different backgrounds, for"]
+[0.09149305522441864, 0.01891704648733139, "example, like where they live disability status, income or educational level."]
+[1.4322527647018433, 5.257462024688721, "It's all of the above, there isn't one group that's different than the other. Again, it goes back to"]
+[0.5030611753463745, -1.1271507740020752, "you can be a very well educated person and had a good education, but your money is going to start to run out the lives. They're living longer. The money runs out, and there is and they can't take care of their homes. They need to downsize and there's not locations to go and downsize at a reasonable cost to them. Yeah, thank you for sharing. What do you what do you suggest is the best way to address this need or issue I don't have an answer for"]
+[-1.4336750507354736, -0.4277176260948181, "so now we can talk about another important issues that you mentioned earlier is there's not enough pay caregiving in home support services. So when you think of this issue, how or"]
+[1.229807734489441, 7.723141670227051, "Well,"]
+[-0.30711790919303894, -0.19821177423000336, "it has gotten so expensive to have somebody come into the home, whether we have to figure"]
+[-1.21005117893219, -0.6426556706428528, "some kind of more available, county employees and have them well trained to go into the homes, because when you go to private caregiving agencies, it is not affordable for families who need anywhere from eight to 24 hours care with family members. So there has to be some system of adequately paying caregivers, to an assistance program somehow, that are interested in doing quality care for these people."]
+[0.747793972492218, 0.36185112595558167, "it is strictly money."]
+[-1.3062103986740112, -0.5401408076286316, "We don't have caregivers that are well trained, they're not paid enough from the county to want to stay at a job and have private caregiving go in is costing people up to $14,000 a month that the average even the middle class person cannot sustain that kind of, you know, caregiving expense."]
+[-4.12103796005249, -1.926849365234375, "Are different experiences for different group of older adults from different backgrounds. No"]
+[2.7328553199768066, 5.995748519897461, "I don't have an answer. Okay."]
+[3.59061336517334, 4.289242267608643, "I know you're I can tell you're going through the same questions through a list."]
+[0.046578023582696915, -3.3428149223327637, "I don't have an answer to all of it. But if I don't see it, on what the county's thinking about and considers important, nothing will change."]
+[-2.7461187839508057, -1.5238285064697266, "Yeah, yeah, I am going through a list. So I apologize if I do save a repetitive but for the transcription and, you know, ratio purposes, we kind of have to ask the same question. Yeah. Yeah. So got a third issue that you mentioned, is the glass and hearing aid for the older adult, how or why older adults struggling with this issue."]
+[-2.2385716438293457, -0.7628651261329651, "Hearing aids can cause sometimes as much as $4,000. The fact that now they do have across the counter ones that are helpful. That is helpful. There is not a Medicare does not pick up hearing aid cost. I think the government or counties need to work with Medicare to provide subsidies for both glasses and hearing aids. When people can't see and they can't get out. Because there's can't hear what's going on. They become home in home isolated, and then their health deteriorates."]
+[-0.7671414613723755, 2.2344436645507812, "What barriers exist to see improvement in this area."]
+[0.7849692106246948, 0.6782570481300354, "Money."]
+[-4.170151710510254, -1.9467170238494873, "Are there different experiences for different groups of older adults from different backgrounds."]
+[4.232761859893799, 8.96961498260498, "No."]
+[-2.5206987857818604, -0.9359889626502991, "Well, I think I just said it, that the counties and cities need to work with the federal and develop a way that some of that is paid for so people don't struggle with hearing and blindness."]
+[0.22532416880130768, -2.4299240112304688, "So I do want to go over the last issue that you mentioned as well because we want to hear from you. And that issue is transportation. How or why older adults struggling with this issue."]
+[0.5432148575782776, -3.197115659713745, "Well transportations difficult in Orange County, and especially when you get into South Orange County, you have very limited number of ways of transportation. We don't have a central we don't have a good bus system. We don't have a train system or a subway system any way like that. We have to again rely on a small amount of"]
+[0.5624170303344727, 1.2602771520614624, "like access buses or something like that through the city."]
+[0.705130934715271, 3.47248911857605, "What they struggle with is"]
+[-2.1450462341308594, -0.2157309502363205, "if they need to go to a doctor's appointment, it can take all day long because the buses have to pick them up and go to several other people at the same time. So it is time limiting."]
+[0.18102063238620758, -2.6403496265411377, "Again, if they need help getting out their front door, to get to the bus at the curb, does not help on much of your transportation. So that that blocks it."]
+[0.5501288771629333, -3.198148012161255, "Yeah. Well, somehow, the transportation system in Orange County needs to take a look at what they can provide and get subsidized. Fast forward course, it'll probably go to the taxpayers. But I think that might be something that could happen."]
+[-4.138565540313721, -1.8895645141601562, "Are there different experiences for different groups of older adults from different backgrounds. No, they're not."]
+[7.225862503051758, 6.206974983215332, "What do you suggest is the best way to address this issue"]
+[0.5277376174926758, -3.2062222957611084, "getting the county to work with the transportation system in the state of California to to consider what they can do to make it better if we're not going to have any kind of trains or buses or anything central like that. The only way to get around down here in Orange County is to have a car practically in the these people can't drive anymore. Thank you for highlighting think those issue and sharing your knowledge."]
+[-2.7093379497528076, 0.40463870763778687, "First is geriatric care. Second, is long term care third is mental behavioral health, substance use treatment. And four is human social services."]
+[-2.4049923419952393, -1.6181044578552246, "Mental health is a major issue here in the senior population."]
+[-3.2559876441955566, -0.24897344410419464, "Geriatric Care"]
+[-2.7762057781219482, -0.41689246892929077, "is limited because we don't have a lot of physicians and medical people. I think, as nurse practitioners are given the ability to practice"]
+[-1.2300775051116943, -2.8288753032684326, "in the state of California, many of them are willing to work with the senior population."]
+[-3.057701587677002, -0.47111690044403076, "Not I know a lot of them that we have, but not not new ones or somebody we need to follow. We have a limited number, like I say so limited number of practitioners, as far as geriatric care"]
+[-3.175750732421875, -0.4512803554534912, "thats partially because geriatricians are paid less than other physicians."]
+[-1.0370393991470337, -3.9272308349609375, "So So young physicians don't want to come out to a practice that isn't going to, you know, support them the way they they want to. Yeah. Do you think that it's long term care is in a mess, and it was proven by COVID. And until they get their act together, long term care is one of the worst things you're going to see that and, and they if you say what can they do better, they need to pay the caregivers, more money, to be able to care for these very sick patients. They need to have the directors of those facilities be better educated, better trained and better paid. And somehow the government needs to step in, like Medicare and stuff and close down some of these places that are just out to make a buck. Yeah. Do you how accessible and adequate are those services in Orange County"]
+[-0.3545221984386444, 0.30661582946777344, "is social services is is reasonable. We don't have enough social workers."]
+[0.5169323682785034, 3.0175764560699463, "You know, and when there's a crisis,"]
+[-0.482186496257782, -0.17996780574321747, "we can't get social workers or some of those people to get into a home right away to help the people. I think the services are very limited. We have it. And they mean well, but unfortunately, there's not enough of them."]
+[0.21344485878944397, 3.512800455093384, "Well, probably the greatest challenges is going to be the caregiving"]
+[1.6634994745254517, 3.104992151260376, "because we're going to see more and more"]
+[-2.960441827774048, -2.201897382736206, "people living longer"]
+[0.7152189612388611, 0.358869731426239, "the rate of"]
+[-2.988959550857544, -1.2449482679367065, "one form or another of dementia, whether it's Alzheimer's, Lewy Body, brain, frontal, temporal, any of those dementias, they all fall under one umbrella there"]
+[-2.487952709197998, -0.1006014421582222, "are going to be increasing and the need for care is going to be greater. They also are living longer. So people with chronic diseases, the physicians are able to to take care of them however, they need care in their home."]
+[-2.488126039505005, -2.2376651763916016, "Well, they need to put the older adults is start to think of it more as a priority."]
+[3.6960012912750244, 15.112542152404785, "Yes."]
+[2.5232911109924316, 6.090773105621338, "I don't I couldn't tell you that. I don't know."]
+[-1.3476706743240356, -2.6652467250823975, "We have in my private practice. I have people that are rich, I have people that are poor, I have all diversities of all ethnic backgrounds, and so forth. As far as h will Senior Services is concerned, we have a very diverse group. So I don't, I can't say that one group is getting more than another."]
+[2.731360673904419, 5.933884620666504, "No, I can't answer that."]
+[-1.5170117616653442, -0.044882774353027344, "I think caregiving,"]
+[-1.0561145544052124, -0.032530948519706726, "between caregiving and housing."]
+[2.3667211532592773, 2.893475294113159, "It's on your list, but it's been overlooked. Nothing's been done about it."]
+[3.3712027072906494, 4.0688652992248535, "We can have every list in the world, but we're not seeing"]
+[2.1865360736846924, 3.843485116958618, "priorities for those things."]
+[-1.3333652019500732, -2.7308168411254883, "No, I don't think so. We don't agewell does not have a large staff."]
+[1.4833950996398926, 8.83144760131836, "And"]
+[-1.2528527975082397, -1.1490942239761353, "I asked, I sent this to people in agewell, frankly, they didn't, they didn't really have the time to spend. And that's why because I am sort of throughout Agewell, well, you know, work with transportation work with care managers, all of that I see the people firsthand, both in the senior centers, the ones that can come to senior centers and congregate meals, also the ones that get meals on wheels, and trying to get what we can afford of grant money to put caregivers in the home. And hopefully, for a little bit is a very, very small percentage. But I see all of that. So that's why I'm the most logical person to be able to address it, or have the flexible time to do it."]
+[-1.7025305032730103, -2.7767908573150635, "You see any organization or any stakeholder gets serving older adults in the community that we should also include their input in this project."]
+[2.171689987182617, 6.08873176574707, "Not offhand, I don't"]
+[-1.3993254899978638, -2.750976800918579, "we, we have the Council on Aging and we have agewell senior services, then we have other groups go through the various religions and so forth, you know, that take care of, of those people. But I don't have a group that I think is being missed at this particular time."]
+[4.898987293243408, 3.336008071899414, "Thank you. So this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our reach out. If you find that you have more to share, please feel free to reach out to us. Okay, and once that information is available on our website at advance oc.com and you can leave any anomalous voicemails on our telephone line at any time. Okay. And I will stop the recording now. Okay,"]
+[5.310476779937744, 3.582667827606201, "Now you can record."]
+[4.553575038909912, 7.2514328956604, "Well, good afternoon."]
+[4.550904750823975, 7.2412214279174805, "Good afternoon."]
+[-2.6937918663024902, -4.794836521148682, "My name is Ron Barnes, and I'm a part of the research team and a member of the battle C team. And we're a local nonprofit conducting the county of origins older adults needs assessment. Thank you for your willingness to take part in this interview. The purpose of the interview is identify the needs of older adults and to gather insights from your expertise and experience. The information you provide will be used for the development of the Orange County Master Plan for aging. This interview will last about 45 minutes, and with your permission, our discussion will be recorded and only for transcription purposes. After transcription, the recording will be deleted. If you don't feel comfortable being recorded, turn off your camera and change your name attached to your picture. Your responses are confidential, and information. And all identifying information will be removed from the report. Please note that your participation is voluntary. You may choose to answer any questions in part full or not at all. You may also withdraw from the interview at any time. If you're unfamiliar with any terms that we use, please let us know and we'll provide a definition or examples for what we what we mean. I do not. Great thanks. So the primary goal of today's identify the needs you think are most important for older adults. And those are adults 60 and older. We want you to think as broadly as possible taking into consideration the older adults caregivers, families and their community. So I'm going to share my screen and you're gonna see a list of common issues and concerns impacting older adults"]
+[3.5507054328918457, 6.642495632171631, "see them Yes, now I can"]
+[3.9512388706207275, 4.977351188659668, "great so I'm gonna give you a couple minutes to look at the list and let me know when you're ready to begin"]
+[4.4799933433532715, 5.496271133422852, "I can you zoom in a little bit yes."]
+[3.532369375228882, 5.129195690155029, "Excellent, yeah, I had a chance to look through it. Okay."]
+[-0.4977273941040039, -3.9110610485076904, "So thinking specifically about older adults in Orange County, for the record. Could you please tell us your name, your role and how you interact and engage with older adults in Orange County."]
+[-1.7576402425765991, -3.6096296310424805, "So, my name is Michael Graf Weisner, and I realized my last name was not in my in my full zoom name, but if you haven't on email, but if you need me to like for the purpose of recording in the interview, I can spell it out. No, no, you're good. Okay. Michael graph Wagner. My role here at chrysalis is Vice President of Strategy and External Relations. And so I work at chrysalis, who which is a nonprofit providing employment services to individuals with barriers to the workforce. And that includes individuals who are experiencing homelessness or housing insecurity. Majority of the clients we serve are also are have been impacted by the criminal justice system. And it's a range of working age adults. So as a relates to your question on age. We don't exclusively work with older adults, but we do work with working age adults, and among those are individuals who are older. So in advance of this conversation that was refreshing my memory of our demographics and in Orange County. We have offices in Southern California but our Orange County office the way we report our demographics has 55 and up so I don't I don't have the 60 breakdown although we could obviously I get that but not real time in this in this interview. So the about 23% was the was our percentage adage of our clients we serve that are 55 and older. So again, I could try to refine that after the interview. And so the way that we interact more broadly, not me personally, but the we chrysalis interact with those older residents of Orange County is essentially helping them get ready for a job and get a job and keep it, which is our program model, which I can go into more details, but is everything from you know, helping them, do a resume to practice interview skills, their job search skills, and then directly connecting them to work opportunities. So I can go into more details about that. But that's the that's the focus of our work around employment. And me, in particular, I work with our partners in the community help get referrals into our program. So have a sense of the other social service providers and government entities that are that are also interacting with the same population, bless you. And as well as looking for our agencies funding opportunities as it relates to government grants, and then also oversee our program data team. So working on our database and data systems, and reporting. Yeah, so I'll stop there."]
+[10.595584869384766, 8.495146751403809, "Thank you."]
+[0.2046843022108078, -3.970226287841797, "Yeah, I thought, as I read through it, it's a good list. So there weren't there weren't any glaring gaps. One thing that crossed my mind was maybe it's on here. I wonder about language access issues, potentially, if I think of kind of the immigrant families in Orange County, and, you know, that kind of first generation story where the kids are maybe now out of the house, and now the adults are older, and they don't have that kid to translate as they navigate the world, if the kid has now moved on and out, so I don't know if that would, you know, that could fit into some of these buckets. But it could also be a standalone kind of issue area."]
+[-1.127819538116455, 1.071251630783081, "You know, I think, I think about issues like for example, poverty, which, in some ways, there's economic security, it's also housing affordability. But I think of food insecurity, which could fall into diet fitness, but so there are certain issues that I think do are represented on this list but but for example, I don't see in the in the left column food insecurity, but I do see economic security. So these things are often overlapping and interrelated, but that so my mind went to some of those some of those areas"]
+[0.15943650901317596, 1.5310890674591064, "I think about you know, things like access to parks which can obviously relate to mental health and physical health and human interaction and social connectedness. And I guess I don't see kind of parks and green space necessarily called out but again, you could you could argue it has to do with fitness or it has to do with environmental concerns, or it has to do with mental health, having places to connect, but correct me if I'm wrong. I don't see that on the list. No. Okay. That strikes me as maybe something that could be called out"]
+[2.469613790512085, 2.931123733520508, "Yeah, so those are a couple of couple thoughts, but otherwise, I think it's a good list of potential issues and concerns."]
+[0.1049339696764946, -4.18937873840332, "Thank you. Now have the means list and including the four I will tell you a list of four language access, poverty, food insecurity and access to parks. Please rank the top three that you feel are the most important for older adults in Orange County."]
+[0.17467351257801056, -0.7843186855316162, "is maybe by us because of the role we Start around employment and within vulnerable populations, but my mind for it starts with economic security. With that in mind, it can be hard to find a job if you have to change jobs as you, you know, if you're 60 Plus if you are in the, you know, lower wage, lower income segment of the economy can be harder to find work that's physically demanding as you're older, if that becomes an issue, and then they're just, you know, hours being cut, etc. So, I think about, I would say economic security being number one. Okay, so I got two more slots."]
+[-0.31646764278411865, -1.3664113283157349, "Think it's, it's hard not to put housing second. Given housing affordability, in Southern California and Orange County, so those, I'm given the top two slots. And then with the third eye, my mind goes to more of a health related bucket, which, you know, there could be a few on here. But I'm gonna go with health care access and delivery, in some ways with, you know, public health care benefits, it's that there could be decent resources to meet those needs. But, you know, obviously, as the population gets older, it's that more health issues. And so even though there might be some insurance for older adults, it's also like, hard, hard to not list that among the top three. So I'll I'll click Submit, those are my top three. Okay."]
+[-2.6546425819396973, -2.9947710037231445, "Thank you. Now, when you think about your three suggested top needs. Now I want to stay we don't have to go through them individually, but I will prompt you or probe with you if you don't cover, you know, each of them. But I want to know how and why are older adults struggling with each of those issues. And why are they struggling with it, and then housing and then healthcare access and delivery."]
+[0.2040075808763504, -1.293809175491333, "So I mentioned a little bit as I just processed, telling you the list. I think, for example, I was talking about just people losing their job or having to change jobs with as they're older, and that can be challenging their stigma in the workplace and the job market on older hiring older job seeking candidates. Potential physical demands of jobs as they as people are aging, that maybe they could have done their 20s and 30s 40s, but struggle in their 60s and 70s, even life expectancy is longer. And so yeah, I think as the job market changes rapidly, technological impacts on the job market and roles, there could be then become a skill gap, if now, you know, the demands the job the labor market are having like aI familiarity and technology, technological skills, and you're now at a at a disadvantage there in the workforce. So all those things, I think, are why that item is on the list. And why I listed it first, I think on on housing issues, you know, if you look at any by any measure, the Percent of residents of Orange County that are housing insecure, and there's definitions of that based on the percentage of your income, you're having to put towards housing. It's daunting. housing costs have gone up. They have not kept pace with wages, and therefore, it's impacting everyone. Obviously, not just older adults, but I think combined with the job insecurity, you know, unless you now own your home and you're benefiting from essentially the dividend on on baby housing values going up, you may be house rich, cash poor, there's that issue. But if you're a renter and rents are going up If you're on a fixed income, and you're between jobs and you've lost a job, and now, how many paychecks are you away from homelessness. So I think it's hard for me now to not to see housing affordability as a real concern, as we look at an aging population. And if you're on a fixed income, or have any kind of, you know, income insecurity, you could easily be priced out of the housing market or lose lose an apartment. So that's why on the housing front, and yeah, I think on the on the health care front, I think I talked a little bit about processing both, yes, there's some benefits and insurance coverage. But again, as the life expectancy goes up, then you're you're managing healthcare and needs that can be pricey. And as you get into the older years, so yeah, I don't know if that's, that's a specific enough for your question. But those are some reasons why."]
+[2.372586727142334, 5.6811089515686035, "Okay. So the second one is similar."]
+[0.09153842180967331, -1.186098575592041, "Yeah, I think starting with, with the employment one. You know, I mentioned, like the changes in the job market, and I would connect to that perhaps the workforce development training, professional, you know, community college system, college system, vocational training system, etc. I think a barrier is, is that system that helps, but it might help build build skills, up to the challenge. So I think it's a barrier in the sense that is not where it needs. It isn't it exists, but it's not where it needs to be, I think looking at the pace of the change in the labor market, and the likely change is coming as the workforce ages, boomers so. So I think I would say the connection of like, is he to, you know, sometimes employers do upskilling of their incumbent workforce of their workers, you know, they provide a chance to continue to train their workforce. So that's obviously one way to help, you know, increase the skills of older workers, I think the other is have a training system that when someone's between jobs, they can get that skill to get the next job. I think the the lower wage and of our economy, there is a structural problem with our job market in the sense that wages have not kept pace with inflation, and cost of living, driven in large part by housing costs. Therefore, you know, even with little increases in the state minimum wage, pretty hard to live on minimum wage in Orange County. And so it's hard not to list among the top barriers to your barriers, question. wage, wages are inadequate, at the low end of the job market. And there's a kind of a, I think, a denial of that, in that, like, people don't want to see it right in front of our face, like, try to live in Orange County do a budget for me, in Orange County on minimum wage, on $1, above minimum wage on $2 above minimum wage on $3 above minimum wage. And if you're an older adult, then you have additional maybe additional costs, and now you have other health needs. And I think there's this notion like oh, yeah, you're going to be in your 20s and you'll have that entry level job. And then you'll you'll go up your career. So I think the barrier of wage stagnation wage pay the current pace of wage growth. And the structure of our new job market, of who is in low wage work is problematic is a barrier. Well, you increase the minimum wage, you unionize and create, you know, worker organizing increase wages and working conditions, you know, or the job market responds and says, We need to increase the wages. I welcome it. Sorry, no, I'm the one being interviewed. I can't turn the questions on you. I mean, healthcare access is not as much of my expertise or agency's expertise. So I might have to say, like, I encourage, you know, bringing in those interviewees who in that sector, which I'm sure you are doing. So I kind of don't want to speak at a turn for that. I mean, I think they're, it's complicated to navigate. Health, the healthcare system is confusing. Because I'm like, I'm not gonna go to my doctor, I don't know which doctor to go to, I don't know what is covered, I'm confused about my bills, I'm scared to go in. Because I know my copay is gonna go up or my out of pocket costs are going up, I don't even know how to understand. And so I think the confusing myths of our healthcare system, which is not something we'll solve overnight, I'm afraid is like, is part of imagined, as an older adult is trying to access care, they might delay going to the doctor, they might be nervous to be delayed doing a procedure because they're like, I can't afford it. And therefore their health suffers and is ripple effect. So if it was easy to navigate, and there was less uncertainty around what the cost would fall in on to people post insurance, then I think they'd have a healthier, older adult population because they would more freely access care. And of course, the quality here is probably really quite good. In Orange County, great hospitals and doctors in that system of care. And yet, I think there's not so easy to freely access at all. Always. So yeah, so access issues, cost and complexity come to mind as barriers."]
+[-0.36221712827682495, -1.6306333541870117, "Short answer yes. I, yeah, it's hard to know, like how to tackle that question. So as it relates to race, there is structural racism in our job market and in our society. So if you look at wages, they are their equity issues there. We look at employment rates, it is not the same across across all those demographic groups. So I guess starting with race as one of the equity measures are our factors. That's a concern, that if that impacts everyone that impacts older adults, as well. So that means lower wages, higher unemployment. So there's a lot of data on that, in terms of you know, for you know, what, what, what a what a white man makes in the economy compared to a black resident of Orange County, for example. So, I don't have the exact numbers at my fingertips. But to your question of like, Are there issues that are more exacerbated that that are unevenly fall across older adults that that comes to mind first. As much as homeownership rates. I don't have those at my fingertips either. I think on healthcare issues, there's there also, you know, equity issues around rates of illnesses and as well as access the life expectancy. So yeah, so I think there's there multiple, like systemic issues around race at racial equity, gender, that and probably disability and ability status to that one and that impact older adults, as well as people across Prosser society. Are there more, you'd want to know."]
+[2.870478391647339, 4.941690921783447, "Um, they were just examples. So you didn't have to hit all of them."]
+[0.11329632997512817, -1.4205154180526733, "Well, I mentioned earlier, just the kind of stigma issues around older workers, and there's something that we observe and that our clients kind of reflect back to us clients is the term we use for the individuals we're serving. And they, you know, talk, they have the feeling and perception of of being at a disadvantage and being overlooked. Maybe getting an interview. And then once they do the interview, it's like, they're they they perceive judgment around being too old for desert candidate. That shows up how, like, we put our resume together, and they don't want to look, you know, reflect their age, or years of experience too much. So, so yeah, in terms of how they're treated in the job market, that shows up. In terms of other biases, that we see a chrysalis, I mentioned that we also serve individuals who have been impacted by the criminal justice system, that means they may have a misdemeanor felony, and a prior prayer record. And even with changes in kind of fair chance hiring laws, obviously, that that still does impact their experience in the job market and housing market. So, you know, as it relates to your question of like, are different subgroups. Yeah, you have the you have the overlapping factor of age discrimination mix with racial bias and inequities mixed with gender bias mixed with so they're very intersectional cross cutting things that are happening all simultaneously. I mentioned, housing is one of my three things, obviously, like so if you're trying to apply for an apartment, and you have something on your record and the landlord is doing background checks. It can be harder to get an apartment so that you know, and then who has records, there's a lot of data that that reflects who law enforcement targets and what who gets, you know, caught up in the criminal justice system, and then who ends up in our program and we're trying to get a job through chrysalis. So So yes, is the answer to the question. Yeah."]
+[-1.4738141298294067, 0.6688241958618164, "Thank you. Now, again, related to economic security, housing and health care access and delivery. What do you suggest is the best way to address the needs or the issue"]
+[-0.28930407762527466, -1.5115472078323364, "So I mentioned earlier when you're talking about barriers, cost of living and wages. And so I would say one is better wages. Again, in some ways, it's simple, like better wages and lower cost of living, especially housing and health care. So there's just a budget balance sheet there that can kind of simplify the the first answer. But But I would say that's where I'd start. Yeah, I mean, in terms of, you know, employment, as one of the issues, you know, are there investments, like I said before, and like skill, building opportunities to make sure the workforce can adapt. And as they get older, to how the workforce has changed, you know, he finished high school or college, and then, many years later, you hit age 60. And I say this as the employment service provider, so I don't mean to sound self interested. But I think, you know, we're one one program but I think across the county, are there resources to help older adults upskill reskill, you know find new jobs in a way that that meets their needs. In particular, that that comes to mind. So I then I think, yeah, what kind of housing and health care again, like I know, less about exactly how I would address those issues, other than make them more affordable. And that maybe means, you know, work with those experts to help answer exactly the how, but maybe it's, you know, navigating the healthcare system could be helped, I spoke to the complexity issues and acts as access as a barrier. Maybe we need more. Especially for older adults, assistance, health care, navigators, maybe some like that a community health worker is a model. That's, that's been utilized as a way to kind of maybe have peers, other older adults that could help the, you know, accompany people to a doctor's appointment, that kind of thing, just like navigating healthcare. So those kinds of things come to mind. It's good. Okay."]
+[3.586146593093872, 4.249301910400391, "So now it's gonna be another list, natural thing list. Just preparing you."]
+[2.6060538291931152, 4.1793341636657715, "Good question. And I don't know if I feel like I'm definitely I'm necessarily an expert enough to give you precise rankings on those things."]
+[2.427483081817627, 4.633212566375732, "Because your experience again, in your in your work, yeah, work."]
+[-3.1525609493255615, -0.042688991874456406, "So I would say, All right, yeah, maybe, maybe let's go down the list a little bit. And I'll kind of you don't have a scale system. They're just like, alright, so geriatric care, I think was the first one. Right."]
+[3.7014620304107666, 15.078448295593262, "Yes."]
+[-3.19254207611084, -0.41677722334861755, "Yeah. So I mean, I think in some ways, we're working with individuals like Chris Lewis, who are job seeking, and they're, they're not necessarily when I think of Geriatric Care. I think of maybe someone who's either retired or maybe not in the workforce. So it depends on what level of Geriatric Care I guess you're talking about. Okay, could have a definition problem there, but I would say, we don't see. See that see individuals accessing that As much as I couldn't speak to like how good or bad it is,"]
+[-3.5441808700561523, -2.0445053577423096, "and then in this case is it can be working older adults is just anyone 60 years and older. So basic"]
+[-2.7306573390960693, 0.17420226335525513, "health care for people 60 years or older that that care. Okay, I was thinking there was some other definition. Yeah, I would say mid level ranking of adequacy or that, that that question then that what's"]
+[-1.1525284051895142, -4.184576511383057, "Yeah, my impression is of long term care is that if if you have wealth and long term care insurance, and like, basically, there's a probably a very big gap of how people in Orange County experienced that, depending on their wealth and income, and that at the lower half of the, of the wealth and income distribution is not great. That's my impression would be that I would say, great if you're wealthy and maybe lower level in terms of how good it's meeting the needs of older adults."]
+[-1.9427562952041626, 1.2643935680389404, "And then mental health, behavioral health, and"]
+[-2.216620445251465, -1.2370936870574951, "so I think, perhaps better than five 10 years ago, but but I would still give it a a mid to high, I think, you know, Affordable Care Act, and those kinds of changes in parity across you know, kind of physical health as well of behavioral mental health, somebody has helped some, but I think the systems are still adapting, and they're still gaps. So I would say better, but a mid grade on that one."]
+[-0.31954795122146606, 0.532026469707489, "Last few minutes, social services."]
+[-0.5397490859031677, -2.093224287033081, "Um, I think there definitely is room for improvement. They're both on like, you know, access to everything. Human Services are very broad, obviously. And we fall and Human Services. But but so I, you know, I also think of entities like the county and access to CalFresh, or access to other social services. And I think, there, there definitely could be improvements there both in capacity as well as like, outreach. And you know, service levels, like, for example, the percentage of older adults that are probably eligible for CalFresh. And that could help their budget and their food access, that are that are not accessing that benefit is probably pretty high and looked at the numbers in a while. And we'll try to help our clients access things like that. And yet, broadly, you know, human services could do a better job of helping for vulnerable older adults access that kind of benefit."]
+[3.795194149017334, 5.478918552398682, "Thank you. Now, last two questions. I know, we have five minutes. So,"]
+[0.42873653769493103, -1.4305940866470337, "I mean, I get I'll get any, anytime you look at the demographics of our aging population. The challenge is that older adults in the next 10 years will be part of that swelling, of, you know, ageing, workforce and population. And so it there's risks for cuts to federal programs and Social Security or other programs that because of that demographic shift nationally, just like zooming out, not just Orange County there's there's risk there like resources shrinking as just our nation digests that generation, that that that ageing of the population. So if if they're cuts because of that, because they're they're one of those, you know, aging population, then there's there's risks they have to experience those cuts. That could be true, again, nationally or state or local. I think if you look at the pace of the gap in housing affordability measured and like, do we have enough units of affordable housing and Cal According to an Orange County, there's a sizable gap and the housing production is not keeping pace. Including, yeah, like long term care are different as my needs change. So, yeah, I felt a little broken record as I come back to like, housing affordability and access to jobs and and the economics and poverty. That's, you know, if we have a, if you look at the next 10 years, yeah, that's where my mind goes."]
+[-0.6593213081359863, -2.7684166431427, "So broadly speaking, so the answer differs on like, what the City of Anaheim asked to do versus the county versus state. But just using that term government broadly, like, all of these issue areas, the ones we've talked about a lot, because I've listed them as what my three and the ones I didn't, we didn't talk about, you know, the government plays a role. And some of them are, are more general to the if you improve the housing and mobility situations, and you help everyone. But you also are addressing the needs of older adults. So some of them I think, are great because they can speak it as having a good healthy community. And the role of government plays is things like building parks, like I mentioned, parks, as one of the things not explicitly on this list, but typically, the government is the one kind of going to build a park, not, you know, some private corporation. And so therefore, if they do they create a space for social interaction and for exercise and for improved mental health, and for that has health ripple effects, you know, you create jobs by someone else to manage to, you know, help the park exist. So I guess that's cop out answer. But I would say to your question of like, the government plays a role in addressing all these needs. For sure."]
+[3.299104690551758, 6.010690212249756, "Oh, yeah. That was last question. Yeah."]
+[1.2797781229019165, -2.4862220287323, "So, my mind first goes to issues of homelessness. Because I know that obviously, there are resources and those focused on the issue of homelessness, if you look at if you talk to anyone that is studying that issue, and looking forward there nationally, nationally, but in Orange County to that is the fastest growing group of older adults experiencing homelessness. And I think it's not being overlooked, but I think I don't see necessarily a clear vision and plan for making sure we're ready to serve the population that will we'll see more and more individuals who are in that older demographic and experiencing homelessness. So that's what comes to mind first, I don't think they're again, they're not overlooked completely, but I think there's there needs to increase the look. And then you know, I mentioned this issue of like language access and whatnot. I sometimes think that people who are immigrants in Orange County and in this older adult demographic group sometime was getting missed. So that that's easy to overlook that subset of older adults that are perhaps, you know, not being even reached, you know, because of language issues, or just they're in another part of communities that aren't be outraged in."]
+[4.660800933837891, 3.4008076190948486, "No, no, I think it was a it was a good a good interview and good questions. And I think I'm curious again, as I try to answer them what my peers are saying in your interview. So I would love to get, you know, a copy of the report and the data to the extent that you share it with interviewees. So that would be about one request is gonna happen."]
+[4.6967620849609375, 3.1813652515411377, "This concludes the interview. Thank you so much for your time, you have been incredibly helpful for our research. And if you find you have more to share, or you you know, like to give us additional info, please feel free to reach out to us. We're available on our website, you can reach me directly, or you can call our telephone line 949-415-6890. At any time."]
+[3.559499740600586, 5.225061416625977, "Awesome. Yeah. Let's meet you and research."]
+[1.5748858451843262, 1.1764044761657715, "Yeah, so we will definitely share the report. And I'm going to actually keep you abreast of the project. We have a newsletter monthly newsletter we send to everyone. So I'll include you just to give you progress. We're currently doing stakeholder interviews with about 100 folks. Expertise. Yes. So it's a big lift for our community health assessment. Usually it's about 25. But because of such diverse needs, and we're really trying to get a really a good landscape, you know, analysis. We are doing more stakeholder interviews, but next we'll be doing provider interviews, and then we'll actually talk to seniors themselves and their caregivers. So that'll come later in the fall season, but we plan to have the report completed and or whatever that may be whatever tool in the first quarter of next year. Okay. Timeline. Okay,"]
+[3.0603885650634766, 5.263845443725586, "so now we're not for a little while, but that's a lot that look forward to. Yeah, we"]
+[1.9937160015106201, 1.3887901306152344, "got a lot to do. And we got a lot of people to survey man, I think"]
+[4.813024044036865, 3.4650371074676514, "100 interviews like, Whoo, that's a lot. Yes."]
+[4.699082851409912, 4.7332634925842285, "Tim, this week, you close out my week, like, I'm, look, I'm done after this this like lunchtime. And"]
+[4.525042533874512, 4.547861576080322, "I don't want to be the one thing standing between you and your lunch. So, but it's nice to meet you. And yeah, please add me to the list. And yeah, thanks for the work you're doing. I was very thoughtful and look forward to staying connected."]
+[1.6932789087295532, 1.2890610694885254, "Yeah. And I think we'll I think we'll be connected for other projects or anything you that comes to mind for you in terms of data and data analysis, you know, you can always reach out in advance, we'll see. We'll be happy, happy to help. You know, with that,"]
+[1.3272767066955566, 1.166090965270996, "ya know, I don't know a lot about your organization. If I'm being honest, I'll check a website more, but hopefully, we'll have other chances to interact or cross paths. So"]
+[1.2261048555374146, 1.391025185585022, "yeah, definitely. Because we're, we're so we created the OC equity map. That's kind of what we've been most notable."]
+[2.186060905456543, 5.7007975578308105, "Okay, so I definitely have seen those that are that whatever product."]
+[1.1265454292297363, -0.40282291173934937, "Yeah. Cool. So that tool we definitely use to support folks with employment and, you know, property, like you said, and economic, you know, insecurity. So, yeah, I mean, if there's anything else that you feel like could help you all in your work, you know, we're happy to help."]
+[4.61835241317749, 4.675095558166504, "Yeah, awesome. Well, it's great to meet you. And yeah, enjoy the weekend. You too. Nice meeting you as well. Thank you. Bye bye."]
+[3.411790370941162, 5.4583587646484375, "Okay. So so we'll start"]
+[-2.4728844165802, -3.4584341049194336, "off, we'll go over the questions for the interviewer right now, the primary goal today is to identify that the needs assessment that you think are the most important to the older adults, the older adults or user, those who are 60 and older, we want you to think as broadly as possible team taking into um taking into consideration the older adults, caregivers, families, and their communities. So I'm going to share my screen so you can see a list of common issues and concerns like that are impacting the older adults. So I'm going to go ahead and share my screen right now."]
+[3.4119415283203125, 6.908693790435791, "I can."]
+[3.9223825931549072, 4.937551021575928, "Okay, so please take a few minutes and go over the list and let me know when you're ready to begin."]
+[4.752580642700195, 8.027466773986816, "Okay, l will do that."]
+[3.5915727615356445, 4.209475994110107, "Okay, I've gone through the list. Okay, good. So,"]
+[-0.48039066791534424, -3.9610159397125244, "we're going to go over the questions, the follow up questions will be based on this, on this table. Okay. So thinking specifically about older adults in Orange County. or engage"]
+[-1.879960298538208, -2.7187821865081787, "Okay. I think it has to do with by belonging to different organizations. And that sales organizations are all older adults. So I get to interact quite a bit with older adults, because we all belong to different organizations like the Carolinas, boards and foundations, etc. So it's good because being in a community service type, arena like that, it gives you an opportunity to interact with older adults and also share each other's cares and concerns."]
+[-0.4489407539367676, -3.7970287799835205, "Yes, basically, your role and how you engage with older adults. Yes. Okay. Yes. Um, so now thinking about Orange County and locate the least of the common issues and concerns that are on the table that impact all the older adults."]
+[2.607694625854492, 8.7655668258667, "Ah"]
+[2.321476697921753, 4.783996105194092, "I can't think of anything. No, I think it covers a wide variety of  concerns so no, I don't think there's anything missing. Okay, perfect. Um,"]
+[-2.6071293354034424, -0.10863027721643448, "Question under cancer, those are the only three because I also have skin, skin cancer and an exposure to prostate cancer. Yes, I can include that. So that would be one of my major concerns. Okay."]
+[-1.528416633605957, 0.6009519696235657, "Another one would be health care access and delivery. Okay."]
+[-1.7936292886734009, 0.7212979793548584, "And probably disability with a third. Thank you. And so for the next questions,"]
+[-2.5695531368255615, -0.10774920135736465, "I will ask you for each of the needs that you just mentioned. I'll ask this all the other questions. So first, I'm going to ask the questions, for related to cancer. Yeah. So so when you think about cancer"]
+[1.8381128311157227, 7.2611494064331055, "how"]
+[-2.6853535175323486, -1.8204797506332397, "and why are our older adults struggling with this with this issue."]
+[-2.6672556400299072, -0.18891485035419464, "For me, it's because I have a history of it in my family. So for cancer is a major concern. Especially these two, which would be the skin cancer and the prostate. And the prostate is directly linked to my service in the military. So that's why that would be a leading concern for me was that the would answer the question or no."]
+[2.290165662765503, 9.523458480834961, "Yes,"]
+[2.3658156394958496, 5.816928386688232, "this can you like be explained a little more about"]
+[1.8577643632888794, 7.260002613067627, "how"]
+[-2.90311336517334, -0.6350012421607971, "Yeah, I think it's, it's it's really prevalent today. And I think it's the more cancer I don't ever remember growing up to hearing a lot about cancer. I think in the last maybe 10 to 20 years. It's become more prevalent and only because of environmental concerns and things like that and and just having family members that have gone through it. So to read that, that's why it's become a major concern, I think for us older adults. Okay, thank"]
+[1.5715898275375366, 7.147122859954834, "you."]
+[-0.12188397347927094, 2.413337230682373, "What kind of struggle a barrier"]
+[-2.6523497104644775, -0.20290277898311615, "Well course treatment would be the, to me the most concern. I think today luckily, I think most cancers are treatable if they're caught early. So the other one is probably the other one would be a diagnosis, making sure it can get the proper diagnosis and catch it early enough. Okay,"]
+[5.609105587005615, 5.974192142486572, "thank you so much."]
+[4.097163677215576, 7.125916004180908, "Oh, sorry. It's a screen froze for a minute."]
+[4.346977233886719, 6.497756004333496, "Sorry. Yes, of course."]
+[-4.113518238067627, -1.9570555686950684, "Ah, boy, yeah, I would think there would be different differences only because I think of the environment that we're in it, and also the accessibility to health care. And I think some, some diseases like cancer are also there. They're certain like me being Irish, I have very light skin, so I'm very susceptible to skin cancer. So I think there are different ethnic and environmental causes that affect different groups of older people."]
+[7.046308517456055, 6.084716796875, "Yes, thank you for sharing. So what would you suggest is the best way to address"]
+[-2.561544895172119, -0.27991241216659546, "Well, for me, it's, it's getting regular checkups. And because of the ones I'm going through, I get checked at least every six months for skin cancer, and I get a PSA check for the prostate, every six months. So I think you have to stay on top of it. And anytime you detect something like, I've got a little thing, mole on my Leg gonna have taken off next week, you've got to be able to immediately cease if you've seen something in the old thing and say something. So as soon as you see something like that you need to get to your doctor and make them aware. that's good. Thank you."]
+[-1.65874183177948, 0.5766152143478394, "So now we're gonna move on to the second need that you mentioned, as we're gonna move through health care, health care access and delivery. So I'm gonna go ask the same questions for this, for this need."]
+[-2.254398822784424, 0.1876816302537918, "Means the main thing is, is the type of health care plan that you have. For instance, I have I have united healthcare. I've had it for 20 or 30 years. And I really think that the different health care plans really affect things such as cost availability, you know, getting appointments and treatment. And so I think that really is all about what health plan you have, and how accessible it is."]
+[-1.9631935358047485, -0.3628042936325073, "Well, I think one of the one of the barriers is just the availability of health care professionals, I think, I know where we have a shortage of nurses, for instance. Getting appointments sometimes can take take a while. Because what I see is that when I go in a doctor, a doctor certain Doctor schedule is not available maybe for a month or two. I read that just because of dealing. I mean, let's face it, the population that's going to be the majority is going to be old. And that means a lot of people seeking health care and And I think one of the barriers is just being able to get into see a healthcare professional as soon as possible. That's not always possible to do it. Like I can't call today and get in tomorrow, I'm sure it can. Unless it was a life threatening emergency, then that's a different thing. That's a big barrier. Thank you."]
+[-2.189833164215088, -1.2539361715316772, "Well, actually, I can only really talk about myself. I think I've been very fortunate that I've been able to have pretty good access. And, and when I needed to, I was able to get the care I needed. So I can't really talk about any other type of groups of people. But myself, I've been actually very, very happy with the care and access that I've had."]
+[-1.4891023635864258, 0.5609936714172363, "Yeah, what what do you suggest is the best way to address healthcare access and delivery."]
+[-2.1234211921691895, -0.287919819355011, "I think it's really important to understand the axis of how you go about doing that. For instance, I know I have to, when when they doctor find something, I have to put in a request for a treatment. And I know that, that I have to request that to be sure that my insurance company pays for it for one thing, and then the other thing is to said I get A a timely response as far as being able to take care of the situation. So once for, for instance, I had an MRI on my knee, because I was having some knee problems. So they found out the possibility that, that once I've had the MRI, the sorry, I had x rays on that. And then once they, after the X rays, I had to go and get a consultation of what the X rays showed. And then I if there was any treatment necessary, I had to get a an approval from the healthcare to get that treatment. So I think it's really important to understand how the system works, to be able to get the best access."]
+[2.9788618087768555, 4.418073654174805, "Okay, thank you for sharing. Now we're gonna move on to the 3rd need that you listed."]
+[-2.723482370376587, -1.5992461442947388, "Well, I think as I said, I'm tied into a group of community service people that are all at my age or even older. And knowing that we have certain disabilities, for instance, vision, or hearing loss, or even cognitive decline. It it makes you aware of the aging process, I can put it that way that I myself have some hearing loss. My vision, they're, they're monitoring cataracts right now. But I think being around older adults, gives you makes you more aware and of what is happening as you age."]
+[-0.8492043614387512, 2.1702516078948975, "and what barriers exists to see an improvement and the area of disability and the need for disability."]
+[-2.720106840133667, -1.8604004383087158, "I think one of the barriers is ourselves. I think many of us are in denial as far as to where we go to have the same abilities that we had when we were younger. As we get older, we may not want to face the fact that we're losing our vision or losing our hearing or, or something is physically wrong. I think for us, we have to be realistic with ourselves that this is a natural aging process and things are going to happen. So if that makes sense."]
+[-2.5694591999053955, -0.8886377811431885, "Well, I think the thing is, once you do recognize and are realistic, that you are having problems with vision or hearing, you've got to, you've got to do something about it. And once you've taken that barrier away, you've got to go through the process. And let somebody know that you need to have your vision checked, you need to have your hearing checked. So I think it's, again, knowing the process of what you need to do to get take care of your health."]
+[10.622977256774902, 8.451355934143066, "Thank you."]
+[-2.18719744682312, -1.1439965963363647, "I'm not sure about other adults, I know people have different have different ideas about their health care system. And the access to it, and how they, how they're processing what they need to do. And I hear about that, but I don't know. It's it's a group thing other than it's just the fact that, again, facing reality. But as far as other groups are concerned, because I'm in a number of groups of older Americans, I know people talk a lot about, about their access and how they're what they're dealing with. Let's put it that way. So"]
+[3.3026039600372314, 5.483831882476807, "thank you. Moving on to the next question."]
+[-2.2711246013641357, -0.395555704832077, "I think the first step is basically to admit it, that you have one. And then once you've you've done that, do something about it. But also make sure that what you're doing is medically feasible. I mean, I know people that go online and look for cures. I mean, you need to talk to a professional and find out what you actually need to do and then follow their advice."]
+[5.489955902099609, 6.391300201416016, "Okay, thank"]
+[3.8399734497070312, 4.471027374267578, "you. Thank you so much for sharing. Now we're going to move on to the next questions. i We're now going to need the table. So I'm now I'm going to stop sharing my screen."]
+[4.571354389190674, 7.903327465057373, "Okay. So,"]
+[1.0046378374099731, 2.390294075012207, "You're talking about access,"]
+[-3.019113302230835, -0.17465579509735107, "How Yeah, accessible, how accessible and how I adequate the geriatric care is."]
+[-2.2089762687683105, -0.2510296404361725, "Um I think overall, I haven't had any really big problems of accessing what I needed as far as health care is concerned. And I've been very pleased with the different health care professionals I've had to interact with. I have a GMP who I've had for years and she's very detail oriented, very, very exact and her diagnosis and what needs to be Done. And I've never had a problem having access to her. So, overall, I think I'm very, very pleased with what I've been have encountered so far with the with the"]
+[0.7609445452690125, -0.8797541260719299, "system. I think so for my for my own self, yes. Good. Okay."]
+[-1.926193356513977, -0.8038207292556763, "Because that's, that's, basically, we know that somewhere in the next five years, over half the population, there'll be over 60, or something. So it's going to put a strain on the healthcare system. So I'm hoping that we have enough people that are going to get into the healthcare field, that's going to be able to take care of us, basically. So long term, yeah, I think it's gonna be a challenge to tell you the truth. Because if the healthcare system is not overwhelmed today, it might be on the verge of being overwhelmed. So no, I don't know if that portends Well, for the future. Okay,"]
+[0.9478254914283752, 2.153959035873413, "thank you. How accessible and how adequate the services are."]
+[1.0525296926498413, 1.8538222312927246, "I don't think I've ever had to use those services. So I'm really not sure."]
+[-2.094141960144043, 0.5201624035835266, "I know, I've seen. I know, there are organizations out there that deal with mental health and, and, but I go, I don't know too much about them."]
+[1.0783683061599731, 0.9176320433616638, "I've heard of them, but I don't even remember who they are, what the organizations are. Okay."]
+[3.4268696308135986, 5.682068347930908, "And moving on."]
+[-0.8448101878166199, -2.9538166522979736, "Again, I've not had any kind of interaction with social services at all. I know there are quite a few places out there where people can get social services and but I've never had to access them. So I'm not sure how accessible they are. But it seemed to me that that just based on the on the on the population of Orange County, I know there's a lot of need out there. Because I'm an organization that provides service to the community. So we're, well we're aware that there are people out there need and there seems to be a number of places where people can go to get that need satisfied. So okay,"]
+[3.354214906692505, 5.56263542175293, "thank you. Moving on now to the next question. Boy"]
+[-1.9954173564910889, -1.1775548458099365, "probably because of the population yet All right, it's gonna the challenge early I think is going to be to that the healthcare system remain accessible to everybody. It's it's just seems to me that we're gonna you know, I think COVID One thing COVID proved was that when you have any kind of a, a chronic disease like that, you the whole hospital overwhelmed and everything else and I think hopefully we won't have another thing like COVID But the problem again, as I said, that is that the, with the aging population, the challenge is going to be able to take care of everybody, no matter who they are or what they can afford or can't afford. And to me that that will be the biggest challenge. And I think part of part of the good thing that's come out of this recently is that people are more aware of things like COVID, and other diseases and how to prevent them and, and take precautions, I still see people wearing masks, which is good. So and and I think we're making more of a point about you being proactive with your health, I think that's, that's, that's gonna be a big challenge, people have to be proactive and take care of themselves, basically. And that's a challenge."]
+[0.10874215513467789, 3.407123327255249, "I think the challenge also is to make people aware of how the environmental effects are health. Because there are environmental factors, some you can control, again, that that have a big effect on our health. And we need to start paying attention to that. So the challenge would be to get that education out there to the population and make them aware of all the things they can do over the next 10 years to improve their quality of life and their health."]
+[5.610986232757568, 5.973462104797363, "Thank you so much."]
+[-0.6915671229362488, -1.5565721988677979, "Well, I think that programs that are that are government funded, need to continue to be funded. And also because of what we're looking at over the next 10 years, increasing the population, and we're probably going to have to increase the funding. And I think that's, that's something that we can help impact by staying in touch with our, our politicians and those that are voting for health care. And to make sure that the, that we let them know that that's a priority for us as older citizens, that we have that health care, not not cutting Medicare, Medicaid, or even social security, that all these are vital to the health and well being. So I think that's, that's it. Thank you."]
+[3.5345699787139893, 8.415359497070312, "Oh, wow."]
+[-0.1698984056711197, -0.876277506351471, "I think you know, it also has to do with social status and financial status. There are people that that can afford certain services, and there are others that can't they have to rely on on government funding or help from agencies. I think that that's something we we have to"]
+[-0.23630817234516144, -1.6014764308929443, "admit that not everybody is treated equally in the system. That different groups may not be treated the same as others. And sometimes they're treated differently because of their status or their or their wealth. So that's something we we need to be aware of, and really help the people that need it the most."]
+[2.0361123085021973, 7.525130271911621, "Like you. So what is the"]
+[-0.20295873284339905, -0.6897923946380615, "I think I think it's the people that have a lower income. That art, some of them because of the financial ability or cannot afford for instance If you take a look at medications, and the cost of medication, I'm sure there's some families that just can't afford it. I mean, when you're trying to feed a family and, and, and, you know, working three or four jobs, I mean, it's just horrible. I don't know how people can, you know, have big families today and survive, just it's just the cost of living and everything else is just as real are making it difficult for us to get exactly what they need. support their families and their health."]
+[3.4886720180511475, 5.54148006439209, "Thank you. So moving on."]
+[3.7586896419525146, 9.706856727600098, "Hmm, well."]
+[-2.5979464054107666, -1.6681607961654663, "I'm not sure. I think one of the may be the mobility issue. I'm not sure. I think that may be a big problem for some older adults who do have those mobility issues."]
+[2.3026297092437744, 5.47772216796875, "That's one I can think of, but that comes to mind anyway."]
+[5.442451000213623, 6.394092559814453, "Okay, great. Thank you. So"]
+[1.8457952737808228, 8.183159828186035, "now"]
+[-1.1876147985458374, -2.5275723934173584, "we're gonna go over some questions. Just in addition to what we already talked about. We're going to just go a little deeper in your area of expertise. Thinking about your opportunities to volunteer and engage across across all generations, what are some ways that is like, like, the opportunities to volunteer are working are now working for the older adults and parents."]
+[-1.128517985343933, -2.624093532562256, "I think the good thing is there's plenty of opportunity to volunteer"]
+[-1.1158908605575562, -2.584355592727661, "places like food banks or or even able to people, the Meals on Wheels, something like that. I don't think there's any lack of opportunity to volunteer. I think it would depend on on. And older people, I think have a, especially for my generation to have more of a desire to help people in need, and are more willing to volunteer. So I think things like food banks, probably a good one, to help people volunteer, and just wherever the opportunities are."]
+[-1.1664819717407227, -2.56858491897583, "And one of the things also being a volunteer. The other thing that begun, because I'm with Kiwanis is mentoring the youth of today. I think older people really love to give back to the younger generation, and share with them their experiences. And just I know I read to first grade class every Thursday. And I know a lot of people that I know go to the library and volunteer their time they're working with youth. So I think that's a great thing, because not only does it doesn't help the youth, but it helps the older person realize they still have value. And I think that's very, very important."]
+[3.083345651626587, 0.1278028041124344, "Thank you so much, and what new or revised policies are needed."]
+[3.298017740249634, 6.512014865875244, "Say that again, please."]
+[2.9972445964813232, 0.06380119919776917, "Yes, what new or revised policies are needed"]
+[2.6534390449523926, 5.903595924377441, "I'm not sure if I can even answer that one. I'm not I don't know."]
+[2.395310401916504, 9.398602485656738, "So this is yes, related to"]
+[2.8918914794921875, 0.07394514977931976, "this political like agenda. Let's see government policies or no,"]
+[2.9172143936157227, -0.010640542022883892, "policies that are related to opportunities to volunteer and engage across generations. Yeah, there are new or revised policies are needed"]
+[-0.6080548763275146, -2.2761459350585938, "I would guess, it's just I think it needs to be more, more awareness, and more. Publishing are those opportunities to let people know, basically, what can be done, and what help is needed. I think many of us may not know, in our own communities, what kind of volunteer opportunities there are. And I think that needs to be much more out there by these different organizations that need help."]
+[2.7252135276794434, 1.735534429550171, "Thank you, and who, or what entity is best suited to address the issue"]
+[2.7090847492218018, 1.7308825254440308, "of what, what what entities"]
+[-1.3155637979507446, -2.5856072902679443, "think you've got the organizations themselves need to need to let people know what's needed. And also, you have places like libraries and senior centers, and places like that, which operate and give seniors a place to go. But it also can be a good place to, to engage seniors in community service and, and, and giving them opportunities to do things in the community. So I think that the senior centers are probably a great place to to get get the word out there and also engage seniors."]
+[5.60703182220459, 5.968173027038574, "Thank you so much."]
+[-2.572488307952881, -3.053341865539551, "One of the things that that I, I find a very good source is AARP. Because they are specifically for older people. And they often i know i That's one magazine, I read cover to cover because it's gotten so much better relevant to, to seniors. And I think that's a very good source of for all older people to find out. Statistics, I give a lot of statistics, as far as health and things that you can do to improve your health improve your life. So for me, that's one of my main chores."]
+[0.04457985609769821, -4.116852283477783, "I know. I read the LA Times every day. So there's a specific column. There's a there's a one columnist that writes specific column on aging. His name is Steve Lopez. And I read that every day, every time he has a column I read. And of course, it's very relevant articles about what's happening in Congress. So the back seniors, different bills Legislation in California and nationally. So I think that's a good source to Great, thank"]
+[1.5834180116653442, 7.149822235107422, "you."]
+[3.7724082469940186, 15.488836288452148, "Yeah."]
+[1.4020403623580933, 1.131380319595337, "No, I think we're already our club, for instance, has already signed up to do a group interview, a group survey when it comes out in August. So the different service organizations around like the waters and the The elks and the rotary and everything. Those are great opportunities because most of those have seniors, as the majority of the members, so as I said, I know our cornerstone is going to do the group survey when it comes out in August. So"]
+[4.73836612701416, 6.162417888641357, "awesome. Thank you so much. I'm sorry. Yeah. If necessary, like for anything that"]
+[3.33225679397583, 8.692974090576172, "yeah, yes, that's"]
+[4.721648216247559, 3.561990737915039, "something else you can always contact us. So yeah, this improves the interview. So thank you so much for your time. You have been incredibly helpful, too. So like I say, if you feel like you want to share more information feel free to to reach out. So to a contact and also you can also do it through the website. Yeah, then please share it right now."]
+[-1.8780851364135742, -3.571274757385254, "Okay, great. So, in a minute, I am going to bring up my screen, I will share my screen with a list of common issues and concerns impacting older adults. And then I'm going to ask you a series of questions relating to this list, but the lists will stay on the screen. You don't have to memorize them. It's pretty comprehensive. But in thinking about the questions, we will be asking you, I would like to you to think about older adults as those who are 60 years and older. And think about them as broadly as possible, taking into consideration they themselves, but also their caregivers, the family members, and the community. All right, so let me share my screen okay, and you should be seeing a table one, which is a representative list of common issues and concerns. Okay, take your time and review this list and then let me know when you're ready. And then we'll start the interview. Okay, okay, great. All right. So thinking specifically about older adults in Orange County, for our records, can you please tell us your role and how you interact or engage with older adults. I do so in both my personal and professional career, so my personal career, I have a 88 year old mother who lives in a senior independent senior apartment community in Old Town orange. And so I I spend a lot of time with her and her friends and spend time taking her to her geriatric doctor and a whole bunch of other physicians and, and assist her with her transportation and food and caregiving and all of that. And then on my professional side, as city manager of Huntington Beach, I interact just in general with seniors. As for older adults, just as because they're members of the Huntington Beach community, and we also, as you probably are aware, we have a very active senior center in Huntington Beach that provides a multitude of services. So personal and professional life. I work a lot with older adults. Wait, thank you. The only thing that maybe can be added is and maybe it's implied or I'm not seeing it but is civic engagement. Okay, is how older adults engage with their local government or regional government. Great, great. Okay. So of the needs that's on this list, including civic engagement. Can you please rank the top three that you think are most important when it comes to older adults I'd say the top three would be housing economic security and Probably health care. Just kind of a tie for me of health care caregiving behavioral mental health kind of. Yeah. Okay. Yeah. Yeah, for sure. Okay, so for the following questions, we will take them, you know, one category at a time. And for the third category, you can broaden the scope of health care to include those other things that you mentioned. But let's tackle housing first, because that was number one on your list. I think as you indicated the population is getting older faster is getting older and it's getting older probably at a rate faster than the production of housing and land in Orange County is at a premium. And and the costs, even affordable housing is still very challenging for a person on a fixed income of Social Security. I believe, here in Huntington Beach, our average Social Security check is $1,700. And makes living very difficult for food and, and housing, etc. So. Yeah, so I think housing is just increasingly difficult. And I know, anecdotally that some seniors have limited choice to cohabitate with family members, as maybe family members have moved out of state or live elsewhere, but their, their social. Net is maybe here in Huntington Beach, and it's just, it's a real dilemma. I think part of it is the availability of public funds to help subsidize housing so that it's affordable housing. There's political concerns that urbanizing suburban communities is, is is that by building more dense urban housing may or may not be consistent with a community's vision for its low density. environment. There's always just barriers of whether the housing market in a local jurisdiction is such that it attracts housing developers. And then just the type of housing needed, whether it's long term care type housing or assisted living type housing versus independent housing, I think, just the the range of housing options that are needed, may or may not exist in a community or may or may not be of interest to the marketplace related to given jurisdiction. You know, particularly I'm thinking about as an example, disability status, their levels of income. I think generally, yes. People, people with Older Adults with lesser economic means may not have the resources to obtain housing for themselves. So we we see a fair amount of older adults and are in Huntington Beach's navigation Center, which is which is our shelter for individuals experiencing homelessness. And, and waiting lists are pretty long for affordable housing. And for housing options that take section eight vouchers and the like. So it's I think definitely economic means has a big influence on the the ability to attain housing. I, I can't really speak to I don't have firsthand knowledge about older adults who have disabilities. However, I would, I would assume it's it's a challenge. But I couldn't speak to it accurately. Think there's probably no one best way to address it. Certainly, the marketplace like existing housing needs to be more receptive to taking housing vouchers, market rate housing to take housing vouchers to to allow people of limited means to get into a stable living situation, I think building more housing that is appropriate for communities that's affordable is is another way to think encourage figuring out ways to encourage intergenerational households. As you know, as far as is a good strategy, I think, in some communities, the you know, the ability to have accessory dwelling units on in neighborhoods is a very beneficial to. to older adults. I know that I live in Old Town orange, and there's a lot of accessory dwelling units. And I know we have very good friends whose elderly father was living independently in San Diego but needed help and and so they built an accessory dwelling unit in their backyard, and now he lives on their property with them, but separate from them. So I think there's ya know there's many different tools in the toolkit that are needed to to address the housing needs of older adults. Yeah, yeah. So now we're gonna go over to the second topic that you raised as your number two item, which is economic security. Yeah. Well, I think I think the cost of living in California is, especially in southern California is not insignificant. And when when people have fixed incomes such as Social Security $1,700 A month like here in Huntington Beach, and our average apartment one bedroom apartment here in Huntington Beach is Between $2100 and $2400 a month, it is just very challenging. And so mobility in Huntington Beach is pretty good for seniors, because we, our Senior Center provides really, really great senior transportation. And, and so that's a really helps people get around. And I was, and there's, you know, there's programs thankfully for like Meals on Wheels and, and other other food related programs for that can provide a lot of nutritional assistance but I think a lot of it does come back to housing and and the cost of housing and then the the fixed income that older adults may be on. I think a lot of it comes down to housing costs, I think, I think seniors ability to increase their fixed income through jobs or, or other means may be limited and challenging at times. I don't have any specific reasons why except maybe distance from potential jobs or the nature of potential jobs may be such that are just maybe not a complete barrier, but challenging. Yeah, I mean, I just think the overall inflation cost of living macro economic factors, you know, our, our barriers and challenges economic security, medical costs, insurance, all of that. Yeah. I think in part, it's more more creative types of living environments that would potentially be less costly. So like cohousing type. of projects where people live in smaller spaces. There's communal, common areas, including kitchen, a single kitchen, and people. You know, it's basically like a cooperative where people take care of each other and work with each other. And it doesn't necessarily need to be mono generate or mono age groups, it can be intergenerational in nature. Yeah. Yeah. Okay. And onto the last of the three is health care in general. And you also mentioned caregiving and behavioral health as well. One is the insurance dimension, whether or not they have adequate insurance to to provide the care that they need. And whether or not they have an advocate or an ombudsman or a family member who can help them with their health care. I also think the virtual health care services, the TelaDoc type thing is a is a great blessing in many respects. However, again, I think, older adults, and I don't have any stats in front of me, but the familiarity with using technology related to TelaDoc type services I'm not aware of. But I would imagine that's a barrier to some, but it could also be a real, you know, could be a real blessing to many if you have their mobility options are limited or their insurance options are limited. Being able to gain access to healthcare, at least at a, at some level, virtually would be very appreciative. But I know with my mom's several times we've timed TelaDoc type services, and that's been really beneficial to her. But yeah, yeah. Yeah, so I mean, I do think that isolation is, that was something that is a challenge I know even with, with my mom, and we see her a lot, she's got friends, but sometimes I, I, I see that she has spent too much time alone. And that may just be six or eight hours, but I can tell that it has an effect on her and her forgetfulness and her ability to articulate and communicate because she's been silent for six or eight hours. So I think the notion of having you know, a regular being in a communal environment and and being engaged is is something that concerns me for sure. Yeah. Yeah. Yeah, I mean, I think like, I know, one of my mom's friends, she had Medicare. And that was her only. That was her only insurance and the type of care that she needed. She was having a really hard time getting because the doctors I think the doctors weren't taking Medicare or something I can't remember exactly. But she was having difficulty, I think transportation to and from many of my mom's friends don't have cars and whether or not they have family members in the area, at the time that they need medical care, that's, you know, that's always a challenge for them. So they end up kind of overusing one of their, one of their friends in the department who does still drive and I know that causes her a lot of stress to shuttle people to their, their appointments. So mobility is a big deal. The monetary side of it is a big deal. And and I also think that when the behavioral health side of things and know that there's been a few times where my mom has been visibly depressed, because it was like an anniversary of my dad's death or an anniversary of my sister's death. And and I talked to her about maybe having her talk with somebody, and she saw that because of I think, largely because of her generation, she saw it as a stigma to talk with a therapist or counselor. So that's, that's an issue. I think so. I mean, I think you know, people, people who have cognitive challenges, or mobility challenges, they may have a real may have more difficulties and getting access to medical care, the mental health care that they need. I think it seems that people who have good insurance and have family around to support them financially and otherwise can get better get access to better health care more readily. I do know that like I mentioned earlier, there's a couple of my mom's friends who barely had enough money to pay for the apartment that they in the building and they live they didn't have much leftover and and it was was very difficult for them to pay for transportation or what have you to for food, or going and getting medical care and a they often sacrifice their nutrition and then that caused a decline in medical care as well. Yeah. So what do you suggest is the best way to handle to address this need I think the degree to which there's models out there. So like, in huntington beach we work with be well, and we have the mobile mobile vans that will come to anyone's home, who needs any sort of support for their behavioral or mental health needs. And and I think that's, you know, that's part of it. Having more in home care is probably a beneficial approach. I know. My mom's geriatric doctor will send a somebody to the home to take when she needs to have a lab test, blood drawn for a lab test, because of my mom's age and mobility, and they'll bring the lab tests to her. So I think, I think just I don't have the magic answer. But I think the more that part of our, our community culture is that medical services can come to the people and the older adults. Whether it's virtually or in person, I think it's a it's a worthy idea. Much like DoorDash for food. Yeah, something of that nature. Yeah, I guess that would be called Uber doc. Yeah. Just that there's having my, my wife and I took care of her Alzheimer's inflicted mom, and then after she passed her Alzheimer's inflicted aunt over a span of almost 20 years, and we did have in home caregivers. But again, I mean, they, they, they had the means to, to afford those in home caregivers, and otherwise, it would have fell on 100% on my wife and me. Right now with my mom, I spent a lot of time every week, probably six to 10 hours. With, with my mom taking care of things at her house, taking her grocery shopping, you name it, taking her doctor's appointments. And we have we're trying to have somebody come in once a week just to help out. But it's you know, it's it's very expensive. And on top of the housing and a lot of I don't know how a lot of families afford it. Yeah, yeah. Definitely a big issue for a lot of families here in Orange County. Okay, so moving on, I'm going to ask you now about access and adequacy of different types of care services for older adults, has nothing to do with this list anymore. So I'm gonna go ahead and stop share."]
+[-1.4677189588546753, -3.9302122592926025, "Well we, my mom moved down here in 2017, from Arizona, and luckily, we had a family friend who happened to refer to us a wonderful geriatric doctor. And we had that doctor or up until present time, but she's retiring in July. So on my own, I really did a lot of searching for a geriatric doctor. And, like I went through Yelp and some others and I wasn't having much success. So I reached out to the doctor again, our our current doctor, and she pointed me to UCI's Center for my what's called senior medicine or something. And, by dumb luck, we got an appointment last week with a wonderful geriatric doctor who I know is going to take great care of my mom. But I will say I was frustrated trying to find a good geriatric doctor on my own. And I don't have a I don't have a good sense of there's a lot of Internal Medicine folks, general practitioners, but I don't have a good sense of the adequacy of Geriatric Medicine providers in Orange County. And, you know, if I was to generalize, I would say, it's probably not enough. Yeah."]
+[-2.366968870162964, -1.2345654964447021, "Yeah, well, so, you know, speaking just firsthand experience only working with both of the two geriatric doctors that I have, it's, it's as much about the adequacy is conveyed to me in as much about them understanding the unique health needs and the behavioral and mental health needs of seniors as it is, knowing what resources are out there. Or a whole host of tangential needs of older adults. So I've talked to I received resources from a geriatric doctor on everything from activity groups, for socialization to the Alzheimer's of Orange County hotline, so that I could get some support has taken care of my mom with her increasing dementia. So, you know, it's I use the geriatric help providers that I've been exposed to, I think the adequacy of the services as a provider are more than adequate."]
+[-1.9711886644363403, -0.40956541895866394, "I don't know if this is factored into your calculus for your mom yet."]
+[-0.9574369788169861, -0.8282033205032349, "Well, when looked at multiple assisted living communities, and, and I know that there's, there usually is a waiting list, but it's usually not insurmountable. In terms of time, the real issue is money. And some of them as I understand, May, if you run out of money, then you may be able to rely on Medicare for continuing on, but most of many of them are market rate, and they don't participate in the Medicare arena. And then, I do know that there's because our neighbors had had found a wonderful place where their father, small group home of I think it was, five older adults, and the amount of fixed income that their father had plus a little bit extra was what it costs or for him to live out the rest of his lifetime. And he was very happy and they were very happy with the care and so so I think there's, you know, and I'm just this is more anecdotal than anything that I can generalize, but I have an experience that there that there's a shortage of long term care, however, I would suspect That really depends on economic. The economic means of the individuals because based on our homeless population here in Huntington Beach, there's not an insignificant percent that are homeless that are that are older adults. Yeah."]
+[-2.1378960609436035, -0.28989043831825256, "I think generally, generally, I do mean, at least from my, my limited experience, I find the care seems adequate. I do know coming out of the pandemic, one of the communities I visited was pretty short on staff. And were they were really challenged by that. Yeah."]
+[-1.7050734758377075, -2.2055952548980713, "I'm really not sure about that. I am not sure if there is adequate services for older adults. I do know that. There there's, in like, our Senior Center here in Huntington Beach, there's counselors there social, social service, social workers there to support seniors in need, like I mentioned earlier, be well, we have to be well vans who will support in any way they need to people with behavioral and mental health challenges, including older adults. But I'm not, I don't really have a good sense of supportive services for mental and behavioral health at a county wide level."]
+[1.463084101676941, 6.488658428192139, "Yeah. Do you think"]
+[-1.252063274383545, -2.3538854122161865, "Here in Huntington Beach, I think it's fairly accessible, I think a phone call to the senior center will, will be will be very helpful to an older adult, whether it's for transportation needs, food needs, or to connect them with somebody who could be a portal into housing. I'm not sure that it's as easy in other communities Yeah, I just don't, I just don't have a sense of it. I think the friends at my mom's circle in senior apartments that she lives in I've seen them I've seen a couple of them really struggle. And they've never really mentioned reaching out to any, any mobility service or any food service or, or any of that to help them through their struggles. So I just I'm not sure."]
+[-2.4119341373443604, -3.579451322555542, "That's fine. That's fine. Okay, so now we just have a few questions left remaining in the interview. You know, thinking ahead in 10 years times, specifically in your purview as city manager for Huntington Beach. What do you think of the biggest challenge facing older adults in 10 years"]
+[0.6022190451622009, -1.9273079633712769, "I think we're, we're gonna need to make sure that that there's definitely more choices of housing in Huntington Beach for people to age in place. The cost of housing here is, is unattainable. And for, for, definitely for newcomers or for young college graduates or whatever, without support from somebody. And so I think housing is really, really important for seniors in the next 10 years. I think making sure that that cost burden is, is reasonable for a senior on fixed income. I'm, I think just continuing our transportation services we provide and probably increasing. So I think, I think making sure that sense of community is really important to focus in on that I am concerned that as time goes on, people and people may be more and more into these iPhones and, you know, maybe socially isolated, except in the virtual world. So making sure that the great opportunities of sense of community and social cohesion occurs. And and then, of course, just making sure that there is adequate accessibility that health care and mental and behavioral and physical health care."]
+[3.739849805831909, 15.461459159851074, "Yeah."]
+[-0.5518417954444885, -2.2514116764068604, "Well, that's, that's a challenge. Because sometimes I feel like the government gets in the way of where we create these incredible bureaucracies and make it more difficult for seniors and others to get the services that they need. So, I mean, there is a role for sure. And I think our our seniors should be our seniors and our senior members of the community and our members that have physical and mental disabilities and and should be afforded the greatest level of government assistance, so that they can have a basic minimum quality of life. And I don't know exactly what I mean by that basic minimum, but, but I certainly know that working families are you know, they're spending a lot of money just to make ends meet themselves. And so somehow, some way government needs to be involved in connecting seniors and older adults with with the supportive infrastructure that that they need to have a good good set of years during their golden years. Yeah, yeah."]
+[0.12352363765239716, -5.015079021453857, "So now thinking about all the older adults in Orange County, who is getting the least amount of attention"]
+[-0.3105083107948303, -0.6173207759857178, "think those who are who don't have extended family nearby thereby and those that don't have economic means to to sustain themselves."]
+[-1.031043529510498, -2.4151177406311035, "You know, that's a tough one. I mentioned civic engagement earlier. Because I sometimes feel that there's an incredible amount of value placed on our youth and making important public policy decisions. And sometimes I wonder if we're exerting enough effort to caretake our seniors from civic engagement and public policy standpoint. And just in general, I sometimes feel that they're incredibly vulnerable population, and yet they've dedicated so much of their lives to being productive members of this society that we're all a part of. So, you know, I That's a really tough one. Yeah. All right. I don't know. Yeah, I don't know. I think that's a good one as civic engagement for sure. Because I feel that a lot of times it's scams that are communicating with them, and rather than, and they're very cautious and leery about who they're engaging with. Okay, so we're ending our interview, I just have one last question for you. This is gonna be a tough one, too."]
+[-0.3426550030708313, -2.412930727005005, "Yeah, well, I am so impressed with Huntington Beach and all that we do in our Senior Center. Everything from travel services to social activities to loaning medical devices, canes Walkers providing meals on wheels, transportation, the matching creating opportunities to match people up with housing, just the list goes on. I'm so unbelievably proud of the city. With the services it provides, its seniors. I think we could in the improvement realm is I think we could do and I'm not aware that we have one and have been in this role for 10 months now. But I think we almost 11 months, I guess, I think we could do a like a the equivalency of a of a master plan or or elements in our general plan for our senior population so that we could thoroughly explore what we are doing and what we could be doing and what needs to be done by nonprofits and, you know, just connecting the dots, bringing up the level of awareness and connecting the dots to resources. Great, great. Great."]
+[4.34477424621582, 4.09464168548584, "Yeah, I think the get her name for you. I definitely think that you could talk to"]
+[0.6625182032585144, -3.3351283073425293, "Michelle yerke y e r K e. She's a social services supervisor with with our community and Library Services Department. And her number is 7143741521. Okay. She briefed me and, and just help help me. Kind of get a better lay of the land. In huntington beach and she's very, very knowledgeable."]
+[0.4378342628479004, -3.4630517959594727, "Great. Okay. Great. I will reach out to her for sure. Terrific. Terrific. Yeah. Yeah. Well, thank you so much for your time. It has been incredibly helpful to us. If you find that you have more to share or that you forgot to mention something, feel free to reach out either email or phone. We will take it whenever you have it to give. And in the future, too, you will be seeing us do community a town halls or meetings. It is really to just engage the community on this effort and really to get them to take a community survey. That will be later on in the fall. And I will be happy to share with you those specific results from Huntington Beach residents because we are set out so I'll be happy to share that with you after we're done. That would be absolutely wonderful. Okay, okay, you got it. So, thank you again, and I look forward to connecting with you for the community town halls. Awesome. Thanks for all your work to do. Okay. Thank you. Bye bye."]
+[-2.7029783725738525, -4.811834812164307, "Yeah. So good afternoon. Again, my name is Tohron Barnes and I'm a part of the advanced OC research team, a local nonprofit conducting the county of oranges older adults needs assessment. Thank you for your willingness to participate in this interview, and the purpose of the interview aside to define the needs of older adults and to gather insights from your expertise and experience. The information you provide will be used for the development of Orange County's master plan for aging. This interview will last approximately one hour. And with your permission, our discussion will be recorded only for transcription and note taking purposes, the recording will not be shared with anyone. And after transcription, the recording will be deleted. If you do not feel comfortable with being video recorded, turn off your camera while you phones though just that's a problem. And your responses are confidential, meaning that we will remove identifying information in the report that your participation is voluntary. You may choose to answer any question in part full or not at all. You might also withdraw from the interview at any point in time. I'm familiar with any terms I use, please let me know. I'll provide examples and definitions."]
+[5.332940578460693, 6.71352481842041, "Right. Thank you."]
+[5.279160499572754, 6.763606071472168, "Yes. Thank you."]
+[2.4238171577453613, 6.1712446212768555, "I do not know."]
+[-2.582066535949707, -2.965015172958374, "Thank you. So again, the primary purpose of today is to identify the needs that you think are most important to older adults. And that is those 60 and older. And we want you to think as broadly as possible taking into consideration older adults, caregivers, family and the community. So I'm going to share my so you won't be able to see my screen, huh. That's the thing that I didn't know. So I guess I can read them off to you. Because I have a list of common issues or concerns for older adults. And so I wanted to be able to look at that but I'll read them off to you and and then we'll proceed so we have Alzheimer's disease and dementia. We have behavioral and mental health, we have cancer. We have caregiving, we have communicable diseases. We have community and family safety, diabetes and obesity, digital divide, diet, fitness, nutrition, disability, economic security, emotional well being environmental concerns, and this is like drought, wildfires, pollution, emergency preparedness, health care, access and delivery, heart disease and stroke, homelessness, housing, pain relief and physical comfort. Personal Care Management, you know, again, hygiene, you know, ADLs, respect, respiratory conditions, tobacco use, transportation and mobility and unintentional injuries like car accidents and falls. So these are the common issues and concerns for older adults currently."]
+[-0.9057611227035522, -3.420612096786499, "Yes, my name is Denise Bennett aerobatics. And I am currently a Community Services supervisor overseeing Senior Outreach Services. I work directly with not only urban seniors, but within Orange County, not only their families, but caregivers, their support systems. And from there, we provide case management, we provide resources, as well as research resource linkage, and just to ensure that they're receiving the services that they not only qualify for, but that would really increase their quality of life."]
+[2.977569580078125, 3.859158754348755, "Thank you, Miss Bennett. And so thinking about the list that I did share verbally with you."]
+[1.02283775806427, -2.433812379837036, "You know, I am looking at it probably goes under housing or either that or behavioral health. But one of the big areas of concern right now is hoarding and individuals are, are in the community, not only Irvine but throughout Orange County, who are at risk of homelessness because of a hoarding disorder. Unfortunately, although it is part of the DSM five, code enforcement gets involved and we've seen this way too many times where a receivership is put in place and the senior is removed from their home with no plan of where they're going to be relocated to, that's part of our job is to assist the senior with not only, you know, connecting them with some nonprofit that could assist with housing on a temporary basis, basis, but challenges is most of the time, they don't get their homes back. And now, they're propelled into homelessness, living in shelters, trying to find, you know, any type of housing, not been a big, big issue, we're working with quite a few people that have gone through this, and one of them remains homeless, he's been homeless for 10 years, because his home was taken through the receivership process. And unfortunately, even though they sold the home, there was nothing, you know, he didn't receive any, any funds for that. So that's a one big area. And part of it too is that say, for Section Eight, the we have quite a few participants that we go into their homes, and provide caregiving tour service to them, because they're coming up for an inspection. And we want to ensure that they're able to keep their section eight voucher. And so through fundraising efforts through the city, we're able to pay for just the the light, you know, housekeeping, light cleanup, but if I don't know if you're familiar with already, but sometimes it's, it's more than just light housekeeping, it's really going through and contracting with an agency, which could be 1000s and 1000s, and 1000s of dollars, to help somebody you know, get their home, in the condition where if the inspector comes, if they pass an inspection, they keep their section eight housing, they stay housed. So I think that's one big area that I found as a gap in our community. Housing doesn't recognize that our housing division doesn't, you know, behavioral health, it goes through code enforcement, you know, so that's, that's an area that I feel that really can be expanded upon, because we're seeing it more and more. And now that we're going back into seniors homes after the pandemic, we're able to go back and do those home visits, we're finding more and more hoarding issues, along with of course, loneliness and isolation. But we are seeing that there are far more hoarding situations than we've had before. Okay,"]
+[2.5765273571014404, 3.9403507709503174, "thank you. Now, I'm gonna read the list again, because I want you to rank the top three."]
+[-2.8087031841278076, -0.9766232371330261, "I'm not gonna send it to you by email. Okay. Yeah, I'm sorry about that. That's why I hate that you can't connect on Zoom. But again, it's Alzheimer's disease and dementia is one behavioral mental health to cancer. caregiving for the communicable diseases five, community and family safety, six, diabetes and obesity seven. The digital divide. Eight. Diet fitness and nutrition nine disability 10 economic security, economic security, yes. 11 emotional well being 12 environmental concerns 13 health care access and delivery 14 health care disease and stroke sorry, heart disease and stroke 15 homelessness 16. Housing 17 pain relief and physical comfort 18 Personal Care Management 19 Respect 20 respiratory conditions 21 tobacco use 22 transportation and mobility 23 and unintentional injuries 24."]
+[-1.456457495689392, 1.3116472959518433, "Okay, top three homelessness emotional write it down emotional well being. And let's see the third one would have to be I think behavioral health. Okay, thank you."]
+[2.700087785720825, 6.809576988220215, "I'm now thinking about"]
+[0.5363740921020508, 1.1699391603469849, "the transportations up there, too."]
+[2.9909822940826416, 8.316954612731934, "What does that oh"]
+[2.2342381477355957, 6.474972724914551, "you know, I think I don't know. I think that's a tough line. Let's keep it the way I have it. Yeah. Go with your first intuition. Right."]
+[-1.4989922046661377, 1.2328104972839355, "Right. So again, homelessness, emotional well being and behavioral and mental health. Yeah. Okay."]
+[1.1568803787231445, -2.4064576625823975, "Well, going back to the homelessness again, I do see a lot of not a lot, but I have seen quite a few even Irvine residents become homeless because of hoarding. They don't acknowledge that there's an issue. And when I try to work with for individuals with the that experience hoarding behavior, they don't see it as a problem. And so for them to get assistance is very difficult, even going in and trying to clean up their home. You know, two weeks later, it is close to the state that we let that you know, it was in when we even first initiated contact with these participants. And so that right there, for homelessness, I do see that that's the biggest problem. Other reasons that seniors are homeless or remain homeless, is kind of goes to their their economic security or their economic situation where they can't afford an apartment, they were renting a room, that rooms no longer available for them to rent, they're living on a very fixed income, and trying to find any kind of rooms for rent right now is very difficult for seniors, and so that's, that is an area that have caused homelessness as well. We do work with those participants. And in we work with nonprofits, to pair them up. So at least a hotel voucher can be provided till stable housing, can be addressed. We work with, again, many shelters in the community, to serve a variety of different seniors with different situations. But I have one right now who just wants to live in his car, he's been provided housing vouchers, and he just feel safe in his car. And, again, there's a variety of reasons. But you know, I think I do feel that there could be more affordable housing units available right now, I'm sure as you know, that waitlist within within the county are could be up to 10 years for affordable housing, that's causing homelessness as well, when an individual is waiting for housing that they can afford, they can't find a room for rent, you know, they're there in their cars, we worked with property management that had available units. And we were able to they they had an opening, we were able to identify at least four finds within the last year, seniors who were homeless and be able to, you know, connect them with affordable housing. But that's, that's rare that it even that they even open up. And I think it's just because of those relationships that we've fostered with property management. And it's a second floor and there's no elevators. So first come first serve. And we're getting seniors in there. So we are seeing an increase of homeless seniors even within the city of Irvine. And again, it's it's a variety of mental health, lack of income, a very fixed income. And in the all these things are are not being addressed, whether it's their own, you know, by their own choice, or they don't feel that they have access to these mental health services, transportations a big one. So they all we I mean, your list was great. And they all overlap in one way or the other, which is, you know, pretty interesting. So that's why it was so difficult for me to choose just the three. That's the area of homelessness."]
+[-1.6735248565673828, -1.718035101890564, "Yeah, that's a great question. You know, coming recovering from the pandemic and being able to go back into the homes of seniors. Our team has seen an increase of loneliness and isolation that may have been present in the community before. But now it's predominant. We are finding that there are so many seniors who either don't want to leave their home. Even in our strategic plan, survey, senior said that, you know, they have felt an increase of loneliness and isolation since the pandemic. And you know, having, especially access to mental health services is difficult. It's a barrier for many participants when they don't know how to access services. They don't have the transportation to get to therapy. There's not enough therapists that will go into to seniors homes to visit them and you know, doing home visits. We are it, we have them sue the city ramped up our friendly Visitor Program. And I know the county has a great program through the Council on Aging, the reconnect program. But it's, it's still not enough there, there really, were looking at this, as well as how do we find those individuals who are isolated, we know because they're, they come to us through referrals, but those that are not referred, it's just really marketing to them, and letting them know what we do through the city and through the county, and through other partnerships, and being able to combat that isolation. And again, through through programs through rent friendly visitor programs, and just increasing those access to mental health services. And it doesn't help that many of the wait time for individuals to seek therapy could be months. And, you know, I know quite a few participants, we do provide transportation to and from their therapy sessions. But there are just a lot of barriers for individual receiving mental health services."]
+[4.228711128234863, 8.966961860656738, "No"]
+[0.8109421133995056, -2.226255178451538, "hoarding disorder, it does get worse as individuals age, it's not something that they wake up and they they start hoarding, but it's now it's issues that have not been addressed. And, and again, the biggest challenges is because many people who hordes don't believe that they have a problem, they don't feel that it's unreasonable. When we go into their homes, it behind, they will be very ashamed to let anybody in. But that's because they're afraid that people are going to move their stuff or take their stuff or tell them they can have their stuff. So they're, you know, that's, that's difficult when they cannot, they're not aware, they're they, they, you know, have poor self awareness of any kind of hoarding behavior. And so part of it is just educating them on what is hoarding, what, you know, what, what are the different levels of hoarding. And, again, why it could be such a hazard to our seniors, whether it's a huge fall risk, we you're not able to get out of the home, if there's a fire because of the blocked windows. And again, once code enforcement gets involved, code enforcement gives them violations and says you have, you know, three weeks to, to become compliant and remove this and this and this and, you know, have the egress available for staff or city staff code enforcement to come through that causes so much stress. And this is where I'm really proud of our team to be able to go in and help seniors navigate through some of these challenges when they do get those core code enforcement letters and maintaining compliance. Because once they though code enforcement letters keep coming and coming, they pile up, and it just becomes incredibly overwhelming for the senior. And that's not something that staff can work with a senior in a week and get it done. I mean, this is long term, it took a long time to collect all of their possessions. And it is not an easy process of being able to you know, go through their home and help them you know, tidy up, if you will. So again from that from that standpoint, it's really more of their lack of, of self awareness of what is hoarding and and that they even possess the behavior of hoarding"]
+[-1.7589027881622314, -1.511395812034607, "Um Well, I think first and foremost is just breaking down the barriers of how do they get to their appointment when they don't drive the stress of trying to figure out how they're gonna get there. We look at that and we have our volunteer driver program where we we train volunteers community by volunteers to be able to provide transportation to seniors for medical appointments, non emergency medical appointments. And so that is one barrier for individuals not receiving service is transportation. Once Once we break down that barrier, it's really working with individuals and self determination if if they're willing to receive the assistance, mental health services, being able to get there is one thing, but for them to be receptive of it is another. And we do see a lot of individuals like this one individual is telling you about is they will live in their car over getting any kind of mental health services, because there's that stigma of I don't want to receive mental health services, there is nothing wrong with me, I do not have a mental illness, and I do not need those services. So that is, that is one of a barrier. But really what we can do to to help this individual or individuals navigate through it is through education, and reducing that stigma of receiving behavioral health services, and really reframing it as you work for emotional wellness. It's not for, you know, per se, you know, mental health illness, it's really, really to promote emotional wellness. And so by by reframing that I do feel that we make a great connection with many seniors in the community. And through building rapport with case managers, whether it's short term or long term case management, we're able to educate participants on what resources are available, what services are available, and how they would benefit from certain services, including mental health services. That answer your question."]
+[1.6560064554214478, -2.3350653648376465, "Yes, No. Any of the barriers exists to seeing improvements with homelessness."]
+[3.7652814388275146, 6.4606828689575195, "Let"]
+[1.0473670959472656, -1.8112525939941406, "me think about that one. Again, I think, more affordable housing options, more shared housing options. I think one of the biggest things is we have individual seniors who have large homes in Irvine who are empty nesters, who could not only benefit from renting out a room to another senior. But with the city and code enforcement, I think you can only run out to one, you can rent one bedroom out not more than one. But those are barriers that are put in place when we're looking at even shared housing. The city of Irvine has a list. It's like an internal list of individuals who want to rent out rooms or if they have a mother in law's quarters that they want to run out. And they come to our resource center. And we have that list. The challenge though, is, again, they can't run out more than one room. You know, and if we don't take liability, so we do set up individuals who need a room and then who have a room to rent. And then we kind of step away from that. But there's just not enough right now there's not enough affordable housing for for families and seniors, for that matter. So I think increasing that opportunity, I know that the city of Irvine is going to be building more apartment units, and quite a few of each development is slated for very low income and low income and moderate income for families and seniors so that that's what we're seeing. But, but even then, they maybe have 20 apartments available and they're getting 1000s of applications. So the need is certainly in the community for more affordable housing, but also to if they if we can remove some of the barriers with the restrictions on property rentals. I think we'll be able to see more individuals being able to rent rooms throughout Orange County, but specifically the city of Irvine. Right."]
+[3.276953935623169, 6.432323455810547, "Then one more time."]
+[1.6777889728546143, 6.574955463409424, "I certainly believe so. Yes."]
+[3.342679262161255, 7.226198196411133, "If you want Yes."]
+[-1.725019097328186, -0.9300049543380737, "Well, for instance, an individual with a disability that cannot drive, they have far more barriers, to getting to places, whether it's medical appointments, a chore to you know, complete errands and chores, it's not as easy for them. And you have somebody that not only has a disability, but they're on a lower income scale, they can't necessarily afford the transportation. And so that definitely is a, you know, they puts them at a disadvantage over individuals that do have money for transportation, or that they can drive and they can, you know, are mobile, and they can get to their doctor's appointments and, and such. So there are some disparities, absolutely."]
+[0.8171760439872742, -2.2732436656951904, "Well, I think first of all, it needs to be recognized as as it is in the DSM five, where when code enforcement is going out and issuing citations, they're not addressing the mental health behavior behind the hoarding, they are saying it's a safety issue. And of course, absolutely, it is. But what's missing is that component of okay, they there's there's hoarding, and helping them understand what hoarding behavior is. And, and what we're trying to do with our code enforcement is, is pairing code enforcement with social workers. So social workers go out with code enforcement, that that the social workers are able to assist the senior in becoming compliant within the code enforcement. And that's, that's missing right now. And it's missing. I've even think throughout the county when I was with the Office on Aging, for Orange County health care agency, older adult services, I found that as being a clinician, we were called out when it was already going through receivership. And it was a little too late at that point. And so being pre emptive, and proactive in our approach, and as soon as could enforcement identifies hoarding, that, you know, social services social worker. With us, it's the city of Irvine case managers are called out to be able to do our best to provide resource linkage and services to these individuals before it becomes a bigger issue where they're removed from their home."]
+[1.1615970134735107, -2.7145779132843018, "Now, what do you suggest is the best way to address the issue surrounding homelessness for older adults in Orange"]
+[1.1676229238510132, -2.2567694187164307, "That's a tough one we are working right now with with be well, we are initiating a health and wellness office through the city of Irvine, that is really going to focus on mental health and homelessness within the community. And so we're really excited we have some stakeholder meetings, there is funding coming in not sure how that funding is going to be allocated. But it's it's a nice little chunk. And what we're looking at is what are the best ways to prevent homelessness. And I think that's where it's really initially going to start as homeless prevention. If we could work with individuals at risk of homelessness before they become homeless. That that is that's crucial. Although Yes, once they do become homeless, we do a we don't have housing vouchers at the time or at this time, but we are looking at how can we best serve individuals who become homeless in the city of Irvine. But again, that's something that a survey is being done, and it's being worked on as we speak and, and that's what the stakeholders are meeting to decide is what is the best way to offer housing to families and seniors who become homeless within the city. So I don't have much of what they've come up with on that. But I do know that they are working on it and really tackling homeless prevention, working with at risk individuals and, you know, hopefully that's our way of preventing homelessness. But once they are homeless, looking at how to to rehouse them in into safe, secure housing, stable housing."]
+[-1.24545419216156, -2.2376415729522705, "You know, that one is interesting, because again, for, for me, going out into the community, we have seen so much an increase in in isolation, what we have started doing is increasing our friendly Visitor Program, we implemented compassion calls, where we're providing individuals weekly calls with trained therapist, just to kind of, you know, check in see how things are going through that we do have individuals who have experienced suicidal ideation. When that happens, we're calling the police and the CAT team out immediately to respond to any kind of, you know, after we do a suicidal risk assessment. But again, I think being in contact with these individuals, and being able to educate them on what's available, even those that just feel lonely, we're getting them taxi rides to the senior center to offer offer, not only a nutritious meal, but socialization as well, whether it's socializing through the eat through the meal, you know, eating meal process, but also with the health and wellness activities and classes and education seminars that we hold at all three senior centers. And so that's one of the things that we implemented, it's just about those taxi rides, to be able to get individuals because a lot of what we're seeing is individuals who are isolated, lonely, because a large portion of them don't drive. And whether it is they drove before the pandemic, and now they don't, or they've had to give up their license, or they couldn't get it renewed. So working with that, and again, making sure that we're breaking down the barriers, to allow them to be able to, you know, to engage in social activities, is a big key for us. And so, again, that's one way we've is by offering that free transportation service. keeping in contact with them, keeping them engaged, one of the ways we're thinking is if they can't come to the Senior Center, how do we bring the senior center to homebound seniors who are experiencing isolation, digital divide is a big one as well, where we do go into their homes, and teach them how to use Zoom, maybe load zoom on their iPad, their tablet or their phone. That way they can connect with their families, and it's not a phone call, they get to see their loved ones. We did that through the pandemic. And we're continuing to do that now. In fact, our case managers go out with an iPad to every single home visit, to be able to offer if there's any kind of you a training that we can do to help them engage with technology and feel more comfortable with using Zoom. And but also on the same token, I know there's going off but teaching them the safety features of you know, learning technology and and what is phishing, and what to look for, for scams and an email. So we do teach them the really cool aspects of technology and, and trying to combat isolation, but we're also giving them those really important, important education. Talks, if you will, on just the safety of technology, we do see a lot of isolated seniors, when they do get those phone calls saying that, you know, they won some money and that they, you know, they're really excited for this senior because they want $450,000 The only thing they have to do is, you know, give us the good pay the taxes up front, we see that a lot. And we do see the isolated seniors falling into falling victim to these scams because these criminals on the other end are so good at engaging the seniors, especially the isolated ones, building their trust, and then scamming them for money. So, again, trying to engage them, but also educate them."]
+[-1.4589028358459473, -1.6641231775283813, "You know, with our health and wellness, I'm really excited to report that it is, it is focused on mental health, mental well being, and homelessness and, you know, prevention, homeless prevention. And I think now, they're really, and I'm saying they, but for me, my experience is the city is looking at at this saying, you know, this, this is a big deal in our community. Mental health does exist, but really reducing the stigma. So individuals feel like they can receive the assistance that they need. Partially to its cultural, there are quite a few cultures in Irvine is incredibly diverse. But we work with many different cultures that view mental health in different, you know, aspects, where some cultures will say, Absolutely not, I will I do not want to talk to a therapist, I will not talk to a therapist, where others are saying yes, in fact, we need therapists at the senior center, because we would like to go and talk to someone once a week or, you know, twice a week. So, with that, it's just education and reducing stigma, by reframing the services and, and, you know, reframing it, you don't have, it's not about mental health and mental illness, it's about, you know, really the emotional well being, you know, so I think that again, the city is doing an outstanding job, I know that, that working with the county, they're also doing a great job on of supporting even nonprofit organizations to provide counseling sessions, therapy sessions, to individuals, from all different cultures, speaking a variety of different languages. In fact, we have contracted language service where if we're working with an individual and they're experiencing, you know, maybe they need a therapist, and they're reaching out to us because they want our assistance. But language is a barrier, we use our translation services. Although we do have staff, case managers who speak Korean, Mandarin, Cantonese, Farsi, and Spanish, we still offer services in other languages to ensure that language is never a barrier for individuals receiving the assistance that they are in need of. So again, you know, breaking down that stigma, reframing and education educating individuals on on the services that are available."]
+[-3.1453635692596436, -0.4123603105545044, "You know, from my experience, I do find that individuals have access to geriatric care. Don't I don't see. I mean, yeah, I'm not that familiar with this one, per se. So I don't know if my rating would be extremely fair. But what I have heard when we do work with individuals, that they do have access to geriatric care, and they, they do take advantage of it. And they're pretty happy with the medical services that they receive."]
+[-2.787583112716675, 0.05512823164463043, "And is accessible and adequate. Yes. How does long term care"]
+[-1.6903973817825317, -0.41012951731681824, "it's not not as acceptable unless you have money to pay for it. And that becomes a challenge. So that is definitely an area of concern. And that really does benefit individuals who have the means to choose not only a A great facility for long term care. But again, with the economic status, they're able to have more leverage on on where they're placed opposed to those who don't"]
+[-1.2114187479019165, -3.800483465194702, "know how accessible and adequate is mental health, behavioral health and substance use treatment in Orange County for older adults."]
+[-2.0701918601989746, -0.9451372623443604, "You know, the accessibility is an issue, what I've heard. And what I've seen, and what I've experienced is that there are long wait times for appointments, especially for individuals really needing services right away. The county has been really great and responding. When we call out for you, whether it's outreach and engagement, older adult services coming out to assist an individual. So, or even the CAT team, we've had great response. But it's just when they're trying to call for whether it's, you know, through their insurance, to access therapy sessions, the long wait times the long wait times, just to book an appointment, one individual waited well over an hour, and they just hung up. And so it's at that point, it's not accessible. And it's more discouraging. I see. From my experience in older adults, when you have all these barriers that I have to sit on the phone for an hour to make an appointment, I won't get an appointment until, you know, three weeks from today, that's as soon as the appointment and I need to find my transportation to get there. So those are a lot of challenges that make receiving mental health services, just not as accessible as they should be. Now adequate. Um, I think it could be more, I know, it could be more. It's, it's not adequate."]
+[-1.2959470748901367, -3.687311887741089, "Now that you know, of any seniors services or programs in Orange County that provide mental health support to older adults."]
+[0.9187240600585938, 1.3234565258026123, "Yes. Which is one area, but I'll have to get back to you some of the other agencies that we work with."]
+[5.573365688323975, 8.788732528686523, "Okay."]
+[-0.7073707580566406, -2.8323750495910645, "Um, you know, that one is a tough one. I don't know that I could. I don't know that I'd really be able to answer that one fairly. Because I don't have the experience with working with individuals. My team does, they would be able to answer but I would not want to give you an answer that is skewed because I heard you know, from one person or the other. So I'm not as familiar with that to be able to answer that question. Okay. But what I do know is that and I will share this. We assist individuals with applying for CalFresh. And we do work with individuals. And it's very successful. By the way, we we've had great success with assisting individuals with signing up for CalFresh IHSS. We do many times work with individuals in requesting an increase for services. So we are hands on when it comes to that. Very grateful for IHSS hours that are allocated to individuals. So from that standpoint, and through even MSSP we do have that experience and our team works very successful with those social service agencies. Okay."]
+[0.22112803161144257, 3.408855438232422, "Well, the biggest challenge I think will remain housing, affordable housing. Another one will will be transportation"]
+[-2.206352472305298, -1.4645512104034424, "I do believe though that mental health services are increasing and their access to mental health services will be greater that oh, that's a tough one. You know they will. Older adults will continue to And to age in place, I think that's, that's something that they're going to want to do. But I think, you know, maybe, yes, I might need to think about that for a minute. It's end of the day. I'm not as quick with my answers as I am at 9am. Yeah. Yeah, I may have to think about that when I think housing still going to be the number one issue, affordable housing that is,"]
+[5.593393325805664, 8.81335735321045, "okay."]
+[-0.6131026148796082, -1.7212668657302856, "Well, I'm really excited about the master plan for aging. And I think that's a step forward to doing that needs assessment within the community, and being able to meet those needs to fill in the gaps. You know, there, there is a lot of disparity with individuals, due to socio economic status, individuals who can afford caregiving, individuals who can afford Long Term Care, opposed to those who cannot. And even, you know, the have lost my train of thought, but yeah, it's like the day. No, I do see that, you know, equity, there could be a greater level. I do see, though, that even for individuals through through Medicare and Medicaid while trying to get any kind of long term care, that they're gonna look like reduce next year, they asset limit, which I think is going to be greatly beneficial for individuals, you know, to be able to receive long term care. So we're in a step to the right direction. But But first and foremost, I'm really excited about the master plan, I do feel that that is the beginning of something really incredible that will open up so many opportunities for older adults within California."]
+[0.10298581421375275, -4.987547874450684, "Right and thinking about older adult residents in Orange County, who was getting the least amount of attention."]
+[-1.2936015129089355, -1.627780795097351, "Those who are isolated to we and the funny thing is, is we know they're there, but we don't know who they are. And they're homebound. There, they're maybe not aware of the services,  There could be mental health that is preventing them from receiving services, or translation. Maybe language is a barrier. So those again, we know, we know, you know who they are, we just don't know where they are. We did a survey and quite a few people came back saying we had no idea that that the city of Irvine had social workers. And we don't know that until many times it's Irvine Police Department giving us referrals that we're meeting individuals for the first time that I've lived in Irvine for 50 years and had no idea about any kind of outreach services. So I think the main, the main point there is the marketing and reaching those that that don't know who we are, and they don't know how to access service. One of the things that we do through outreach services is assist individuals through the application process, whether it's through social services, through affordable housing. So it is our application assistance program that provides translation services, as well as other you know, services navigating through some of these challenging whether it's a website or even the documents that they have to provide for receiving services. So, again, it's we we just don't know, we don't know where they are, or who they are."]
+[3.290355920791626, 5.988191604614258, "Last question."]
+[0.9175922274589539, -2.2601137161254883, "I definitely think the hoarding is it's certainly in Irvine, but also through my experience with a county being overlooked is being really thrown in as a code enforcement issue and not any kind of behavioral health. And so it's being treated as such. And so I think that's, that's one big area that certainly is being overlooked. And I think it's just because how do you address something so large, you know, with there's really not funding allocated for individuals who are hoarding are on a limited income and, and can't, you know pay for somebody to assist them with the cleanup. So that's that's a big area that I would like to see addressed."]
+[1.4003816843032837, 6.27072286605835, "No, I think that's it."]
+[4.722116947174072, 3.1703174114227295, "Okay. Well, this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research. And if you find that you have more to share, please contact me, our website events oc.com, or we have an anonymous voicemail that you can call anytime. 949-415-6898."]
+[5.300675392150879, 6.371273517608643, "Wonderful. Thank you so much. Thanks, again, Denise."]
+[0.2700546085834503, -3.5611703395843506, "And we'll be in touch with updates about you know, you know, next steps, of course, especially the part where we're going to outreach to the community because we want to get the input from those seniors in Irvine again, you know, I know they provide feedback for yours. Assessment, but we'll need their feedback for the county assessment as well."]
+[5.885648250579834, 6.7084503173828125, "Fabulous, thank you."]
+[4.551492214202881, 4.589334487915039, "Thanks again, and I look forward to meeting with you and your team."]
+[4.824324607849121, 4.9581098556518555, "Sounds great. Take care. Take care you too. Bye bye bye."]
+[-2.7660350799560547, -3.050144910812378, "Okay, fantastic. No. Okay, so I'm going to show you a list that's going to be on your screen, a representative list of common issues and concerns impacting older adults. And they're just appearing in alphabetical order no ranking or anything like that. Otherwise, please take your time and read through it. You don't have to memorize, it'll be up on the screen the whole time. But, you know, in minute, I'll ask you to maybe rank your top three, most pressing need facing older adults. And so just kind of keep that in mind. And as you're reading this, and as we're talking about older adults, we mean to specify older adults who are 60 years and older. And we want you to think as broadly as possible, taking into consideration the older adults, their families or caregivers and the community. Okay, so I'm going to share my screen now. Once again, take your time and let me know when you're ready."]
+[1.945204496383667, 5.8232293128967285, "It looks like it's not all the way down."]
+[3.533238410949707, 7.5555195808410645, "Okay, yeah. Okay. Yeah,"]
+[4.6996331214904785, 5.409927845001221, "that's the last, I tried to like, shrink it. So it fits on the screen. But sometimes it can be a little hard to read."]
+[1.0749541521072388, 3.8703839778900146, "It's, that's difficult. Some of these really, really overlap."]
+[1.731776475906372, -1.1853188276290894, "Well, if you want to talk about it together, you can like I know, some people will say housing and homelessness is one category, we can do that."]
+[0.5856947898864746, -1.4879142045974731, "Yeah, I mean, you know, I am a Houser. So I, I see housing as being the number one priority. But mainly, I mean, that's coming from a couple of angles for me to be honest. One is that housing is like the largest part of our of our budget, for the most part, it's what costs us the most every month, most, most rents have gone well beyond people who are living on Social Security. And, and so those folks who don't have a lot of savings, or, you know, a defined pension program or something like that, housing is becoming almost impossible for elderly people who have retired, a lot of them living with medical issues that prevent them from working. And, and their, their situation isn't going to improve. It's not like they're young adults who can get skills and hopefully, when they join the workforce there, their situation is not going to improve in that manner. And so I, I see housing as being kind of at the heart of a lot of a lot of issues. I see that, you know, especially when it comes to like long term care. I look at the Alzheimer's disease and dementia and behavioral mental health issues. And I see those as tying very tightly to the housing issue for older adults. I know that these issues are becoming more widespread among older adults in our society, the kinds of epidemic of diabetes, driving some of that, and causing a lot of dementia that we may not have seen, you know, 30, 40 years ago. So, and I know that like memory care, and those types of long term housing options where a person can be kept medically stable and safe. They're incredibly expensive. And there's not a lot of good programs to pay for all of that. And so I see all of those things being very much intertwined."]
+[1.5980323553085327, -0.9106467962265015, "So, but if you had to pick and we're trying to rank so that we can prioritize needs for the community and isolate them, I heard you say housing would be possibly a number one for you."]
+[0.3154362738132477, -1.393285870552063, "I think housing is number one, because you say, you know, affordable affordability of housing, more housing options and long term care. So that's like a whole spectrum of housing. And I think that that is kind of just the, the key foundational problem for a lot of seniors. And then I see that I think that behavioral and mental health is probably second for me. The need for caregiver, memory loss, depression, we see that a lot. And I not just professionally but among a lot of people that I know, like, a lot of us have dealt with it or are dealing with it with family members as well. So I just kind of see it all around me."]
+[1.5159752368927002, 6.186602592468262, "Um I think that it's that one's"]
+[-1.2149457931518555, 1.1615662574768066, "difficult between economic security and emotional well being, I think that if you were to take care of some of the housing issues, that economic security might, might come along with it. So maybe emotional well being would be my third. Okay,"]
+[4.407723903656006, 7.181617736816406, "wonderful."]
+[-0.8196868896484375, -3.211439371109009, "Sure, I am the Acting Housing Services Manager. For the City of Anaheim, I oversee our housing authority, which includes all of our rental assistance programs. I oversee several other programs on the other side of affordable housing, like monitoring, property acquisition, so I kind of see both sides, the development side and the housing side. I've been in I've worked for housing authorities for 17 years now. And we, in all of that time, we do focus a lot on seniors, and, and kind of the issues surrounding seniors both on the rental assistance side and the housing development side. So we're constantly looking at, you know, homelessness among seniors, the the amount of seniors that are, that we think are going to be falling off into homelessness in the next 10 years. So that's basically my role. I don't do client interface very much anymore, just usually when someone's angry."]
+[1.1533199548721313, 1.3995305299758911, "And they call you."]
+[1.1284908056259155, -1.339576244354248, "But other than that, we're looking at like higher level numbers, you know, and how these things, these issues are impacting our seniors so that we can get ahead of them and be more proactive in terms of addressing housing shortages."]
+[5.378622055053711, 6.383076190948486, "Okay, great. Thank you so much."]
+[2.3939168453216553, 4.893884181976318, "Not that I'm aware of it is missing. It's beyond my, my professional capacity to determine."]
+[2.864729166030884, 4.225921154022217, "Yeah, it would be of Me too. Okay, so the three that you had mentioned and ranked, I'm going to ask you a series of questions. And we will go through them for each of the three that you've selected, so we'll have plenty of time to address them individually."]
+[0.34138211607933044, -1.2018859386444092, "Like I mentioned before, if if a an older adult is not a homeowner, and without a mortgage payment and they have to either rent or continue paying a mortgage or in property taxes and things like that. But especially renters, the rental market is just getting so far beyond people living on fixed incomes. And there, I mean, granted, there are a lot of people living on fixed incomes that are pretty decent, you know, who have, who had really high paying jobs before they retire, they have a lot of, you know, investments and, and pensions, but we, the people we see are those living on Social Security as their main source of income. And social security just has not kept up with renting small apartments for I'd say, probably at least the last five to six years that we've seen, just a real, you know, market explosion, that where people who are on social security, I really don't know how they're doing it. And we're seeing more and more seniors living on couches, living, you know, sharing bedrooms and people's houses, because they cannot afford their own place. And they're not, they're not stable where they are. So that's how that's one side of it. And then the other side is also the long term care aspect. When seniors have serious health conditions, where it is very difficult for them to live on their own. And they need not just, you know, a place to live, but they need additional, like auxiliary care. And those things are incredibly expensive. And there's not a lot of programs that cover them."]
+[-0.677775502204895, 2.3538928031921387, "Yeah. And what barriers exist to seeing improvements in this area. I think that"]
+[-1.0097399950027466, -0.8617876768112183, "one of the barriers is that we tend to as government programs, we put up a lot of walls in between our programs. You can pay for this, but not this. And unfortunately, you know, humans don't live that way. We need, we need something that's going to address us as a whole person. Now, I think we've made some advancements in in that over the last couple of years in the state. I don't know where it will all lead. But we definitely need. We definitely need programs that are able to pay for housing, and able to pay for actual care, and will provide the amount of money that it's going to take to actually provide that care. I think about you know, the, you know, the question about diabetes, and also, you know, dementia and people who are living in assisted living facilities, they have to pay not only an exorbitant rate for assisted living, but they have to pay for a nurse to actually administer injections for them, which is very cost prohibitive to a lot of seniors. And yet, there's not a lot of programs that will pay for that whole that whole package for them. So I think that that's that's really the the issue with like the long term care side, too."]
+[2.3349785804748535, 7.189239978790283, "Um, I think that I would,"]
+[0.2591228187084198, -1.1247378587722778, "my answer would just be a guess, based on what I'm what I know about other types of things. So my, my answer would be that, I would assume, yes, especially because if a senior, like during their lifetime, if they owned a home, they built some wealth, maybe they were the beneficiary of generational wealth, where their parents or grandparents before them had to own homes. I'm sure their experiences are quite different from those who have not had that ability to build that kind of wealth, then they are just kind of left reliant completely on whatever the system can provide, which is not always the best. So and there are obviously groups in our society where they are less likely to own homes and build that generational wealth for a variety of reasons. So I would say that yes, I'm sure there. There is definitely a difference there. Yeah."]
+[1.5820006132125854, -0.9184918999671936, "And so thinking about the housing problems you mentioned, what do you suggest is the best way to address this need"]
+[-0.712103545665741, -1.227805733680725, "in In terms of Well, I think that there's probably there's probably a lot of answers to that. If you're just talking about a senior who is just happens to be, you know, 60 years old or older, they're pretty healthy, they live independently. I think just to an increase in rental assistance programs, to address the need right now, obviously, help for people in their younger years to help buy those homes and build that wealth that they can rely on when they get older is probably a more long term solution for that. But on the long term care side, I think there has to be better programs that help people live in better types of housing environments with that medical care that they need, where they're not necessarily confined to like a, like a long term skilled nursing facility, but maybe are living in a place where there is where they're a little bit more mainstreamed. I think that that that would really help."]
+[0.15338093042373657, -0.8477262854576111, "When you say that, you know, build wealth as a younger person, maybe they, you know, can buy a house, or have a house reserved for them in some capacity. Well,"]
+[0.9568470120429993, -1.643555760383606, "part of what I do here is oversee some programs, or we have a couple of programs through the state that allows us to develop more affordable housing, for purchase and supplement that with like Silent second, loan programs, that really helps people who are kind of the median income or lower than median income to be able to purchase a home so that they can start building that wealth. I see that, you know, expanding the role of those types of programs where the government has like incentives for developers to build more affordable units into their regular projects, where there's more money and fuse from the federal and state governments for, like loan assistance to help with the affordability of those homes."]
+[-2.2743642330169678, 0.9289971590042114, "All of that could help. Gotcha, gotcha. Okay, great. No, I think that's it. Okay. So now I want to move over to our your number two, which is behavioral mental health. And as you mentioned earlier, it was, you know, needing a caregiver and being very all encompassing. Well, I think just for the very"]
+[-1.1470943689346313, -0.9708360433578491, "nature of getting older, our bodies are breaking down and sometimes are, and that includes sometimes our brains as well. I think that, from what I've seen, in my years of working in housing assistance, that there are a lot of seniors out there who are really struggling even when they are lucky enough to have a voucher and they live with their rent, primarily paid for by the government as their their physical and mental health declines. It is very difficult for them to get out and find someone who helps, who can help them if they don't already have family members who are willing to jump in and fill that role. Finding a caregiver who want who will do the job at all. Being able to afford the care like a true caregiver is very difficult because IHSS does not pay very well. Even the the programs that we tend to partner with under Cal Optima to help pay for supportive services, it doesn't pay for the kind of support that is often needed when someone is having a very serious mental health issue or is living with dementia. So I think that that is that's kind of why I see that being a real problem. We are facing it all the time now as housing providers. And even if people are able to physically come into an office or something like that, sometimes they are just not able mentally to advocate for themselves anymore. It's very difficult to have to have a caregiver dedicate the kind of time that they need to live independently. And to do that advocating for them."]
+[3.3805012702941895, 8.211690902709961, "Yeah, yeah. Again, I"]
+[-2.1277756690979004, -1.4797861576080322, "think that we don't fund behavioral and mental health programs nearly like we need to, there's not, you know, just in my own personal experience with family members who have this kind of issue and who've had other physical disease issues that, you know, which they don't play well, together, when somebody is having a, you know, a mental health crisis. And then they also have a physical health issue that they need to also keep up on. There's not a lot of places where people can go to become medically stabilized to, you know, well, while other options are found for them. And we just don't have, we don't have the funding for it. We don't have enough professionals in the field anymore. I don't think we have had enough professionals in the field. But now after the pandemic, it has gotten so much worse. There's just a there's just a real crisis for everybody, not just seniors. But with seniors, you have the added issue of possibly a frailer, physical state of frailer mental state, and, and just not that ability to go out and advocate for themselves to do the work that it takes to find caregivers. And I I see that as kind of the main problem there. Yeah."]
+[-2.131911516189575, -0.7514171004295349, "I don't know. I don't know. I don't have the I don't have the firsthand knowledge enough to speak on that. That is that is a good question. Obviously, we're more funding, more more program availability, the ability to actually go into people's homes, send caregivers into people's homes, the ability to fund full time caregivers at a decent wage where, you know, more people would be willing to go into that field. I think that probably more educational funding to expand educational programs for those treating mental health disorders would help. But also, I think that there's another barrier in that people don't have to take the services. And oftentimes they don't, because they don't necessarily have the the mental capacity anymore to see that there is definitely something wrong, and that they do need help. And that is that is a barrier that I don't know how we overcome that."]
+[3.424687385559082, 9.064056396484375, "Yeah, yeah."]
+[-1.3709526062011719, -2.026503801345825, "I think that, you know, as we grow older, you know, we start losing people. And the younger people in our lives, they have their own their own lives, and they don't understand the needs of the older, their older family members or friends. They get very busy and kind of forget. And also with more physical and mental frailty, you know, it's very hard for people to go out into the community and make connections. I used to work at a senior center where I saw people I saw seniors coming in every day, and they had great social connections. But I also saw a lot of them that could they volunteered with Meals on Wheels, because they knew that eventually that was going to be them and they hoped that there would be somebody there who would come in and they would tell me how they would go they drop off the meals but they would sit and talk to their their the people that they were assigned to and for an hour or two each time they got went there because most of the time that was the only social interaction that they had during the week. And, and I think that those are the barriers to the emotional well being. And I think it's very important because I'm a big believer in, like whole person body and mind connection. And with the decrease in emotional well being I do believe it opens the door for physical and mental health deterioration. Yeah,"]
+[-1.0403270721435547, -1.9251606464385986, "you raised a good point in the fact that those volunteers from Meals on Wheels, spend time with them. And that's part of the emotional well being right, it's to have that social connection."]
+[-1.2926214933395386, -2.057445764541626, "Yeah, no, I agree with you, they really do. And I think it's also really great, because a lot of meals on wheels, volunteers are seniors themselves. And so they are people that I think a lot of a lot of people you know, they don't, you know, it's just, we're just human. And so we tend to gravitate towards people who we feel we have shared experiences with. And so it's comfortable, I think, for people to have people around their own age to come in and be able to talk to them about, you know, those generational experiences that they're all familiar with, and, and everything. So it is appropriate is a program that you really don't you don't have that kind of emotional health outreach. I mean, I know they're delivering food, but they're delivering more than, than just food there. And they also don't have, you know, the other people that sometimes senior See, or the, like the medical caregivers that come in to, you know, check up on them administer shots, whatever it is that they do, they don't always have that same relationship with them, because they're maybe there to tell them things they don't want to hear or do things they don't want them to do. So the Meals on Wheels, workers really do have a very special function in bringing that emotional well being into the into the home."]
+[-2.9899165630340576, -1.6933592557907104, "Yeah, yeah. And what barriers do you see exist in seeing improvements in emotional wellbeing for older adults."]
+[-1.4420205354690552, -2.225160598754883, "Just kind of what I was talking about earlier, I think a lot of, you know, seniors are house bound, that, in and of itself is going to be a huge barrier. Not necessarily understanding that there are places that people can go to make those connections, but also the fact that there is not a there's not a lot of places that that people can go to make those social connections. And despite the fact that I said, sometimes there's a comfort with people, you know, having people your own age to talk to you because you have shared experiences. I have known a lot of seniors, who, when, when we talked about this, this issue, and you know, I talked to them about well, you know, there's there's always day centers and and they don't want to go there a lot of a lot of seniors don't want to go to like senior day centers, they want to go places where they're going to be able to interact intergenerationally you know, they want to be around younger people so that it gives them energy and, and everything. So I think that is also kind of a barrier is that they they don't want to feel like they're just relegated to the senior sphere. They want to feel like they're, like a thriving part of the community still."]
+[-1.5042892694473267, 1.4820650815963745, "Yeah, yeah. And are there different experiences for different groups of people when it comes to emotional well being. Um,"]
+[-0.7205203175544739, -1.1150151491165161, "like I said, Before, I don't, I don't have a ton of experience to be able to speak on this with with a lot of confidence. But I think that just in my everyday professional life, I have seen different cultural communities definitely take care of their seniors better than others. And especially when seniors are living in like intergenerational households, I think that there is always more of a feeling of still being integrated into the community into the family, and providing, you know, necessary contributions to the family, even, even if they can't get up and cook for the family anymore. They can still be there and kind of provide, you know, stories and wisdom to the younger generations and everything. And so I think that yes, probably there is a there is a big difference, depending on the type of cultural community that you are from and whether or not that you have more intergenerational connectivity. Yeah, yeah."]
+[-0.8533949255943298, 0.5657408237457275, "I know that the antithesis of social isolation is social integration. Oh, you know,"]
+[0.3932524025440216, -1.795275092124939, "one of the things that we've done here in the city, and with our housing development is there is a there's there are two developments that sit right next to each other one is for formerly homeless families with children. And then the this development next door is for seniors, half of which are set aside for homeless seniors. And the and it was developed, by in large by the same developer, the two different projects. And what they try to do is they try to have intergenerational programming. So you know, they couldn't go back and forth between each other's projects, and do art and do just different kinds of programs where they are connecting with each other. And I think that probably having more focus on that intergenerational type programming in various ways, could be incredibly helpful. We're looking at doing that in a couple of other projects that are upcoming in the next few years. And we really do I mean, we know that there is the whole senior tsunami, the silver tsunami thing going on. But you know, and we know that more and more housing is needed for seniors. But we do want to make sure that there is a intergenerational component there so that seniors aren't, don't feel like they're just kind of living off on their own, they can socialize with each other, there's more programming to help socialization within the housing itself, but also intergeneration intergenerational socialization within the within the project to and I think that it's very important for that to happen at the, at the housing community level, because that way, they don't have to get into a car, they don't have to wait for a band or a bus to come pick them up. They can they can have that interaction just by walking down to a community room or, or something like that. So I think that that is that is definitely needed. And that's something that, you know, we do try to encourage our developers to reach out to different partners who specialize in that including the county in order to bring those programs right to the seniors doorsteps."]
+[-1.69601571559906, -3.6177186965942383, "That's awesome. Yeah, exactly. Okay, well, that does it for this section of the interview. Next, we're gonna go on to just separate questions about the continuum of care for older adults, some of which you may or may not have, you know, knowledge of, if you don't, and you you know, one of just pass, we can do that, that's totally fine. But in the areas where you may have some insights, we would love to hear them. And then, you know, just and then later on, we're going to drill in a little bit deeper into housing, because that's your area of expertise. So I'll ask you some questions with that. And then after that, we will end the interview, I just want to kind of foreshadow what's ahead for you. Okay, I'm going to stop share now. I'll start with, we wanted to ask you to describe how accessible and how adequate the following care services are in Orange County for older adults. So the first one would be geriatric care."]
+[-2.23807954788208, 0.3147130310535431, "Yeah. Yeah, health care. And you can think of it in terms of like, I don't know if you guys have had to refer people. Right."]
+[-1.7684297561645508, -1.0257508754730225, "We don't we don't refer anybody to for medical services. That's kind of beyond our, our ability. I think. Just looking at it from personal knowledge, I think that it can be very, very difficult for seniors, especially when they do have a lot of medical concerns that every everything's very kind of farflung and they can't, you know, they can't is going to receive all of the services they need in like a smaller radius. So it makes it very difficult for seniors who don't drive, who need transportation who rely on other people to get them to doctor's appointments and things like that. So while I think that there is good medical care available, I think that just kind of how spread out it is really presents a problem for a lot of people. Long term care, I don't think that there is there is enough, and especially not affordable long term care."]
+[3.845672607421875, 15.400312423706055, "Yeah."]
+[-2.193423271179199, -1.4566209316253662, "I think it's getting well. Substance. I don't think any of its adequate. I think that we just don't have enough mental health professionals in the field. I think that for substance abuse there, there's not enough like detox beds, and then places for them to go once they detox, and to help them kind of build back into being able to make those first steps out into living a normal life. I think it's hard to find services period, let alone affordable services if they don't have good insurance. So I think I'm pretty pessimistic on that whole system."]
+[2.2275915145874023, 5.261190414428711, "I am not aware. I'm sure there are but I'm not aware of them."]
+[5.580266952514648, 8.803705215454102, "Okay."]
+[-0.39754003286361694, -0.13100428879261017, "I think there are a lot of good organizations out there who do provide those services. I've seen them become very overwhelmed in the last few years. And you know, we've, a lot of us have received a lot of funding from various areas, especially with the Cares Act and everything, a lot of money has come flooding into the social services sector. However, we weren't necessarily prepared for IT staffing wise. And this is not the kind of this is not the kind of industry where you could just throw somebody out there and expect them to be proficient at serving somebody who's in desperate need of help. While that's what we've been doing. It's not it's not very effective. Yeah. Yeah. Okay."]
+[7.211086273193359, 4.817221164703369, "Thank you for that."]
+[0.6942135691642761, -1.3851338624954224, "Think housing is still going to be a huge problem, and probably even even worse problem than it is now with population growth. And with climate change. You know, I've I went on a tour of Santa Rosa a few years ago, that hit after the wildfires hit, and hundreds of housing units had been burned in an area that was already struggling with housing affordability and accessibility, and it wiped out hundreds of homes, both, you know, rich and poor alike were affected. And I see that happening more in the future. I think we need it's not just housing. It's like climate change, also impacting housing. I think that with the opioid epidemic that we've been dealing with, I think that our mental health challenges are just going to get worse. And because of that, I think homelessness will will get worse. I I'm not terribly I'm not terribly optimistic about what we're looking at for those things."]
+[-0.992709219455719, -2.8210742473602295, "Yeah. And in your opinion, what do you think is is the government's role in meeting the needs of older adults."]
+[-0.2014516144990921, -1.6566311120986938, "I think that the government needs to be there more than it has than it has been. You know, I have felt like, as being part of like the sandwich generation myself, I have seen where the government has basically said, Take care of your parents take care of your children. And really, we're not going to provide you a lot of assistance on this. And it's hard to how do you save money for yourself so that your child, children don't have to worry about you. And it just seems to be an expanding problem down the generations. So I think that the government needs to provide better ways to save money, they need to provide better health care and housing options for people as they age. And that's not just including older adults, that's including younger people as they go through hard, those difficult times in their lives when their children are young, you know, better health, better childcare opportunities, so that they're not wiping out their ability to save for their older years. It just is a, these are issues that just kind of compound on each other and never really go away. So many of the older adults that we see on our program, and, and my rental assistance programs, about 30% of our 6300 households are senior your households. And a lot of those people are people that never really had much of a chance to prepare for their older years, because they were so busy throwing every dollar they made into taking care of their children, and that they had basically nothing to fall back on when they became older and couldn't work anymore. So those those issues, I think there's, there are things that the government needs to do to right now address those issues, including looking at the amount of money that they're paying for Social Security, looking at better programs to help subsidize housing for older adults, but also looking at how we are how we are helping younger people who are not making a lot of money, build some wealth, to take care of their children so that they can start saving for that. That eventuality of of becoming an older adults out of the workforce."]
+[1.2665272951126099, -0.9578195810317993, "Can you see yourself personally struggling with housing and cost of living in"]
+[0.23087362945079803, -1.1223188638687134, "Well, I'm so if everything goes to plan. You never know. I do have a defined benefit pension. So that's always good. And I do own a home. So that's also something that's that will help me in the future. But you know, not everybody works for the government, you know, and nobody else offers defined benefit pensions, and even even those, I mean, they're teetering. So like I said, if everything goes according to plan, I should be okay."]
+[0.2820499539375305, -1.071109652519226, "And I hopefully won't have to put that burden on my children. But if you know, the pension system collapses or something like that, then yeah, absolutely. I can see that being a real real problem."]
+[0.7377367615699768, 3.6257410049438477, "Yeah, yeah. No, it's it's very difficult only getting more difficult."]
+[2.700568675994873, 7.62922477722168, "Well, I I hesitate. I mean,"]
+[-0.3991038501262665, -1.9019510746002197, "I'm going to speak from my own experience, and obviously I can only see one part of it, but to me, the older adults who can't advocate for themselves are the ones that aren't going to get the most attention. So I think, you know, we have on the on the ballot, we've had some some propositions in the years past that have been very much about protecting older adults and their tax liabilities going from property to property. And these are very much propositions meant to help protect adults who have already built a decent amount of wealth in their life and, and have assets to take care of themselves. Because they're terrified. There's not a lot of advocacy going on for those folks. They don't have they don't have the kind of political power that, you know, wealthier older adults have."]
+[-0.2508071959018707, -1.7839347124099731, "Yeah, yeah. Yeah, I read a statistic that said, like 2% of philanthropy, goes to older adults and their needs. So it's definitely, we need a lot more. Yeah. And then now thinking about all the issues facing older adults, I mean, we went through some of them in detail, but there were a lot of issues there."]
+[-2.6865899562835693, -1.305609941482544, "Right now, I think it's the issue of more adults develop, I mean, as we're living a little longer, and I see that the issue of Alzheimer's and other dementia related disorders rising in our older adults, and I, myself have experienced in knowing what that looks like. And it is very, very difficult. When you're, you know, a person's family all has to work. And they can't truly take care of a person who, who might be a danger to themselves because of that. disorder. It's very difficult to pay for full time caregiver in the home, or to pay for for decent, long term care, that will keep that person safe. And I see that as becoming a real, you know, more and more of a problem in the future. Because I know, I just keep reading so many articles about how many more people are expected to get Alzheimer's and dementia related illnesses in the future. And knowing what I know about how trying to take care of someone like that. It is. It's very concerning for me, and what our what our society is going to look like in the next 10 to 20 years. Yeah, yeah."]
+[1.0575724840164185, -2.5426864624023438, "Okay, so, gosh, we talked about a lot today, but I wanted to spend a little bit more time digging deeper into your area of expertise. So thinking about housing, and this doesn't have to be just for Anaheim. But thinking about housing."]
+[-3.220165252685547, -2.173149824142456, "For older adults, specifically."]
+[-0.47877711057662964, 0.7955142259597778, "Yeah, or maybe young people because you know, we're doing some prevention work, I'm sure right, as well."]
+[0.9053916335105896, -1.7875715494155884, "I don't know if I would say it is working. There are some things that give me some hope that it might work better. I don't know, if I necessarily classified as working yet. Things are too new. I the thing that I'm most hopeful for is kind of that Money Follows the Person type of program with Cal Optima, where it does pay help pay for housing, housing, navigation, supportive services, all of those things. I, I see that as as possibly working more in the future. It's too new though, for me to know kind of the long term benefits, I do worry that we're not going to fund it properly, to provide the level of services that are going to be needed for many of the people that it is helping. I have some hope that the state is starting to really crack down on housing production for cities and counties and they're kind of holding our feet to the fire. However, I am always a little gun shy because that can change in an instant with a new governor or a new legislature. So I think that we have have"]
+[1.8515444993972778, -0.38693246245384216, "to be vigilant in the state about holding localities accountable for, for developing those those having those production numbers. And it's those the numbers seem"]
+[0.9260342121124268, -1.850017786026001, "unrealistic. And sometimes I think they might be considering the fact that we have built out so much in our state already. And we have, you know, decreasing water resources and things like that. But I think that if that we could keep going in that direction, we might, we might start to see a change in our circumstances, but none of it is is a notice it's been going on long enough for me to say, Yeah, this is definitely making the impact that we want."]
+[3.521285057067871, 7.63466215133667, "Yeah. Okay."]
+[1.154332160949707, -1.288474202156067, "Think it takes too long to develop housing. And that's something that could be changed, if we change some of especially some of our federal laws. You know, anytime you touch federal dollars to develop housing, it comes with a whole host of requirements in terms of how much you have to pay those workers to work on the on the project. And it gets to the point now, where it's two to three times more expensive to develop affordable units than it is to develop a market rate unit. Which makes no sense at all, when you look at it from a higher level perspective, it should not be the case. And my thought is, is that while Yeah, people need to earn, you know, a good wage while working on on, you know, doing construction or whatever. If the market is paying a certain amount of money, then why can't we all just go with that would that payment and and get our production numbers going faster, but it takes like years for these developers to piece together the funding to be able to build something, you know, like these projects are in the pipelines for five years. And during that five years, we could have lost like hundreds of people on the street. So I think that that is that is the one of the biggest things that that is really holding us back. Are the these kind of antiquated, lopsided requirements for affordable housing versus market rate housing."]
+[2.974438428878784, 4.997334003448486, "Yeah. So that you've mentioned a lot there. My next question may be redundant. Yeah, that. Yeah, I figured I figured, yeah. Okay,"]
+[1.2811132669448853, -1.324822187423706, "that's desperately needed. Oh, and one other thing, too. There is, there are laws in place that require of affordable developments to go before like community groups for public comment and things like that. And I have to I just don't agree with that. It becomes a discriminatory issue, that very much that not in my backyard type of thing. And it's like, well, you're you only got this backyard, because you could afford it, or because your parents left it to you. But these people don't have a backyard or you know, they may be living on the street, or they may be on the verge of homelessness. And and all studies point to the fact that affordable housing improves property values, and yet we still allow community public comments to destroy our ability to build affordable housing. And it's just, it's just really, really, it's just wrong."]
+[1.9175680875778198, 4.414336681365967, "Yeah, it kind of sets us up for failure."]
+[1.5898654460906982, -2.4348504543304443, "It absolutely does. You know, we had a project in our city a few years ago, that we were ready to run with and it was to serve homeless veterans. It would have been done by now. And we would have had a probably another 60 homeless veterans off the street and living in their own place, but it was destroyed by the surrounding community. They didn't they didn't want homeless people living near them. Even even though there were veterans and usually you can get past a lot of things by saying hey, these are veterans. These are people who fought for our country and a lot of people go okay, but"]
+[1.6454925537109375, 1.1974694728851318, "wow, yeah, that I heard so much so many, like such early praise for Esperanza Yeah, is that one of the projects you said you're kind of hopeful about that's kind of too early maybe, to tell"]
+[3.3171050548553467, 8.629024505615234, "what Esperanza Yeah, I mean,"]
+[2.852203607559204, 8.242201805114746, "that's,"]
+[1.515458583831787, 1.1491177082061768, "that is a, that is a good project, it has a lot of things going for it. We still need to work out some kinks and in keeping at least and things like that. So it's just one of it's just one of many types of projects and different ways of approaching things. We're always trying to kind of change it up a little bit, see what works the best. And so yeah, that is a it is a it is a great project. But, you know, we hope thank goodness, we didn't the community didn't shoot that one down. But our other one, you know, you think about the people you could have served and and now you you can't. Yeah,"]
+[1.6474199295043945, -0.8979532718658447, "yeah. Okay. So we talked about all the things, all the policy changes that need to happen, who or what entity is best suited to address this issue with housing and with all the barriers to housing."]
+[2.9557383060455322, 0.012111599557101727, "Congress, the, our Federal Congress needs to address those issues. For the most part, there are some policy changes that can happen at the state level, to get rid of that, like the public participation requirement, and make it more of a by rights type of development, that can be addressed at the state level. The prevailing wage issue has to be addressed by Congress, though"]
+[2.405458450317383, 5.839694976806641, "Like, can you be a little more specific,"]
+[1.6336898803710938, -2.6391544342041016, "you know, like, I talked to some homeless organizations, and they say you should really dissect the HMIs data set, for example, right to really know how many older adults are in the system already. I mean, you don't have to have an answer. You can always email me like, hey, you know, I was using this today. And I thought of you. We could do that. For"]
+[1.1210262775421143, 0.17183414101600647, "four, we were looking to develop new projects, and we're trying to figure out whether or not we want to specify a certain type of population for that. And we're looking at, like, say homelessness. We do look at the PIT count. And in the years past, Anaheim has actually paid for its own PIT count. Yeah. So we can get more specific data, because it's not always readily available from the county."]
+[2.6573262214660645, 5.9395833015441895, "I'm not sure. I'd have to get back to that."]
+[0.05606952682137489, -3.535806655883789, "Yeah. I would love to see it. Yeah. And also how it maybe is different from the county report."]
+[2.769915819168091, 5.42511510848999, "Yeah, the last one. We did I do remember it being quite, quite different."]
+[-0.6912040710449219, 2.41860032081604, "Okay. Okay. Be nice to know. You know, some other kind of structural change like that. Okay. Um,"]
+[2.058361291885376, 5.616537570953369, "probably no one that you haven't already thought of to be honest. Yeah, I, I, I really, I don't know. I wouldn't know."]
+[4.665889263153076, 3.265151023864746, "Sorry. No, that's fine. And if you do think of anyone, because we do, not just these interviews, but following these interviews, we have a provider survey. And then we have focus groups. And so we divide the focus groups into priority populations, the populations that we feel are underserved, or maybe the most overlooked, right. And then we will go into issues and so we're always you know, kind of curating participants for those issues. So if you if you think of anyone just let us know. Okay, we'll do excuse me. All right. Well, thank you so much for your time. I know we went over like six minutes on this call, but I really appreciate your help. And, you know, if anything else comes up, please feel free to reach out. I will. Thank you. Thank you. Bye bye."]
+[-2.6230173110961914, -3.079742193222046, "All right, great. All right. So here we go. So the primary goal today is to identify what needs you think are most important to the older adult population that you serve those who are 60 and older. Now, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families, and their community. Now, I already shared with you, you know, so you can see the list of common issues and concerns impacting older adults. Now, I'd like you to take a few minutes to read through this list. And let me know when you are ready to begin I'll follow up with some questions regarding this list. Okay."]
+[3.4599649906158447, 6.33165168762207, "Okay, I looked at Les."]
+[3.8629531860351562, 7.081799030303955, "Okay, great. Yeah. Yes."]
+[-0.9567239284515381, -3.3947079181671143, "So my name is Mark Paredes. I am the Senior Manager of our sales, sales and field engagement team at clever care health plan. It's a Medicare Advantage plan that serves the medi Medicare eligible folks, that includes the senior and each community."]
+[0.13336290419101715, -4.139159202575684, "Okay, now, I'm thinking about Orange County, and looking at this list of common issues that concerns impacting older adults."]
+[3.16385555267334, 4.350196838378906, "I think it's pretty comprehensive. So yes, no, I don't do anything that comes out of mind. So I think it's comprehensive. Yes."]
+[2.4667370319366455, 3.826979875564575, "Great. Yeah. So of the needs on the list, you know, Please rank the top three that you feel are the most important."]
+[-1.5877004861831665, 0.7140331864356995, "Well, coming from my health perspective, and the work that I do, the health care access, and delivery is going to be one of the priorities that I kind of focus on. The the other piece that I think is the behavioral and mental health piece, and then the, I will probably say, I would go with respect. And I can do would you like me to go into detail with the"]
+[3.22200345993042, 4.52772855758667, "I'll ask you some follow up questions for each. Yes. Okay. Yeah. So I'm gonna follow up with a set of questions for each of the three that you just mentioned."]
+[-0.5574721693992615, -1.5772409439086914, "I would, I would share it. The population that I serve, is the Asian Pacific Islander community. And so a lot of the aged seniors, language and culturally sensitive materials is really important. So for example, that the health plan that we have, provides a lot of the in language materials, we provide in language, customer service and Member Services. And we were set up primarily for for that purpose, because we realize that there's a strong need for, for for that, because a lot of our age aged Asian Pacific Islander seniors struggle navigating healthcare when it's not in language."]
+[3.8404316902160645, 7.9166412353515625, "Right. Okay."]
+[-0.5148829221725464, -1.495792031288147, "The barriers is that there's still not enough caregivers, I mean, providers that have the language needs. So for example, if we're trying to link people up with mental health services or other programs, we may even say for example, transportation. Once we try to hand off to another organization that doesn't have the language capacity, then that senior still struggles in that. But, but yeah, I think a lot of it is the that would be that's why I think that the linguistic appropriate care and culturally sensitive stuff is really key, especially to the the vast, diverse population that Orange County serves. I think in terms of Maybe the Latino or the Spanish speaking, there might be more resources available. But when it comes to specially, say, for example, the Cambodian community Khmer, there's limited, there's limited services or language pieces to their, to their needs. And then even with the Chinese community, there's you got Mandarin, Cantonese speaking, folks. And it's, even though Mandarin is the written language, but the verbal senses a little bit different. So that's, so I think that's where I see some of the challenges and just navigating like the, the websites, when they're going to certain things, it's, it's hard for them to access that."]
+[-0.5705392360687256, -1.4411640167236328, "Um, yes. So there is a vast difference amongst the various API, Asian Pacific Islander groups, primarily because of their experiences. Some, some groups tend to be higher educated, they may have come through a program like a preferred visa program, right. And so they are educated background, while others have come in because of a refugee or fleeing some type of civil war. So these are things that kind of impact. And I think, for example, with the eye sight, the Cambodian and the Vietnamese community, in this, where you have a range in the Vietnamese community have a range of educated and and there's some that are, aren't as educated. And so they struggle a little bit more, but especially in the Cambodian community, when seniors at their seniors now but that when they fled the country, many of them were farmers or agrarian, and so they weren't as highly educated. So a lot of the communication in that to me may be more verbal, rather than written."]
+[-0.5576313138008118, -1.4213707447052002, "So when the way I look at it is, I think in in some ways, families still tend to rely on family members, for as kind of translation translators. This isn't actually an issue in terms of privacy, right, that I think we need to address. But this is the way that a lot of the Asian community kind of looks at things. I know that in the medical setting, that's not the most appropriate way. So it'd be it'd be best if there if organizations had that diverse language, but it's really hard to, it's really hard to, to have that. But I guess, the way that the way that organizations are getting around that is utilizing language light. So making sure that we have making sure that we have fundings for for groups that have language services."]
+[-1.9955165386199951, 1.413003921508789, "Right. Okay. Now, so moving on to the second of the three issues that you'd identify. So that would be a behavior and mental health."]
+[-2.0261824131011963, -1.6623344421386719, "Oh, sure. This the realize like the behavioral and mental health, we we have been seeing in terms of just using the pandemic as the example here. A lot of isolation. And folks kind of staying away that social interaction, social interaction being important, especially when when someone retires and, and I think that this is something that, for example, I've covered care we we have a community center, and one of the reasons why we have our community center, we have games, we have activities, they have wellness activities going on at the community center, is because we want to reengage or try to engage seniors to have that social interaction. We're concerned that a lot of seniors go into this isolation, depression and, and so this is something that we're really trying To make sure that it's its address. So that's why I kind of highlighted the behavioral and mental health component. And then the other thing, too, is just, I think, in general, drug and alcohol addiction is prevalent in some of the AAPI communities. And so we need to make sure that just drug drugs and addiction is not just a, a young people problem, but it's a problem across the board to"]
+[-0.9940216541290283, 2.0309948921203613, "Okay, and what barriers exist to see improvement in this area, where we find to be heavy on mental health."]
+[-1.7489519119262695, -0.91022127866745, "In regards to mental health services, there's really a lack of, at least, from my perspective, trying to connect with mental health providers that are culturally sensitive, or linguistically linguistically capable. Just there's, there's, I think we need to try to increase the number of social workers the number of mental health providers out there, I don't think that there's enough that serving the AAPI community."]
+[5.589608192443848, 8.809316635131836, "Okay."]
+[-2.096471071243286, 0.6661943793296814, "I think with each with each group, I I'd like to say yes, because each has different experiences. Some are dealing with Post Traumatic Stress Disorder coming when the really fled their their country situation. But then there's also that it's different levels. I think, for example, there's also the the people who leave their country, in their family to come to the United States, but can't seem to find a way back. And so that they too, are dealing with some depression at a different level."]
+[-0.6428597569465637, -1.6581506729125977, "I, like I shared with you I think the number of providers that meet the various languages in the community is lacking. For example, just in the Vietnamese community, I think there's only a handful of providers that's that have in language, mental health services. And so and that's a huge population and the Garden Grove, Westminster, and Fountain Valley area. Right. And so that that's where I think we need to kind of assess what resources do we have right now. And, and really try to recruit or increase the number of those providers that speak the language and also tap into and identify organizations that are already doing that type of work."]
+[3.1236634254455566, 4.619215488433838, "Okay, now, thanks for the questions for your third topic, which was respect."]
+[-1.2559243440628052, -2.392646312713623, "Well, I think that this this almost ties in with with the behavioral health piece, as I shared with you, I think when seniors retire, the jobs usually tend to give people purpose, right. And when you retire and you're no longer working, you have to find other avenues that allows you to find value. So I know that there's probably newer programs out there that were kind of workforce, voluntary. I guess voluntary job placement, that if not, it allows seniors to to still be engaged in activities that gives them purpose. I know. For example, maybe at some senior centers, they may have assigned various roles to a senior to handle certain activities I think that the assigning those certain roles gives people purpose. There were programs in the past from what I remember, and I don't know if they're still around, and I don't, I think they may have cut them out where they, they provide funds to organizations to hire, or bring on individuals to who may be seniors to do services. I know at our health plan, we'd like to do something like an ambassador program, where maybe we could integrate a senior to be at our community center to greet and welcome people. Right. And I think that would add some of the dignity and feeling and being seen being heard and empower piece."]
+[-0.6907182931900024, 2.3040342330932617, "Right. Okay, you know, what barriers exist, you're seeing improvement in this area."]
+[-0.8775696754455566, -2.8120505809783936, "I think the barriers right now, it's, there's, there's no incentives, as I shared, I think there's a program in LA that allows folks to be able to utilize seniors and placed them in locations where seniors can have activities for them. I don't think we have that in LA in Orange County, or at least maybe look into putting something like that. So maybe identifying pot of money were organizations that work with seniors to give them roles and responsibilities in the community. Okay."]
+[-1.3923906087875366, -2.4627420902252197, "Did this one I'm, I'm gonna say I'm, I'm not I don't have a clear answer. I want to share that. I think, I think just a general understanding that I think everyone wants to feel that they have purpose. And so I that's where I think having that scope of activities that a senior can do, because and understand. I think also a lot of seniors, they have different life experiences. So some are coming from high level executive positions, while others were working in the service industry. So I think there's, there's, I probably will say, there's a wide range of not everyone wants to be a greeter or not, but but I think it's allowing people to have that option if they want."]
+[5.567847728729248, 8.780548095703125, "Okay."]
+[-0.9490175843238831, -2.6795780658721924, "I'm looking to programs as a shared there, there were programs in the past that were offered at the at the state and at the local level, maybe reinstating or bringing some funding back to, for organizations to possibly apply for and, and probably integrate that program for seniors to either participate or be part of, and I would I would push for working with nonprofit organizations, because their missions really tend to serve other other seniors in the community. So but yeah,"]
+[3.369075059890747, 5.441637992858887, "okay. Great. Right. Now moving on to the next set of questions."]
+[3.9681217670440674, 7.235820770263672, "I'm sorry."]
+[-1.22574782371521, -3.9357802867889404, "Oh, wow. No, just if you could describe, I'll just repeat that. And I can also I read out a couple of definitions. So the question is, can you please describe how accessible and adequate the following care or services are in Orange County, and by accessible, we mean, access includes not only having insurance and be able to afford co pays premiums, but also having a primary care physician versus using urgent care or the ER, and being able to get timely appointments with various providers. So that's the question in the first one we're asking you to describe how accessible or adequate is geriatric care. And that we did. We defined that as the branch of health care that focuses on our unique needs as we age. Justice, pediatricians specialize in the health needs of children. geriatricians and fellow geriatrics health professionals specialize in the health needs of older people."]
+[-1.391312599182129, -3.6841843128204346, "Um, I would say the access to geriatric care in Orange County is, is still low. I know that seniors when they're trying to set up appointments for doctors are still having lengthy wait times. And I think that's areas where we can improve care. I think the challenge there is, is providers, we just need certain providers, I think it varies from type of providers as well. As we get into more specialty care, it does get a little bit harder for for some folks, but more general carrier thinks a little bit better. And then in mental health services, I think there's as I shared, I think it's a little tougher. Okay,"]
+[-2.6760270595550537, 0.336800754070282, "I'll get to that part later, just a little bit. So the second one is long term care. And I could just say, you see, we defined that, as you probably know, but a long term care is a variety of services, which help meet both the medical and now medical needs of people with a chronic illness, or disability who cannot care for themselves for long periods."]
+[-1.4769446849822998, -0.6862121820449829, "So I think what when it comes to long term care, the challenge there is a cost. The, I don't think a lot of people have access to the long term care, through medical, how they are provided some in general, I think many people struggle with that. So I would probably say, still very tough for the senior community to receive long term care."]
+[-2.976421356201172, -0.1272682547569275, "Do you have any idea as to how adequate either to geriatric or long term care,"]
+[-1.3240139484405518, -0.5320009589195251, "I think when it comes to long term care, it, it really falls down to the home, the in home supportive services, right. And that usually relying on family, unfortunately, the the pay for in home supportive services is not so great. So if there is a possibility to increase in home supportive services, this, this actually is a better way to help solve some of the the costs, because it's much cheaper to take care of family member at a home with family than to have them in it in an institution, or a care facility."]
+[-2.1929938793182373, 1.2873377799987793, "Okay, and the next one asking you to assess or to describe the accessibility and inadequacy is mental slash behavior, health slash substance use treatment."]
+[-2.0450334548950195, -0.641909658908844, "I think there's, when it comes to behavioral mental health and substance use, we need to have programs that identify in the Asian Pacific Islander community mental health, behavioral health services and drug topics aren't discussed. And in aren't really focused on. And I think we need to have more programs that are able to go and do outreach to the community to first of all, share with people that it's, it's okay, that they think about these issues. And it's nothing to be ashamed of. So I think programs that promote education, at the at the ground at the grassroots level is going to be very important. Only a handful of organizations tend to do that. So I would be supporting that. We it's not even assessing if we need more, we just need to ramp up our providers."]
+[-1.6413511037826538, -2.2046103477478027, "Yes, I mean, there's there's certain when when it comes to linking seniors up with the, the mental health services we rely on to one one, to identify what programs are available, but it also I think that's, that's that's the tool that I've been using to link people up with the service as a health plan. We have a list of providers contracted providers that we we we deal with. But those are for our members. Yeah. But when it comes to the at large to community at our community center who comes in there, we'd link them up to 211."]
+[4.055364608764648, 7.326284408569336, "I see. Okay."]
+[-0.4076020121574402, -2.7929062843322754, "human social services. I believe that there's a lot of there are programs out there that really serve the social service aspect, faith based organizations, nonprofit, I think it's coordinating those services. That the one thing I will try and share, at, in looking at the resources, they're kind of concentrated in certain areas. So maybe they're more the services down in South County is limited. But then say, for example, there's a lot of services that happen in the Santa Ana region. So I think that that would be the the piece there that could really help. It's it's targeted areas, that I mean, there's targeted zones already, where there's a lot of services, but I think when you start going broader outside of the areas of like Santa Ana, and go go towards more of the outskirts, you don't have as much services. So okay. Sorry, go ahead."]
+[0.13565701246261597, 3.4478001594543457, "No, no, you're fine. You think of anything, we can come back to this. But I'll just go ahead and ask you the next question. So what do you think will be the biggest challenges older adults will face in the next 10"]
+[-0.3167630136013031, -1.840461015701294, "We talked about the baby boomers coming in and retiring. And that huge number that just every year, turning 65, or 67, or seven years old, and there's gonna be less, more more, more individuals, but still the same amount of resources. So in order to, in order to help support these programs out there, whether they're providing services, whether they're providing education in the community, they're going to become more and more very, they're going to become more valuable. But, but it's unfortunate, I think sometimes we hear the comment, like, do more, do more with less. And so, but the reality is, is we're really stretched pretty thin already. And, and I think that's really, the that's what I kind of look at, as one of the big issues that and that, more and more, there's going to be a greater senior population that we have a bigger wave that will be coming over the next 10 years that we aren't ready for."]
+[5.581073760986328, 8.8026123046875, "Okay."]
+[1.1689503192901611, -2.2410073280334473, "I think I think with the government's the government's role, should be ensuring that there are programs that exists to meet all these issues, whether it comes to homelessness, housing, that's why when I look at this list, and and you you mentioned to me, what are the big issues that tend to these are all big issues. I mean, transportation I could have put there's another big piece there and homelessness. I think government has to play a role in terms of supporting programs. EMS and, and ensuring that these organizations that do receive funding and support are actually doing the services are being asked to, to do. So."]
+[0.09224740415811539, -4.87870454788208, "Okay, now thinking about all the older adult residents in Orange County, who is getting the least amount of attention."]
+[0.02879869006574154, -2.1246933937072754, "I will, I will say the, the AAPI community, the Asian Pacific Islander community, I still struggle with trying to find resources. When I look at the county organization to county agencies, I think programs tend to be geared towards a more general population. I will push an advocate for the Asian Pacific Islander community cares. First of all, there's not enough. There's not enough programs and agencies out there. So that's where I would come in push for that."]
+[1.115386724472046, -2.5064401626586914, "Okay, an issue that's being overlooked. I think right now, homelessness is going to be one that gets to be overlooked. Because no one talks about no one talks about the older homeless community, they tend to generalize, they tend to generalize homelessness, from the better end to people have various drug, drug or mental health issues. But I haven't I haven't really seen so much or heard about, but I think that, at least in the similar centers that I've seen, I'm seeing a little bit more and more seniors dealing with homelessness out of the communities. Okay. Oh, but But can I ask I guess, I was just thinking about maybe looking at tying that with housing. If we're able to have greater affordable housing, for our aging seniors, I think that will really help address the homelessness issue. Orange County being a very expensive place to live, and cities, limiting, I guess, rent control or different things like that, or low income housing. I think that's something that we should actually look more into."]
+[-2.381442070007324, -0.21565109491348267, "Okay, great. Now we're coming to the last part of our interview. So just a few more questions here. So thinking about, well, your topic, right, we kind of put you in the category of what we can help reimagine healthcare as we age."]
+[-0.3712526261806488, -1.845647931098938, "Yeah. So um, so the question is thinking about this topic that, you know, you're you're discussing, which we kind of put you in, I guess I'll go back a little bit. So again, I apologize, you know, not sure how much you've learned from Katie or from others about what we're doing, right. So we're, we're doing just older adults needs assessment for the county. In all the data or the interview that we're collecting will eventually assist the county supervisors in creating their own master plan for aging, which, as you probably know, California just released its own plan. Right. So each county is doing their own. So under the California plan, their five what they call bold ideas. And one of which one of the five is it's the label health reimagined. So basically, it's healthcare. Right. So we're putting, you know, Clever Care and other, you know, hospitals or other health care provider under this, this idea, basically, this pillar."]
+[-0.715171754360199, -1.732488751411438, "I see. I think health health care is we're working towards a better we have a prevention preventing a lot of the some of the more chronic diseases. So I think in terms of information education about that is those topics are helping our community be a better part. I think in regard in regards to the additional things that are working with the healthcare landscape. I think we're getting, I believe we're improving on getting some of the education piece out there, through through various channels, whether it's participating at events in the community. But there's still a lot of work that needs to happen. I, for me, I don't know if I'm a little bit more, there's still a lot of things. I, I were taking small steps there, for example, for for the plant that I work for, and seeing other other health plants, too. They are also starting to incorporate language. In another, there's another help another plan that also focusing on some of the API communities. So I could kind of see where it's moving towards that direction. But I still think that there's so much more room there. I guess I struggled to answer this question, because we've, we have are taking the baby steps. But I wouldn't call it successful yet. If that makes sense. Yeah. I don't want to I don't want to discount the fact that we are moving in the right direction. But I also don't want to say like Mission accomplished, because there still needs to be a lot of work done in terms of language,"]
+[2.988771915435791, 0.06257131695747375, "understood, you know, what a new or revised policies are needed."]
+[-0.3991928994655609, -1.9427874088287354, "I think when it comes to dealing with the various communities of color, we we still need to have some type of vehicle for for organizations to have representation for those communities. So it's more like an ongoing topic, right conversation. I think, I think it's evolves through time. And so I think that those, and then not only just having organizations, but including within this kind of framework, to have different players sit at the table, right, I would not want to have all nonprofits sitting together to discuss healthcare issues by themselves. I think it's important to have like, nonprofit organization sitting with health plans, sitting with the hospital system, sitting what the county together and really discussing it and therefore, having a more open table to come up with the solutions. Because I think what I've seen in the past has been really people talking about problems, but not having the groups. They're present. So if we're gonna, if we're going to address education, right, and access to children, for example, or we may need to have schools there. Yes. I think it's a collaborative that integrates all the key stakeholders at a table to address certain issues."]
+[3.853210926055908, 7.895666122436523, "Right. Okay."]
+[2.416391611099243, 2.771836042404175, "issues in terms of the, the things I've talked about, or Yeah,"]
+[-2.127241373062134, 0.2984800338745117, "yeah, we could talk about that and or, you know, maybe just healthcare in general right, because you know, this is really your area."]
+[-0.8674253821372986, -2.8353145122528076, "I think the there's the Office of Aging is a good, a good partner to have along there. When it comes to when it comes to the senior community. A Medicare plan. Cal Optima would be another key player there. because they they deal with the medical and Medicare population. I would include organization to just cover care or scam that also have a large population of seniors. But then there's also other key organizations that you might want to consider. There is one organization could be the, the Asian American Senior Citizen Service Center. They serve. They serve not only the API community, but they're based in Santa Ana serving Latino community. Caprica there. And another group that people can often overlook is the the labor groups. There's there's a there's a group, I believe it's called care. They are the retired. They're retired. Union, folks. Right. You also have a large body of folks who come from other sectors that that have certain issues. So I think those are some of the partners that I've seen and worked with that I think would really be good to have at the table."]
+[3.3485288619995117, 5.034817218780518, "Great. And yeah, well, I was I'm going to jump ahead to the next few questions."]
+[-0.6008448600769043, -3.3411076068878174, "is, I think in touch with that group. If you know GLORIA Alvarado, right, just dis reach out to her and find that maybe who would be the best person to connect with in that group. But that's the retired the retired group. Let me just ask somebody here."]
+[5.581358909606934, 8.799856185913086, "Okay."]
+[-0.8900586366653442, -2.898420572280884, "Socially retired. Si, a ra. Let me let me look it up real quick. I'm sorry. No, no, no, I appreciate that. Because, yeah, I think they're a good group to connect with especially. I think they like they get off and we often we often overlook this group. So"]
+[-2.0061326026916504, 0.10009152442216873, "yeah, let's say there's a lot of organization called care."]
+[0.019531233236193657, -1.6614941358566284, "Ah, California Alliance for Retired Americans."]
+[0.008117632940411568, -0.8378366231918335, "for Retired Americans. Okay."]
+[0.17949996888637543, -1.1995930671691895, "Yes. So. So So yes. There that like so for example, if you're working for the county, and then you go into, the reason is that they'll have a different set of issues, because they're probably not gonna be the ones that are going to be on your Medicare Medicaid programs, because they may have a pension programs or so but their experiences are going to be a little bit different. But then aside from just union workers, there's a wide spectrum, folks that are county workers, and then you also have the ones that are service workers that work in hotels. Right. And so they said that their retirement is a little bit different."]
+[1.0565155744552612, 0.8735167384147644, "Okay, so they're this is an organization based in Oakland."]
+[-0.4311559796333313, -3.7952497005462646, "Yes, but they also have a, they have a chapter I believe in Orange County. Okay. So I think what you could do is if you'd like I can try to connect you with Gloria and And then so that that might be a useful thing."]
+[5.115834712982178, 3.521164655685425, "Yeah, that will be great. So let's just finish the last couple of questions. And then I think once we hit that, you know, when I put out the recording, then we can go into a little bit what that order, maybe we can follow with an email. So just a really quick, really last question."]
+[1.556056022644043, 0.46923327445983887, "I said, So the data that I look for is data that's provided by the county in terms of just just general census data as well. Uh huh. Okay. I think, I think the the, the, when we when we're talking about data a, I also referred to like, the the CHIS data, the California data, nation. And, yeah, but but a lot of it is census, I look at information, primarily looking at the demographics of who we're trying to serve. I'd like to have I guess, more data that breaks it down by ethnicity. That's sometimes of a challenge, because we lump all the Asians together. Yeah. Because we all know that the API group is not a monolith, kind of a sum. So that's why I think it's Dana's there. But it needs to be broken down further."]
+[4.384641647338867, 7.1645188331604, "Okay, great."]
+[1.1432065963745117, 2.095942497253418, "Sure. You can reach out to me the telephone number that that is provided to us, you can still use it to."]
+[4.875882625579834, 3.6293718814849854, "Great while also this concludes our interview, thank you so much for your time, you have been incredibly helpful to our research. If you find that you have more to share, please feel free to reach out to us. You know, our contact information is available on our website, www dot jfn sosi.com and you can leave an anonymous voicemail or telephone anytime. And then of course, you can always reach out to me or reach out to Katie right. So let me stop recording. Okay Gosh"]
+[-2.6935935020446777, -3.2572524547576904, "Okay, the primary goal today is to identify what needs you think are most important to the older adult population you serve. Those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen. So you will see a list of common issues and concerns impacting older adults. And please like to take a few minutes to read through this list. And let me know when you are ready to begin at all, as some follow up questions are related to the list."]
+[4.650527000427246, 5.444153785705566, "Please do let me know if you'd like me to enlarge it or move it around or"]
+[4.595006942749023, 5.468285083770752, "anything if you if you can enlarge it a little bit, please. Yeah, I"]
+[4.63046932220459, 5.404256343841553, "know it's, I try to fit down to one page. But I'll tell you what, I could just scroll down what you're done with."]
+[1.314611554145813, 7.72695255279541, "That's look good. Well,"]
+[3.845522165298462, 4.457126617431641, "I'll just just go ahead and take her to read through this. Yeah. And then I'll ask him questions about this list. Yeah, so when you're ready, and I'll scroll down when you're done with the very last item."]
+[-2.053431749343872, 0.29406431317329407, "Yes, I'm at the healthcare access."]
+[0.12857899069786072, 2.7029340267181396, "Okay, so I'm add in internationals injuries, okay."]
+[-3.440244197845459, -2.9802331924438477, "Okay, so for our records, can you please tell me your role and how you interact or engage with older adults."]
+[-1.235632061958313, -1.84577476978302, "So I'm with Adult Protective Services. So we are mandated to receive reports of allegation of abuse and neglect, including self neglect. And in the community, especially in law, only in Orange County, each county have their own adult protective services. So when those referrals came in, and will be assigned to our one of our senior social worker, they will respond to investigate that allegations, and then provide the seniors or depending adult with resources and linkages. One thing that I keep reminding the community is that even though we are state mandated to accept referrals, and mandated reporters are mandated to make the report if they suspect abuse or neglect, it is a voluntary services to our clients. So because we work with adults, they have the right to self determinations which means that every time we engage them, they have an opportunity to either accept or refuse our services."]
+[-2.193084955215454, -1.6146687269210815, "Thanks for invitation. Well, I would say I think, you know, tobacco use is very specific, you know, I I did not see substance use. So I would I would, you know, expand you know, substance use when to include tobacco use. See, and then we have we I think we already have mental health. So yeah. And then we also need to consider that older adults that have intellectual disability. So I feel like there is a narrow focus on services that for individual with disability, intellectual disability, but once those individual age, there are other concerns and issues that are associated with aging. So you may have somebody that is diagnosed with, I don't know, autism, and then they're getting older and then you have the physical limitation, you have all the chronic condition that is associated with, you know, aging, and you may have dementia on top of it. And so, you know, just just make things a lot more complicated. What I see is that we have specific resources for those with intellectual disability and then we have specific aging resources. There, there shouldn't be some blended or bridge between those two because you know, same thing that would mental health. You know, we have very specific resource for mental health and then all the adults recently we do have some mental health agency that are catered specifically to adults with mental health. So that that's good."]
+[2.490973711013794, 3.7960703372955322, "Now of the needs on this list, including those that you just suggested, Please rank the top three that you feel are the most important."]
+[-1.1823128461837769, -0.030332325026392937, "Definitely housings all different type of supportive housing. Yes, care caregiving. Thank you."]
+[1.6383806467056274, -0.7308506965637207, "And I will ask you a set of questions regarding each of the three that you just identified. So first one housing."]
+[0.3900495171546936, -1.4628934860229492, "I think we all struggling with this issue. As housing get more expensive, and scare is put pressure and all level of residence. But you know, with older adults, you at the age of retirement, they live on very fixed income. And their income does not correlate with an increase in inflation. And we all know that housing increasing is surpassing the rate of inflation's. And so with that said it, the if we continue with this trajectory, we're gonna see more senior citizens, we are on fixed income or at risk of homelessness, if they don't have family support, not everybody had the fortunes to move in with families. And, you know, the older you we live, there is a higher chance of us outliving our support system. And I mean, spouses, children, you know, friends and things like that. And so that's why I think housing could be older adults is even more crucial, because of the the mere fact that you know, they're, they're on a fixed income, they they don't, they have more limit opportunity to to work to do to earn additional income, and they may have less available support system that can take them in."]
+[1.3607902526855469, -2.3147714138031006, "This is ongoing conversation at all level, you know, at the federal or the state at the county in as we see a trend of homelessness, we also see a lot of money coming down for for different projects to tackle homelessness with people that address homelessness, the issue with these fundings, as generous as they are, they are meant for a stop gap, or transitional. But you can put all the money you you want in a stop gap. If they're not a surplus of permanent housings, then all the short term solution would not work because you have nowhere to safetly move people into. And that what we see right now, with our community partner is we try very hard, you know, to to navigate the housing environment and trying to link the client with shelter. Well, there are only a certain number of assisted living facility out there. And so yes, all of that is a barrier until we can have a more permanent solution. And I mean that in terms of more available availability in all types of housing, including assisted living."]
+[-0.14327234029769897, -1.574821949005127, "Oh, absolutely. I mean, you know, we, we all have our challenges and our privileges. Like I said, the older adults that we work with are very vulnerable. They are the one that either lack family support, or may not make the best decision for themselves as they, you know, age and now they get into a crisis situation. They're low income or no income or Are there undocumented. And so those are the most vulnerable at risk population for homelessness and in the most need of housing. Now, if they are educated, and they have a lifelong successful career, that would lead them into a retirement fund or saving, or they own their own home and the home is paid off. Obviously, there is a very different category, we see a few of those individual, most of the time, the scenario that those cases come to us is financial abuse, because the client have money. And so they are also a different target of financial abuse by either scammer or their own families or their own acquaintances just because that they know that they have money. So it's really depends on it was, well, where the client live is depend on what kind of income that they have. So like, we have south County, we don't see as much housing insecurity in South County, a lot are concentrated in the central part in the northern part of the county, just just because of the financial stability that the people have"]
+[-0.6635675430297852, -1.1418520212173462, "this city, why I have to say that based on my encounter, the cultural that for buy multi generation support. So for example, the Asian culture or some Hispanics culture to that provide multi generation support, there are multi generation household. And so even though the senior citizen may be low income, they have that support from their family. So you may have like eight people in a two bedroom apartment, but it is more stable than somebody who does not have that kind of family relationship. So in that situation, then you have the caregiver and stressed and then you have the other issue."]
+[4.180168628692627, 6.428549289703369, "Sorry, go ahead. No,"]
+[2.4666249752044678, 5.351202011108398, "I know that there was a couple of layers, so I just want to"]
+[7.127033710479736, 6.173046588897705, " Okay. For me, you are getting 100. So not to worry. So what do you suggest is the best way to address this issue or this need"]
+[1.2719568014144897, -1.3381065130233765, "Well, this is not a popular opinion. But I think you know, the status have to build more housings. So there's bigger questions, and it's way above my head on that. But yeah, we we really need the government to really decide how they're going to invest the fundings. That's going to lead to more permanent housing, or public housing. Actually, that's the term public housing. We need a place where we can just refer people and it's rarely available. So I'm not sure is that feasible or even doable right now."]
+[-2.809018135070801, -1.2393622398376465, "It's sadly, as we age, and this is dementia is not part of healthy aging, but it is a risk factors. In one or the adult, the dementia or Alzheimer's disease. Part of the dementia is there are more more vulnerable to abuse and neglect. They also more vulnerable to not how do I say there's a gimme, you know, of course for self for self care. So, that's, that's why I think that we need support area of educating the family educating the public on the disease progressions, and the adult itself, like, you know, more focused on prevention and because once you know we don't have the cure for Alzheimer yet. So unfortunately when the person is diagnosed with Alzheimer's disease or a different type of dementia and It just managing the progression and the support for that older adults in that family."]
+[-0.5126379132270813, -4.2410807609558105, "I feel we definitely doing better in Orange County. They're already two Alzheimer associations. And they're, they're doing a great job in terms of community outreach support group and linkages."]
+[-2.880742311477661, -1.146467685699463, "Not I'm not sure. I think that is it's linked to maybe not the disease itself, but it's linked to caregiving. Yeah, so it's more it being a caregiver is very challenging. But it's even more challenging to be the caregiver of somebody's who moderate or advanced on Alzheimer disease and dementia."]
+[0.09359469264745712, 0.06750909239053726, "For example, you know, where they live, their disability status, income, education level, etc."]
+[-2.9881770610809326, -1.248763084411621, "Well, again, you know, going back to the topic that you identify, right, which is dementia."]
+[3.409743547439575, 7.081637382507324, "Okay. Well, I, I would say yes."]
+[-2.5971710681915283, -1.3105934858322144, "Um, like in increase access to, to medical, medical care, you know, look into not only medications, but also, we only I believe we only have one adult day health care that is focused on individual with dementia, so maybe expanding that service, so that the client will have reliable access to, you know, stimulating support group, engaging, you know, social engagement and also medication management, and also at the same time providing some relief or caregiver."]
+[1.2231820821762085, 7.711956024169922, "Well"]
+[-1.2906920909881592, -0.6074941754341125, "a caregiver, a paid caregiver is very expensive. And as as we age and start losing some of our independence, if we are fortunate enough to live longer than the cost of caregiving increases. And so again, same thing if those that have available family support, then you looking at how to support the caregiver to avoid caregiver burnout. But for those that don't have the family support, how do we you know, make caregiving more affordable. So, yeah, in general, you know, I'm already thinking about how I'm affording my caregiving. And I can tell you, with my income right now, I wouldn't be able to hire full time care. And that's just that's not very encouraging."]
+[-1.1546722650527954, -0.7815096378326416, "You know, childcare, l elder care, all caregiving is just very expensive. And it's expensive for a reason, because the people that doing the caregiving is hard work. And they need to be compensated in a living wage and benefit. And so if we talking about making the industry cheaper, that is not fair for the workers, and you're not going to get quality caregiving. But if you are making, you know, a worthwhile professions, for people to enter into caregiving and quality, caregiving is going to be very expensive. And we're already talking about our senior health and living fixed income. And if they're not low income enough to qualify for IN HOME supportive services, and they're not well off enough to afford, you know, overall care. So we have this gap of middle class, I would call them middle class seniors who work all their lives, save money and realizing that is not going to be enough. And how we're going to make caregiving quality caregiving more affordable and accessible."]
+[-1.1990833282470703, -0.9346302151679993, "Let's say I have the same answer for everything now. Because you know, obviously, different social economic, will play a factor, those with low income will qualify for some public assistance in term of caregiving, those that are more wealthy can afford their own, or they can pay into long term care insurance. And so then we have a middle populations, who's not qualified for public assistance, but not well off enough. And so you know, they are going to be struggling the most. And then you looking at the other families that are able to or willing to provide the caregiving. So then you look at, again, cultural perspective is that, for example, for the Vietnamese culture, there will be an expectation for you to take care of your parents, even though it's not a legal obligation is a cultural ethic obligation. And so we see that more. or individuals that live alone and their their spouse have died. They have no the children live in different states. Even Yes, so depending on their family dynamic, what the relationship they are with the family, what their economic security, I get they all tie together that will have impact on whether they have access to caregiving."]
+[-1.161694884300232, -0.9939084053039551, "Think to address any of this issue will require more money. But again, it I would say expanding adult day health care, I know that the first things the state cuts in the budget is you know, adult day health care. But it's really is crucial in terms of having a supportive place for for the seniors to be socially engaged and to have access to meals and to care during the day and reduce the need of caregiving around the clock. And if they have family caregiving is reduced some of the stress and burnout and also, you know, in home supportive services is at their capacity. They have been very overwhelmed with the needs. And so maybe also a different program that is a bridge program from between in home supportive services."]
+[7.0589599609375, 6.129032611846924, "This is what I'm suggesting."]
+[-3.104423761367798, -0.058600667864084244, "Because I've heard that also from other folks. Okay. This is a case of this is the end of this set of questions. And the first one is geriatric care."]
+[-3.2921290397644043, -0.27117919921875, "In terms of medical geriatric,"]
+[-3.355178117752075, -0.3400688171386719, "geriatric care and we define that as the branch of health care that focuses our unique needs as we age. Just as pediatricians specialize in the health needs of children. geriatricians and fellow geriatrics at geriatrics health professionals specialize in the health needs of older people."]
+[-3.0869863033294678, -0.40761250257492065, "I think it's, I mean, geriatric specialties has been around for a while. I'm not sure if all the medical groups have provide, you know, the primary care doctor most of the time or internalist. I'm sorry, I don't I don't think that this service is widely accessible yet."]
+[5.588677883148193, 8.811056137084961, "Okay."]
+[2.073930501937866, 7.2787017822265625, "Or how would you"]
+[-2.7076690196990967, 0.2685151696205139, "Very good. You're the first person who's asking all these questions. Long Term Care is a variety of services, which helped meet both the medical and non medical needs of people with a chronic illness or disability who cannot care for themselves for long periods."]
+[-2.1958706378936768, -0.14819109439849854, "Very broad. In order for me to say its assessable, I need to know what agencies are offering long term care. I feel like there's bits and pieces that we put together. I mean, obviously, they're the aging and disability resource center, the ADRC. You know, we have the Council on Aging, the office and Aging. But, you know, and some of the medical group right now, you know, with Optima, they already have the case management in place. But honestly, a lot of those services are overlapping in the way that they are linkages surfaces. So they're like a portal to link out to different services. They're not direct service provider. Well, I mean, CalOptima offer healthcare. So I guess that isn't direct kind of ever. So"]
+[-2.677743673324585, 0.3012778162956238, "if you talk about long term long term care as in connecting to wraparound services, then yeah, that's that's the hard one. Because I'm not sure that that long term care if that's it's a definition is very broad."]
+[5.560830116271973, 8.777059555053711, "Fine."]
+[-2.5694260597229004, -1.3276780843734741, "We don't have enough all healthcare system in general is not enough. We have you know, we have this dilemma as a society where it's conflicting with mandatory for mandatory services to the client self to determinations. So all the services that he or need or the other services, actually not all services, most services available are voluntary services and mental health with the exception of a 5150 psychiatric hold of voluntary services. And there is a distinctions between mental health and dementia care services. So once somebody let's say they have a mental health diagnosis, and then they also have a dementia diagnosis. Well, The mental health agency would not accept that referral because of the dementia diagnosis. So again, we don't have on my knowledge, I'm very limited with an agency that have a cross over that offer both. And as we see an increase in this population, same thing that I was talking about intellectual disability, we need an agency that will cover all and right now is hard. So that's yes, that's what I need is an agency that can provide mental health to those that have dementia."]
+[-2.600865125656128, -1.3069841861724854, "Yes, but once they know that the person have dementia, they will not take the referrals."]
+[-0.4106367230415344, 0.43090111017227173, "So social services in term of So okay, so social services, we have CalFresh, we have Medi Cal, we have like the benefits side of it. Well,"]
+[-0.2669682800769806, 0.5789493322372437, "I would say like basic needs, like food, shelter, other human needs. And yeah,"]
+[3.2431933879852295, 6.281975746154785, "I let me repeat the question. Feel free to answer how, however you feel."]
+[-1.6949329376220703, -2.0694844722747803, "Yeah, that's also very broad. So let's say I Okay, so if that's the case, then yes, it definitely a lot more accessible now, in the sense that there's a lot more agencies available. And they are trying to target the population. So I would say that for senior citizens they met, they may not know, everything that available, but I think that they have at least been touched by one program or another."]
+[3.28008770942688, 6.028007507324219, "Hey, next question."]
+[1.7773619890213013, 6.5961689949035645, "This is really your personal opinion, what you think"]
+[0.726090669631958, -0.9426421523094177, "Well, you know, I think Housing and Economic securities kind of tie in together. So yeah. Yeah, probably economic security. If the inflation is continue, the way that we see is continue than they're not going to be able to afford the basic needs."]
+[1.1987146139144897, 7.7442708015441895, "Well"]
+[-0.10314103960990906, -1.906498670578003, "that is tricky. The government need to take a stand in terms of where they are, are we a socialist society or the capitalists, so it is a socialist society, then we talk about raising taxes, expanding your social safety net and building more public housing and providing, you know, more public services and expanding healthcare. But if we are not a socialist society, then it's come down to the individual responsibility. now I'm Not sure how I feel how I feel about that. Yeah. Because you know, we are we are standing in the middle, we try to provide some support, and it's not enough. But then when the person when the individual refused the services and make choices that not in their best interest, they have the right to self determination. And so where we are right now, that right to self determinations can be conflicting with their well being or, or their safety. And so I guess, as the society we have to decide which one is more, we value more self determinations. I don't have an answer for you, I'm sorry."]
+[0.07485128939151764, -4.887307167053223, "This is this is fine. We're thinking about all the older adults, older adult residents in Orange County, who was getting the least amount of attention."]
+[-0.7256616353988647, -1.1334282159805298, "It was the middle class. Older adult, I feel like we have the way that the safety net are designed right now that support low incomes. So if you are low income or medical, you qualify for Medi Cal, you will also qualify for CalFresh you know, for Foods support, then you qualify for IN HOME supportive services that provide caregiving. And then you know, also if they're lucky, and they're one of the lucky one that qualify for a housing voucher, then they already kind of encompass, encompass all of the special needs. And then you have the other spectrum where people are wealthy enough and you know, they pay for everything on their way in and so we have a group of people in the middle where they're not qualifying for services, public assistance, but they're not able to pay everything private even the nonprofit have a income threshold so I feel like the middle class are being left out in terms of needs or for for services"]
+[1.2123725414276123, 7.730717658996582, "Well"]
+[3.4481542110443115, 4.055407524108887, "the I'm looking at the list again."]
+[-2.065502405166626, -1.4546279907226562, "I think what it will come down to the emotional well being be prioritized prioritize basic needs, food, clothing and shelter, the physical needs. And a lot of agencies out there, whether it's government or community agencies are focused on those services. And we make great thrive in terms of healthcare and accessibility. But, you know, with the pandemic and you know, we are so focused on protecting the world We'll be the physical well being of the older adults with, you know, contacts and isolations and things like that, that sometimes we forget the emotional connection."]
+[2.900451421737671, 4.849388122558594, "Okay, so we're almost there. The next set of question will focus, basically your area of expertise."]
+[-1.2857259511947632, -1.8153506517410278, "I think at the beginning, you already mentioned this, you know, is that to see you know, how to call or when to call to us. And I think that we, the volume of report that we received will indicate that there is an increase in popularity in among the community. And so, we actually received quite a number of seniors that calling for themselves calling for other. And so that's good. We tried our best to do all community outreach on just just to get the word out. Why it's a challenge, I wouldn't say not working, what is the challenge is that we cannot do it alone. And the reason why is that well Adult Protective Services when we respond to an allegation. And we addressing the allegations, is, and then we have a binding, whether it's confirm, and conclusive, unfounded, but the finding to me is the least important. Because what matter is how to get this person to a safer, more stable place. Whether it's confirm or unfounded, if the client is too vulnerable, and lack all of the resources mentioned, or have all these needs, then we're gonna still going to leave them where we found them, and we're not making their life any easier. But we as an agency cannot do all of this alone. And so what I've found in recent years, that the cases are more complex, not because of the boxes that you check in the allegation, but everything that's surrounding the vulnerable adults, like the housing insecurity, homelessness, you know, in combination with substance abuse in combinations with, you know, dementia or, or mental health, and then there's component of family dynamic. So all of those factor are something that we are not equipped to address alone as an agency. So yeah, and another challenge for us is getting the cases to prosecution. And so because we are social services, while social worker we don't do criminal investigation, for example, what we call physical abuse is an assault. In though there is also a criminal neglect, there's a penal code for that, what do we call financial abuse is either a scam or fraud or, you know, and we need our law enforcement partner to be more willing to investigate the criminal side of it. And our DEA too willing to bring the case to prosecutions."]
+[-0.22533926367759705, -3.565514326095581, "I think we, we just need there is a penal code already in place for law enforcement, that is penal code 368. And to outline that is enhancements like you know, if they get called on an elder abuse because of neglect or physical abuse, you know, they they can put on that they can use that penal code to investigate and to bring the cases da thing, not that we need any policy in place, but more of the willingness to to take these cases seriously, I think that Elder abuse is competing with your murders, your, you know, Grand Theft, your burglary and all that serious crime. And like I said, it's it's difficult because those crime are serious, and they need law enforcement attention. But if law enforcement don't have the bandwidth, or the willingness to investigate and bring charges to elder abuse, then no matter what we do at Adult Protective Services, the perpetrator, the alleged abuser, there will be no consequences. So yeah, I think it's just a prioritizing. Looking at those cases at a different light, not that there are lesser than other crime,"]
+[2.717366933822632, 1.7545334100723267, "or what entity is best suited to address this issue."]
+[-0.13111121952533722, -3.4718055725097656, "When we're talking about, you know, prosecution, probably going to go back to the DA, and the local law enforcement."]
+[2.529963970184326, 7.446994304656982, "You know, ATS, obviously,"]
+[1.8839985132217407, 0.9739521145820618, "People track a lot of data also. You know, so"]
+[4.220916748046875, 4.505156517028809, "Is there anyone else you think that we should talk to you,"]
+[0.8919700980186462, 1.2909103631973267, "in my agency or outside,"]
+[-3.006845235824585, -2.8574070930480957, "anybody that you can think of, you know, without, you know, giving what you have share with us and what we're doing right, in terms of doing just older adults needs assessment"]
+[3.802964687347412, 4.272100925445557, "so well, it's maybe already on your list, because I know that you guys have attended some of the meeting that I intended. I'm trying to think, because I Yeah."]
+[1.7653834819793701, 0.11703984439373016, "Um, yeah. Okay. Public Authority, probably."]
+[4.1436262130737305, 4.459676742553711, "It's okay. I mean, it's just, it's just something that you know, as you think about these, because we're talking to so many different people, and you started seeing questions, and sometimes, oh, yeah, you should talk to this person in this agency. So we always want to ask if there's something, something that you feel like, Hey, you got to talk to this person, this expert or just, you know, whoever."]
+[-0.2624952793121338, -3.6122653484344482, "Yeah, you know, I went, I actually I would if you have not on your roster to reach out to the sheriff to the sheriff's department. You know, or, you know, another law enforcement agency. Yeah."]
+[3.3451616764068604, 5.851626873016357, "Well, this is, this is last question. We follow up with you if necessary."]
+[3.673847198486328, 15.08318042755127, "Yes."]
+[4.692808151245117, 3.186321258544922, "So this concludes our interview. Thank you so much for your time, you have been incredibly helpful to our research. If you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website, www dot events. osu.com. And you can leave an anonymous voicemail, or telephone line at any time and then of course, you can always reach out to me if you think of anything else, after this call that you want to add, please feel free to reach out to me"]
+[-2.6874074935913086, -3.1770339012145996, "Okay, so the primary goal today is to identify what needs you think are most important to the older adult population that you serve those who are 60 and older, we want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. I'd like you to take a few minutes to read through this list. And let me know when you are ready to begin in our follow up with some questions about the list."]
+[4.6684794425964355, 5.428791522979736, "And please do let me know if I need to enlarge this in any way or move up or down. I'm just trying to fit it on a one on one page."]
+[-0.8222606778144836, -3.4649131298065186, "Yeah, so I'm the director of Orange County Community Services. Within Community Services is the office on Aging, the Veterans Service Office and workforce development. In each of the three programs, we have programs that are serving seniors, obviously, the office on Aging, mostly 65, and older CBA, California Department of Aging programs, we receive the funding directly and some are done in house and then some are contracted out with the Veterans Service Office, about 75% of the veterans that we see on a daily basis are considered seniors as well. So we cross refer them depending on what kind of means they have. And then when it comes to workforce development, we have a senior employment program that we're responsible for managing as well."]
+[0.13084782660007477, -4.169650554656982, "Great now thinking about Orange County, and looking at the list of this common issues and concerns impacting older adults."]
+[-0.343444287776947, 1.1754403114318848, "Oh, um, I guess under economic security, it says education employment. So. Right. Yeah."]
+[2.3887546062469482, 5.507802486419678, "And, of course, the examples are, right, what they are examples, right. They're not exhausted in any way."]
+[2.6323862075805664, 3.8946940898895264, "Yeah, yeah. No, I mean, I think you you pretty well captured, like our top five, you know, the common themes that we hear we have a call center, and we get approximately 100 calls per day, for various reasons, but we track what they're calling for. And, you know, the top bar are listed here."]
+[2.409968376159668, 3.800097703933716, "And of the of the needs on this list, and, you know, Please rank the top three that you feel are the most important."]
+[1.4541845321655273, -0.9325563907623291, "Number one is definitely going to be affordable housing."]
+[-1.0451639890670776, 1.087681770324707, "I think economic security and transportation would be probably transportation before economic security kind of on on my list based on what we provide here would probably be the top three. Okay. Well, I think I think one of them was, you know, health and disease and things that it's all very relevant, but we don't necessarily provide those support services. So it'd be hard for me to say how many people on a regular are trying to access programs related based on their need,"]
+[1.6354458332061768, -0.7647365927696228, "understand it, and I'm going to follow out with a set of questions for each of the three topics that you identify. So first of all, housing."]
+[0.5918528437614441, -3.174622058868408, "Because if you live in Orange County, it's quite expensive. And so depending on what their financial situation you know, was whether you know whether they own their own home or not, there are many people that have rented all of their lives and the rent just keeps escalating and their Social Security does not know out of the rain, the same rate, we also see that, you know, there's a to home income. And as you age, sometimes that's not always the case, whether it's because of divorce or death, and one person can't do it alone. And then, you know, of course, you know, we see those folks that do like the reverse mortgage to try to stay in their home. And then at some point, you know, they just have zero equity left, and so they really have nowhere to go. It also plays into, you know, some of the examples of the diseases that you've shared, like dementia. You know, there are reasons that people you know, are on the street. But But honestly, the stuff that we see, really is separate. And apart from that, it really is, folks that are living paycheck to paycheck, and are too proud to ask for services. I have, we have a client, and she lives in mobile home, it's I've been there, it's a beautiful, very well kept, she's been there for for many years. There's, there's services for people who are just, you know, homeless, or ill, but there really isn't services for people who are doing their best to stay in their home and have some income, but not enough."]
+[0.9381083250045776, -1.7778899669647217, "Well, I mean, you know, there were pretty built out in the county. And I think, you know, trying to move a senior from, you know, San Clemente to Riverside County, you know, one the lose the bill to be isolated, because when they lose that social component that they're accustomed to, they want to stay in their home, they want to stay where their doctors are, they want to stay where their friends are. And so I think the barriers are the limited number of housing units available. And then the the number of affordable housing units that are available."]
+[-0.7131520509719849, -0.8103105425834656, "Yeah, I'm sure that's a huge factor, I also think, was I gonna say about that, you know, there's a lot of cultures where, where the families like, join together, so the grandmother, you know, stays with, you know, her son or her daughter. And if she were to get some financial assistance, she's not able to take them with her. And so you're separating the families as well. And so I think there's, you know, when it comes to their, their background, and their, the way they were brought up, I think that those factors come into play as well."]
+[-0.4426659047603607, -2.261596918106079, "Oh, wow, you know, I wish I had a magic wand. And I could just build, you know, units for these people. So Laguna Woods, in my opinion, is a good example. But a more affordable setup than what's available there. You know, there, there's Association, there's a, you know, are all kinds of stuff. But if we just had, you know, if I had a bill, the ability to create a similar model, where everybody was welcome. And maybe you pay based on your income, but everybody, there's, there's something for everybody."]
+[0.5721530914306641, -3.3849968910217285, "I don't think they plan to live as long as they they are. I don't think that people planned for that. And I also think that, you know, again, it's expensive to live in Orange County. And I think most are living, you know, off of their social security check, and they're living paycheck to paycheck."]
+[0.33916720747947693, -0.8608531951904297, "Yeah. I mean, it's it's really the federal government deciding you know, what the increase to their social Security is."]
+[-0.36212098598480225, -1.3245984315872192, "Yeah, I mean, I think, you know, education level, obviously, you know, I think folks that are more educated, knew that it would, could or could be a problem and plan for that. I think folks over educated obviously got a better job and probably have some retirement, you know, that comes to them each month, I think that, you know, it all depends on the situation, whether they, you know, they come here and have to learn English and, you know, start out in the kitchen or something of that sort, there's not a lot left, you know, when you're in your weekly paycheck to save, right. And so, it's a big difference from working, you know, maybe a corporate job or a government job where we're very lucky, you know, if you don't save, they're basically saving for you. But, but I don't see that that was the situation for many of our seniors. And I also think many that are, that are current seniors were lived in a in a household where it was, the mom stayed home, and the dad went to work. And now we're seeing that these individuals are passing the male figures passing, and the female figure has never want one worked, done the bills, or you know, doesn't isn't eligible for the retirement, and then they're left with nothing."]
+[-0.10379534959793091, -0.9157522320747375, "Yeah, that's a tough one. I think they're, you know, we could do some better education, when it comes to, you know, financial management, financial literacy. You know, going through some of those scenarios, helping them understand even a simple thing, like writing a check. You know, we have we have, you know, Homemakers that come in, and, you know, need to pay their taxes. Because their husband did it for 80 years. And so just, you know, the just the, even the basics."]
+[0.20406098663806915, -2.7576723098754883, "Well, I think that they're very, they think they're very independent, they want to come and go as they please, once you pull that from them, you know, it takes away from their ability to kind of, you know, do as they please. And the programs that the county has, while they are good, they are limited to non emergency type visits, so I can't pay for someone, or I can't pay my contractor to take someone to the mall. But I can pay my contractor to take you to the dentist. So there's a lot of things and places that they want to go for their independence to maintain their independence. And we don't have any type of service other than like the bus, Octa. And even with Octa, I mean, you're not getting from one place to another very quickly. And I think there's hesitation to use the bus system. I know, in some, you know, states in other counties, it's a normal, you know, way of transportation in Orange County, it's it's never been, it's always been frowned upon. I don't think I would want my mom taking the bus to the wall."]
+[0.7137109637260437, -2.5642430782318115, "I think it's funding, you know, a, we could easily you know, if we had more money, we could reshape the current non emergency transportation to transportation, right, regardless of where you want to go, you know, we'll be able to take you through probably some limitations still, like, you know, probably couldn't take you to the casino or maybe adding a few additional stops within there, like the mall or the library or something like that."]
+[0.08759359270334244, -2.6948070526123047, "I think if you're, you know, if you don't know the language, it could be a challenge. One, I don't I don't think you know, I don't know I don't know this, but I just have a sense that, you know, those bugs drivers drive for long periods. So their days are long, only 12 hours. And so they're not thinking about what every person on this bus is going to be stopping, and, you know, helping them on and off the bus. I don't think that that's something they can do. There are separate programs for that, like access to things like that, but at the general bus system, I think it's, you know, they're on a schedule. So it's, you know, it's very quick. And, you know, I think, again, I think there's, if they're not comfortable, or if they don't have another senior with them, I think they could get lost in the process."]
+[0.9612867832183838, -0.13790464401245117, "I mean, I think, you know, maybe looking at expanding an existing program that has some capacity, but including funding, because, you know, obviously, that's, you have to be able to pay for the service, but, or even looking at maybe, you know, expanding and maybe there's a small stipend, you know, like, you know, I don't know, $2 $5, whatever it may be. But something that's a little bit has a little more flexibility in where you can go. And it doesn't take you all day to get there."]
+[-3.2120723724365234, -0.05734219029545784, "Alright, moving on to the next question set of questions. I just read out the first one geriatric"]
+[1.1593806743621826, 1.1726726293563843, "care. I don't have much experience with or direct knowledge. I know it is available. And we do refer out to different organizations. But how I think the question was, how available"]
+[-2.8748724460601807, -0.1432643085718155, "how assessable and adequate the following care or services are in our accounts."]
+[1.0078636407852173, 2.2580933570861816, "So I think it's accessible. I don't know how adequate the services are."]
+[1.8538485765457153, 6.111749649047852, "I would have to say it's about the same."]
+[3.674267053604126, 8.047119140625, "Oh, sorry. Yeah,"]
+[-1.3566771745681763, -3.544705867767334, "yeah. So for each of those, we do have services. So someone called the call center, and we're to say, my mother needs some she's, you know, 85, and she needs mental health services, we would pull that up, and there are resources in Orange County. Were just a referral piece. Right. Okay."]
+[-0.6624322533607483, -3.999124050140381, "Yeah. So orange County Health Care Agency does"]
+[0.9178435206413269, 2.184889316558838, "Are they Yes, I think that they're accessible. I don't know how well received they are. They think that there is some hesitation from the general public when it comes to government services, and that they, you know, tend to frown upon them. Before even trying to access or figure things out. It's like, oh, that I gotta go to the government. I don't want free cheese. I don't want you know, you just right off the bat, there's kind of hesitation."]
+[0.5736714601516724, -0.22819772362709045, "Well, I think housing will be will be one of them. I think there'll be some new isolation issues. I think that this younger generation doesn't communicate in the same manner that the older generation does. And kids nowadays have a different relationship with their grandmother than used to be the case. And if if the older generation isn't tech savvy, I think there's going to be some voids and really impact isolation issues."]
+[1.2139102220535278, -0.24034175276756287, "Well, I don't think we can do it alone. I think that we're already mandated to do so much with such little funding, that the government's role really is to meet the state mandates. And we can't really do much more, because we don't have the resources."]
+[0.1160062700510025, -5.018431186676025, "And thinking about all the older adults rested in Orange County, who was getting the least amount of attention"]
+[-2.932992696762085, -2.0924184322357178, "when older adults are getting the least amount of attention, probably those that are self sufficient."]
+[1.910040020942688, 3.52996563911438, "Yeah, those that are self sufficient."]
+[0.1194562092423439, -3.906017541885376, "Thinking about all the issues facing older adults in Orange County, what issue is the overload, if any,"]
+[1.1765769720077515, -0.778092622756958, "lack of affordable housing."]
+[2.8138418197631836, 6.321838855743408, "May be asked."]
+[3.916609764099121, 7.28976583480835, "Sorry, I"]
+[0.03224107250571251, -3.010902166366577, "was gonna say the other thing is, it may be a clearer understanding of what services are available and what the county is responsible for, and what the state is responsible for, and what each individual city is responsible for. Because they think sometimes, you know, those lines kind of cross and it's unclear."]
+[-2.3624720573425293, -2.853057384490967, "Now, in addition to what we have already talked about here, just dig a little deeper into your area of expertise. So thinking about your topic, basically, inclusion and equity in aging. Well"]
+[-1.0755438804626465, -2.3378539085388184, "I think it's, I think the problem is, seniors don't know who we are or what we do. And so we're not capturing everybody. So it's very difficult when we do these surveys, or we have meetings when we only know a small group, a small portion of the population. But then when we look at the sheer volume of seniors that we have in the county, we don't know where they are. We don't know what their situation is. We don't know what their needs are."]
+[3.0278689861297607, 0.07062935084104538, "What new or revised policies are needed."]
+[0.11221963167190552, -2.1895086765289307, "I would think maybe at the state level, they could do such a better like allocation of resources based on like the total population, not necessarily like the poor total population of those in need, or those low income. There's no requirement that you have to be low income, but we don't have enough funding to assist, you know, the 500,000. You know, there's just, it's not. So we don't, we don't do a whole lot of outreach, because our funding is gone with just the people asking for the services."]
+[0.0012648022966459394, -1.9793204069137573, "Well, I think the California Department of Aging, it really comes back to the funding. You know, we could do twice as much as we're doing today, if we had twice as much staff and twice as much funding. And so you can always do more, but it really boils down to the funding."]
+[1.719153642654419, 0.6007751822471619, "Well, we're mandated by the state and to collect certain data and our data is very exempt. It's exhaustive. It's very expensive. And most of it is like unduplicated clients, we call them service units. Are each contractor is responsible for reporting those things as part of their monthly invoice."]
+[-0.9045358896255493, -1.9674885272979736, "Well, I think that, you know, some of our service providers would probably be helpful. They do this day in, day out. I think there's some volunteers that also, you know, assist in the programs when it comes to our home delivered nutrition programs, that would probably be helpful. I think you guys already have that full list, though. So I'm sure I think Claudia took a look at the list that you have. And I think we tried to clear everybody on there. So"]
+[3.343413829803467, 5.999635219573975, "one last question. Yeah, of course, of course."]
+[3.9965150356292725, 4.343321800231934, "I think of anything, it's, you know, right now being on the spot. I'm kind of always trying to wing it. But um, I think that yeah, definitely follow up with me and I will do the same if I have any."]
+[4.708942413330078, 3.194265365600586, "I just read off this very last part at the This concludes your interview. Thank you so much for your time, you have been incredibly helpful on our research to our research. And if you find that you have more to share, please feel free to reach out to us. Our contact information is available on our website www.smc.com. And you can leave an anonymous voicemail on our telephone line at any time. Then, of course, you can just reach out to me if you just have anything that you'd like to add."]
+[4.799861907958984, 4.954933166503906, "Very good. Well, Tammy, thank you so much. Absolutely. Take care. Bye. Have a good"]
+[-2.681123971939087, -3.2672576904296875, "So the primary goal today is to identify what needs you think are the most important to the older adult population that you serve. Those who are 60 and older, we want you to think as broadly as possible taking into consideration of older adults, caregiver families and their community. I'm going to share my screen so you can see a list of common issue and concern impacting older adults. Please take a few minutes to read through the list and let me know when you're ready to begin and when you want me to scroll because it's it's a long list"]
+[4.022807598114014, 5.539254188537598, "here you see my screen"]
+[2.30609130859375, 9.506338119506836, "yes"]
+[4.3391618728637695, 5.421290397644043, "okay, you can scroll down"]
+[4.251193523406982, 5.469846725463867, "Okay, let's scroll down."]
+[3.3989384174346924, 7.073947429656982, "Yeah, one more. Okay."]
+[-0.9465550780296326, -3.506453514099121, "Sure. My name is Deborah Levy and I'm the Executive Director for the Alzheimer's Association Orange County Chapter and we work with older adults who are experiencing a form of dementia or mild cognitive impairment and their families"]
+[0.20997664332389832, -4.101296901702881, "thinking about Orange County and looking at the list of common issues and concern impacting older adults is anything missing from the list scroll"]
+[0.27478671073913574, -0.32587191462516785, "so I am wondering why diversity"]
+[-0.20500481128692627, 2.246997356414795, "is not there and language barriers and cultural barriers and sexual orientation yeah good point"]
+[2.527334690093994, 3.8667263984680176, "I'm making a note that up the next on the list including those that you suggested Can you Please rank the top three that you feel are the most important"]
+[3.3983561992645264, 4.110162734985352, "Yeah, it would be great. I can only see a third of the list."]
+[4.621771812438965, 5.409055233001709, "Okay, I will try to put everything in one page."]
+[10.634052276611328, 8.45866870880127, "Thanks."]
+[2.111346960067749, 5.205293655395508, "Just one on the bottom"]
+[0.1056593731045723, 2.3618552684783936, "so I still just see from environmental concerns to unintentional injuries that's all I see."]
+[3.664825439453125, 6.448484897613525, "And let me see"]
+[3.9162795543670654, 6.977599620819092, "okay, there you go."]
+[3.5066182613372803, 7.602145671844482, "Yeah. Okay. So"]
+[-1.7586926221847534, 0.4650763273239136, "Yes. health care access and delivery."]
+[-0.3898853063583374, 1.277426838874817, "Economic Security"]
+[0.3418484628200531, 2.264498233795166, "also don't see like safety,"]
+[-0.9217488169670105, -1.0834592580795288, "You know, when when individuals get older, I think that their health becomes definitely a primary focus and insurance costs, you know, the cost of their care, making sure that they're able to be seen by a provider. You know, you have in here culturally and linguistically appropriate care. I think that's really important. Long term, like long term care, which I see under housing, per se, but"]
+[1.5950225591659546, 5.998244285583496, "I think that becomes a big focus."]
+[2.7354068756103516, 5.937641143798828, "Not sure that I know how to like that I can answer that question. Yeah."]
+[-2.742591142654419, -1.1906696557998657, "I do, but I'm looking at it from the lens of my agency. And so I'm trying right now to put a broader hat on. You know, from my agency's perspective, when it comes to mild cognitive impairment, and Alzheimer's disease, there aren't very many specialists in our area, and getting an appointment can be difficult. And now, there's two treatments that are available to slow the progression of the disease if it's caught early on. And physicians. It's not like widely used yet. And it's also the drugs are currently not covered by Centers for Medicaid and Medicare. So that's from just my agency's perspective."]
+[1.8287060260772705, 2.321107864379883, "May I dig a little deeper into why not offer Wiley and"]
+[-2.1138627529144287, 1.4150382280349731, "Yeah. They've only been released in the last year and a half. One of them was had a kind of a controversial approval through the FDA. The second one is showing some promise and there's a third one that probably will be submitted for approval to the FDA. So there could be three Yeah,"]
+[7.170547008514404, 4.650193691253662, "thank you for sharing."]
+[1.9395759105682373, 1.0978084802627563, "Well, if I can pull information information out"]
+[-2.684175729751587, -0.7071047425270081, "so I'll just share something from our facts and figures. or So primary care providers say they lack the tools to care for patients and experiencing cognitive issues. They rely on specialists to fill the gap."]
+[-3.0667874813079834, -0.5867919325828552, "specialist physicians see a substantial number of patients 60 And older every year. Nearly four and five emergency medical specialists noted that they see 500 or more patients in this age group each year. Many geriatric specialists report seeing 500 or more older adults each year. A little more than one in three neurologists indicate that they see more than 500 patients age 60 and older each year. It's it, there's lots of issues one is, you know, primary care providers say that they lack the tools to care for patients who are having mild cognitive impairment issues and it's hard for their own specialists in our area"]
+[-2.9731204509735107, -1.190771222114563, "when it comes to Alzheimer's and dementia so I think it's really really challenging for folks to get a diagnosis and treatment"]
+[3.1336867809295654, 8.879956245422363, "Yeah,"]
+[0.059087660163640976, -0.7827314138412476, "thank you for sharing. So when you think about economic security, how or why older adults struggle with this issue"]
+[0.4916035234928131, -3.366849660873413, "again, I'm not an expert. So I what I've heard from you know, some of our constituents is you know, they have a fixed income and it's expensive to live in Orange County and that that is a concern as to how long our money you know will last before they they run out of funds"]
+[-0.6138442158699036, 2.6986083984375, "like barrier assists to see improvement in this area"]
+[0.5825214385986328, -3.490790605545044, "probably more affordable housing for seniors in Orange County, that you know, it's quality affordable housing"]
+[1.633133888244629, 6.564023494720459, "Oh, I definitely think so."]
+[-0.579226553440094, -1.3872345685958862, "Again, you know, language, the language barriers we have a very diverse population here I don't think that all agencies are set up to be able to translate into different languages to speak to individuals with different languages or different backgrounds cultural sensitivity training for employees within an organization"]
+[1.9193472862243652, 4.6952080726623535, "I think that there's a lot of work that needs to be"]
+[7.201464653015137, 6.095897674560547, "done what do you suggest is the best way to address this need"]
+[2.6805307865142822, 6.014527797698975, "we don't have the answer"]
+[-2.476778745651245, -1.7448891401290894, "when you think about safety, how or why older adults struggling with this issue"]
+[-1.4445486068725586, -1.6939985752105713, "it just came to mind when I looked at the list that it wasn't there so you know safety within their own home you know if they're living alone and I've seen unintentional injuries you know falls so I think about about safety in somebody's own home making sure that you know, they're they're eating not everybody has you know, is living with other family members you know, that if they're living in a multi generational you know, household they're there people that are there to, you know, watch out for their loved ones, but if they're living alone, I think about communities, you know, what the safety is in communities. You know, last night we were having, having dinner with some older adults, and they were sharing a story about, like, artificial intelligence right now and getting scammed. You know, if they got a call and AI is using, like, a loved one's voice, to say, like, I need help. And not knowing that they're being scammed, you know, and maybe giving money to a thief, you know, unintentionally."]
+[2.1450629234313965, 5.518693923950195, "There's just There's so much going on"]
+[2.7036843299865723, 5.946308612823486, "I don't know that I have the answer to that."]
+[2.2850959300994873, 5.451282978057861, "I'm sure that there are, but I don't have examples."]
+[7.14695930480957, 6.129720687866211, "What do you suggest is the best way to address this need"]
+[2.728318691253662, 5.9162774085998535, "I don't know that I have an answer to that either."]
+[-1.2562936544418335, -4.2520246505737305, "Okay. Can you please describe how assessable and adequate geriatric care in Orange County"]
+[2.7980329990386963, 4.746764659881592, "I'm not sure that I might be the best to answer some of these questions and in turn that I'm just not an expert in you know, in the field."]
+[2.8106698989868164, 5.277669906616211, "Yeah, I understand. So, like I mentioned, you can choose to answer the question in part in full or not at all. Based on your expertise. Okay."]
+[2.7520289421081543, 5.015933513641357, "I don't feel like I'm an expert in that either."]
+[2.8496851921081543, 5.693894386291504, "I don't feel comfortable answering that either."]
+[2.841951608657837, 5.715560436248779, "I don't feel comfortable answering that either."]
+[0.16737817227840424, 3.4863243103027344, "No, thank you. What do you think would be the biggest challenges older adult will face in the next 10 years"]
+[-3.0233609676361084, -1.2361438274383545, "I do think the prevalence of Alzheimer's disease and the growing population and if we're we don't make bigger strides you know to help with memory loss and"]
+[-0.21938303112983704, -0.1393323838710785, "being able to help individuals is it is a big problem"]
+[2.735398769378662, 5.822369575500488, "I don't know that I feel equipped to answer that either."]
+[-0.024549251422286034, -4.847683429718018, "Thinking about are the older adult resident in Orange County who is getting the least amount of attention"]
+[4.715357780456543, 3.497351884841919, "I don't feel comfortable answering that either. I'm gonna be a great interviewer"]
+[4.808940410614014, 3.4420976638793945, "I just want to you know assure you that our answer will be confident now interview will be confidential."]
+[-0.5153332948684692, -4.1110615730285645, "You know, my agency focuses on Alzheimer's disease and dementia. The county of Orange just applied and received a Healthy Brain Initiative grant for the next two years. So I'm think that that's going to be a great, you know, kind of first step for the for the county and being part of taking part in the Healthy Brain Initiative."]
+[-0.46687957644462585, -4.179960250854492, "If we can dig a little deeper in your area of expertise, thinking about Alzheimer's disease and dementia, what are some way you know that Alzheimer disease and dementia is working and not working for older adults in Orange County."]
+[0.09921952337026596, -4.714276313781738, "So you know, I you are already aware that Orange County has the fifth largest population of seniors aged you know, 60 years and up We're expected to see substantial population growth through 2060. So"]
+[3.2178215980529785, 6.16121244430542, "go ahead and ask me the question again."]
+[-2.957679510116577, -1.3057935237884521, "So when you think of Alzheimer's disease and dementia, how or why older adults struggling with this issue"]
+[-2.764526844024658, -1.2261656522750854, "one of the things is, you know, dementia patients are more likely to require assistance for a range of instrumental activities of daily living like transportation, finances, medicine, management, outside services."]
+[-0.6227815747261047, -1.5568619966506958, "I'm looking at just some of my statistics here that Orange County residents with Alzheimer's disease, about 37% belonged to non white racial ethnic groups. So we definitely need to be looking at, you know, linguistics and interventions that are culturally tailored to this population. There's definitely a staffing shortage of skilled workforce, it's pushing more elder care back on to families."]
+[3.634690761566162, 6.516674518585205, "So let's see."]
+[4.018763065338135, 5.218634605407715, "Looking at some of my notes. Yeah, take your time."]
+[-2.3600966930389404, -1.142816185951233, "The caregiving piece is a major component as well. The impact that it has, if a family is caring for their loved one in their home, you know, just the economic and emotional strain that that takes on a family. We need to address, you know, those issues as well. Respite Care is a big component that I hear over and over and over again, from families is that if they're caring for someone with Alzheimer's or another form of dementia, that the caregiver, it's not just about the patient, but the caregiver, the toll that it takes on the caregiver and needing to provide respite care, so that they can take a break and and do other things. And the stress that it takes on a family if they're working outside of the home, while taking care of somebody with Alzheimer's or another dementia. You know, those are those are real problems and how do we work with employers to educate them about you know what it's like to care for somebody with Alzheimer's or dementia."]
+[2.031702756881714, 5.45430326461792, "Yeah, there's a lot."]
+[-3.981490135192871, -2.0373144149780273, "I've had different experiences for different group of older adults from different backgrounds."]
+[-0.5350983738899231, -0.3828955292701721, "Yeah, I mean, the cultural sensitivity and language and all of that plays a role for sure."]
+[2.961843729019165, 5.250960826873779, "I don't necessarily have an answer. You know, I can talk about what we're doing to address it that I can't talk about, you know, bigger picture."]
+[3.7878518104553223, 7.2874250411987305, "Yeah, that's whatever that you feel is, is appropriate."]
+[-2.6012580394744873, -1.3292711973190308, "Um, so the Alzheimer's Association, you know, we, we have support groups that are taking place. We definitely need more qualified volunteers, you know, who, who can help facilitate support groups in a variety of languages and a variety of communities. We're doing education programs, you know, in the community, on a variety of topics that can help caregivers that can help family members from that can help those who are early diagnosed with the disease and help them as they navigate the process. You know, we have a 24/7 helpline to be able to provide referrals for families and a multitude of areas. So I don't know that like the county needs to recreate certain things that we are already doing in the community. Our helpline can be translated into 200 different languages. So I think we could be definitely be a partner for the county, as it plans its, you know, master plan on Aging, to be able to use our 24/7 helpline. You know, we're doing DEI work in in community at all levels. We're investing in research. So, you know, currently at UCI, the Alzheimer's Association is investing a little over $1.7 million in research here in our own community and about $56 million worth of research in the state of California. We want to do prevention. So healthy brain, you know, initiatives within the county, we want to be able to educate young people about the importance of taking care of their brain. And weight, just like we talked about cardiovascular health. Over, you know, 20 years ago, we now need to focus on teaching kids about, you know, taking care of their brain and how that also aligns with you know, taking care of their bodies. And that needs to be part of like, just our nomenclature. knows, you know, we want to raise awareness about the disease because one in three seniors over the age of 65 will die with Alzheimer's or another form of dementia. We want to work the Alzheimer's Association wants to work with help systems to be able to provide the resources that they may not have in house that they don't have to recreate that we already have."]
+[2.1601154804229736, 4.594262599945068, "Yeah, those are just some of the things that we, you know, that we do in our community."]
+[1.742240071296692, 0.6531673669815063, "We use, you know, we use the Alzheimer's Association produces a facts and figures report annually. You know, we use that as a roadmap quite often. You know, the state of California has information that we utilize as well. The census, you know, census data is another, you know, component that we use."]
+[-0.7252272963523865, -1.541837215423584, "Well, right now, for us, it's a federal, it's a federal issue, not necessarily a state issue. But at the federal level, you know, we're urging the Centers for Medicaid and Medicare to change its policy on covering this class of drugs, to treat individuals, you know, with early, early stage, you know, cognitive decline. And then we sponsor pieces of legislation in all 50 states, through our advocacy and public policy efforts. We're working on, you know, pieces of legislation right now in the state of California, that we want to pass. And we do that annually, where we identify"]
+[-0.808755099773407, 1.0528137683868408, "our priorities kind of for the year. You know, one of them, for example, is is training law enforcement and first responders on how to"]
+[-2.8009486198425293, -1.3080313205718994, "training them on on how to deal with an individual if they believe that they could have some cognitive issues, you know, maybe they're experiencing some they've wandered. And or they're having an outburst or reaction, a hallucination due to you know, dementia. And so we're, we're working with the state of California to get legislation passed to train, you know, all first responders about dementia, dementia care."]
+[2.230158805847168, 5.29785680770874, "No, I think that you probably have everybody covered."]
+[4.945346832275391, 3.4184978008270264, "Thank you. So this concludes our interview. Thank you so much for your time. If you feel that there's more to share, please feel free to reach out to me or you can also reach out to our general phone number and our email as well and leaving an ominous voicemail, or telephone line at any time. I'm gonna stop the recording now."]
+[1.0175929069519043, -1.2344436645507812, "Okay, great. So we were just talking about and I didn't hear anything you had said. So if you can repeat it, what are some ways housing is working, and then not working for older adults in"]
+[0.5409800410270691, -1.786787509918213, "Yeah, if you have a voucher or you get into a unit, then you're it's subsidized. We need more of it, for sure. To meet the needs. I think one of the things that I mentioned and not to be a broken record, but on permanent supportive housing for chronically homeless, we're building in the services to wrap around, but in general, affordable housing. We're, you know, seniors that just as low income as they age, what services can they access to age in place, because their rent is taken care of, but, you know, now they need daily living activities. And it's not like they can afford, you know, contract. Like I said, some of that maybe just their coordination and access to their mainstream benefits. But it also depends, if they don't have family members. It's extremely difficult for an individual and navigate the system without somebody to help. Yeah. Oh, yeah. Oh, the working part is we're housing that that meeting. So I mean, we're, I mean, housing is getting built for, for seniors. And that that works. The voucher program works. We just don't have enough of it right now. That addresses the housing needs, you know. So, yeah,"]
+[4.3618550300598145, 7.117727756500244, "that's great. Okay."]
+[0.9706982374191284, -1.778719425201416, "You know, on the housing development side, and the permanent supportive housing side, we have a funding strategy, we've, we've looked at homeless needs, I think it'd be great to have the data from this needs assessment, right, to see if we need to pivot in the type of senior housing that we're developing. So it may, it may change the policy right. On what we're looking at. I mean, we need additional funding for the voucher program. It's, you know, like I said, we have a majority of the people on our voucher program or older adults, we just don't have enough to serve. Everybody. So definitely need that."]
+[0.3357970118522644, -3.639712333679199, "In our conversation, you mentioned a bunch of different organizations, including the county, but also CalOptima. And also you were referring to private partners as well. Who are what entity is the best is best suited to address housing needs of orange, Orange County, older"]
+[-3.1983983516693115, -2.26928448677063, "adults. Cuz I don't know who the who like."]
+[0.16554181277751923, -2.285433292388916, "Yeah. So in our conversation, you mentioned, you know, what you're doing at the county, you mentioned county Optima health as a partner. But you also mentioned that you think there should be a public private partnership, so private entities as well, although we didn't name anybody specifically."]
+[-0.12871211767196655, -1.5378299951553345, "Yeah, again, it's a partnership. So it's government private. That's their job. They, they know how to, to develop affordable housing. So our partnership with them is in developing that housing, but we generally make the policies right if we, if we said 50% of everything we have to do has to be senior housing, then that's the way it's going to be right if we base it on a needs assessment. So some of those privates, some of the private is the health care industry, especially for older adults. So CalOptima right is for because I, we deal more with low income individuals. So Cal Optima is in there, but there are a lot of private providers. Right. I think there are a critical component on the health care needs of the older adult population."]
+[-1.1273151636123657, -0.16954122483730316, "We don't have a general hospital for right homeless in the county. So we rely on the private network, Cal Optimas. All of that. To, to pay for that, to provide that service. Yeah."]
+[1.103519320487976, 0.15334942936897278, "How do you keep these programs accountable."]
+[0.9482143521308899, -1.9796823263168335, "So on the purpose part of housing side, we have a housing funding strategy, we rely on the point in time count of the homeless, they generate demographics. The last assessment we did is we've we've built some housing, and we've made some progress. But we still need 2396 permanent supportive housing units to meet the needs of our homeless population. In the county, our permanent housing needs were not shelter and transitional, or just straight permanent housing. And we need just about as much of that, and just regular affordable housing. How many units are we building of housing. And as I mentioned, everything is needed in the county, it's very hard for a right to say that anything is a needed older adult, transitional youth senior Mental Health Services Act eligible. So we're trying to, you know, develop everything. So we have, you know, senior housing units other. Like I said, it, this assessment will be great, because we can look at the senior population to see what might, but as far as on the housing side, when we measure outcomes, it's, you know, the Housing Choice Voucher. Each time we do a waiting list, we're keenly aware of how many people are applying, but how many people we can actually serve. And that's one metric. On the development side, we know how many units we need, and how many units we have, and how many units are in development."]
+[1.6498632431030273, -0.8468696475028992, "So I suppose you have to take into consideration the housing element analysis that's done. Yeah,"]
+[1.2206565141677856, -1.3023748397827148, "the interesting thing about that is, is it's based on that you have enough available land for your future needs. And it ends up being a number. And I think I mentioned one of the barriers is land, right, getting land for affordable housing development. So I think it's a critical piece and you know, getting appropriately zoned and available land for this."]
+[1.1920115947723389, -1.3806407451629639, "I think it's interesting because you also, you have to know how much of that maybe just will get built without any subsidy, we're on sort of the low that really, the very low income and extremely low income and when we're trying to build those units. So that's where we focus. And so the housing element, a critical part where we're a partnership in that, and on the very low end, the extremely low income units getting built, because you you can't get those built unless you have a subsidy. They just don't get built in the market place. So yeah."]
+[4.235719680786133, 4.51794958114624, "All right. So almost almost the end here. Just wonder, is there anything else is ours and anyone else we should talk to, other than your two colleagues that I'm gonna definitely call and follow up on."]
+[1.0500370264053345, -2.6748650074005127, "Um, yeah, so you've already got the two people I just cuz Michelle is just involved in development, she may say exactly the same things, I might say, January is a little bit more involved on the housing authority side, which is more, she serves a lot of one on one senior. So you'll get a good perspective of I mean of people in general, but and then I'm sure you're talking to Office of care coordination, Doug back, or Zuly, Melendi. From their perspective on, on homeless older adults. And, I mean, if you're, I don't know, if you're, you're speaking to housing developers that are have built senior housing developments or nonprofit partners that have been providing services in the housing area. to older adults."]
+[4.783129692077637, 3.6393213272094727, "Yeah, well, we're interviewing 100 people. isation. So lots of them, but you know, happy to take any other suggestions. Even after this call, if you think of somebody and say, Oh, Katie, I forgot to mention so and so. Just let us know, and we'll add them to the list. It's always better to talk to more people, even if they say the same things, you know, we'll have it on record. So super important for us to, to interview them if you can think of them."]
+[0.39289554953575134, -3.479494094848633, "I was my my husband's a teacher. He's got a teacher conference in Costa Mesa. So I guess we're headed down there because he has some of that tonight. It's on Cinco Demayo."]
+[4.517294406890869, 4.5485734939575195, "Well, we're gonna go Maxon probably with everyone in town. So if there's a restaurant we can go to, but I'm gonna go chips and salsa in today. Yeah. Well, thank you so much for your time. Okay, appreciate it. If you think of anything, and you'd like to, you know, ping me with either a resource or something else you forgot to mention or program that you're working on information on that program. Please feel free. This is meant to be an open door to you and to everyone in the community and just don't hesitate whatsoever."]
+[5.123305320739746, 6.475934028625488, "All right. Thank you. Great."]
+[-2.7032859325408936, -4.811991214752197, "So good morning. Good morning. Hi, my name is Torhon Barnes, and I'm a member of the research team at Evangel. See, we're a local nonprofit conducting, conducting sorry, the county of oranges, older adults needs assessment. Thank you for your willingness to take part in this interview. The purpose of the interview was to identify the needs of older adults and to gather insights from your expertise and experience. The information you provide will be used for the development of Orange County's master plan for aging. So this interview will last approximately an hour and with your permission, or discussion will be recorded only for transcription purposes. And note taking, the recording will not be shared with anyone and after transcription, the recording will be deleted. If you do not feel comfortable being recorded, please turn off your camera and change your name attached to your picture. Your responses are confidential, meaning that we will remove identifying information in the report. Excuse me, but please note that your participation is voluntary. You may choose to answer all questions in part full or not at all. I may also withdraw from the interview at any time. If you're unfamiliar with any of the terms used, please let me know. And I'll provide an example or definitions. Yes, thank you. Yeah, great. So the primary goal again today is identify what needs you think are most important for older adults, those 60 and older. In Orange County, we want you to think as broadly as possible, taking into consideration the older adults, their caregivers, families and their community. So I'm going to share my screen. And this list, it'll be a list of common issues and concerns impacting older adults. Like you. Excuse me, I'd like you to take a look at that list and let me know when you're ready to begin. One second."]
+[1.8506481647491455, 5.5573906898498535, "Coming up"]
+[4.068920135498047, 6.889754295349121, "here we go. My apologies."]
+[1.4895966053009033, 3.296426296234131, "Because it may be small."]
+[4.143817901611328, 7.357203006744385, "I can see that's fine."]
+[4.749632835388184, 8.028379440307617, "Okay"]
+[4.44011926651001, 7.11407995223999, "awesome. Okay."]
+[3.5865108966827393, 7.220778465270996, "Yes. Okay."]
+[-0.5011795163154602, -3.876987934112549, "So thinking specifically about older adults in Orange County. Please, for the record, could you also first tell me your name, your role and how you interact or engage with older adults in Orange County."]
+[-0.864536702632904, -3.4722564220428467, "So my name is Gloria Alvarado. I'm the Executive Director of the Orange County Labor Federation. We work with not only with working individuals, right, but we also work with retirees, and I'm talking about individuals 60 plus. And in my former career, I manage a senior center for over 10 years. So I'm very, very familiar with the issues that seniors face."]
+[10.695934295654297, 8.454096794128418, "Wow. Thank you."]
+[-1.4079563617706299, -2.339207172393799, "You know, if yes, I'm looking for it. And I'm not looking. I'm not finding anything that is career or work. One of the biggest issues for some of the seniors are that one, they retired 60 to 65. And they're still feel young. And so, um, they live in their own homes, but they are and I'm looking at the words that are describing those those behaviors or those issues, and loneliness, and lack of usefulness and ownership of pride is one of the biggest things that I feel is missing in the overall services that we provide to certain seniors. There's only a few senior work programs, and look, they will work for an hour, they will work for two hours, they don't care as long as they have that ownership and that pride that says I did something"]
+[1.4616544246673584, 8.853270530700684, "and"]
+[-1.6397647857666016, 1.4006046056747437, "So, first is the behavioral and mental health. And I'm gonna say that I'm, I'm very I don't know how to rank this too, because I think emotional well being it's already been taken care of the health, but also transportation and mobility being key. No, I don't know what to rank those."]
+[-1.9463222026824951, 1.3603923320770264, "So I you said the first one was the mental and behavioral health. Yes. Okay. All right."]
+[-0.7435827255249023, -1.3635843992233276, "Thank you have to look at two things, you have to look at the benefits that are already existing for like example. They're struggling because of their cultures, because some of the programs are not culture savvy. And I think that's where the respect comes in. You have a large community of API, in Orange County, you have a large community of Latino, you have a large community of African American, of seniors, and they all think differently. And so if you don't have a multicultural, more more multi language, language program, then you you lose somebody, you miss somebody, so they fall into the cracks. Just to give you an example. That's why behavioral and mental health are so important. Majority of the seniors in Orange County who are living, they live with a family still. So they depend a lot on that behavioral, I want to say support, when the families decide that it's time to move him out. Or for them to be, you know, to have their own environment. One is because the family style, something happens, Alzheimer's, dementia, you know, a lot of families cannot handle that, maybe the homes are too big for them. And so they need to move them into something smaller. So now they're independent. Nobody understands that there has to be a transition, they don't know how to function without their family support, any their support where so the senior centers, I always promote the senior centers, because I think they do a good job. But if the senior center that is assigned to them, or to where in their neighborhood doesn't have cultural friendly activities, then again, they suffer more. And so they go into this depression, I don't belong, you know, that sense of lost continues to be there even before they actually face you know, whatever difficulties may come. And that's just one example. In the Latino community."]
+[3.6568431854248047, 15.562439918518066, "Yeah."]
+[-0.8643640279769897, -1.3483693599700928, "Yeah. So So look, respect and I just mentioned one example. But with respect, again, we go back to if you look at the menus, on food, again, right, something simple something as simple as that. SeniorServ is for the most part, the county kitchen, right that sends meals to the seniors. You look at the food and yes, it's, it's it ranks in the dietary component that they need to follow. everything, but there isn't. It's not cultural culture savvy. And you know, like the tamales for us that will eat as make tamales every Christmas. When you eat the tamale that they've served, they're like, this is not a tamale, this is not what we consider. So again, it's cultural. So lack of respect, in that sense, not knowing specifically what it is, and what people eat, and what people expect with their meals. And what happens is that senior serve delivers the meals and they don't eat. If you serve a sandwich to a Latino family, they're not going to eat, that's not food. That's not real food. That's a snack. So it's connecting that. So that's the lack of respect, and then immobility in transportation, as much as we want them to be active. Unfortunately, they don't have the fortitude in their bodies to be able to, to go to the grocery store, buy groceries, and walk from the grocery to, you know, to their homes, with bags of food. Not only that, again, we go into the mental health issues, but the physical issues have a lot to do with it. That's why a companion is always good. That can, you know, help them cook and help them do all that because the lifting and the pulling, and it just makes a big difference."]
+[3.5628349781036377, 7.592382907867432, "Yeah, okay."]
+[-0.5398401618003845, -2.022399425506592, "And then again, transportation and mobility, very important the language we have, we used to have very good programs, the dial a ride, I think right now it's called access. But some of the operators don't speak Spanish, or don't speak the language that is needed. And so a lot of the seniors hesitate. need adult children to make the appointments. And so again, if we were able, it would, it would be very helpful. It will be we could add a language or called cultural connection, right, in all those needs."]
+[-1.7756868600845337, -1.2563261985778809, "I think it's about funding. I don't know if through their Medicare or their medical or whatever insurance they might have. If it is as limited as it is for us adults, you know, for me, if I call my insurance, they can between three and five sessions, depending what I need, supposedly. And that's supposed to be enough. But when you're, you know, when you're in that age, and you're supposed to be fighting this new era in your life, I don't know that three to five is enough. And I don't know if the seniors know how to detect the need for counseling or the need for support. So I think it should be embedded in in the regular checkups. I think it should be embedded in in some of the activities that we do with them. And the office on Aging, for the most part helps a lot. But the help is at the senior centers again. So maybe extending the benefit, not only a help nurse for checkups, but maybe having a behavioral and mental health nurse, perhaps extending the services to them might be helpful. I don't I think that that's what it is those those are the barriers, I think it's more money, or location, and then capacity."]
+[-0.7832974195480347, 2.279669761657715, "And what about the barriers that exist to see an improvement in the respect with respect,"]
+[-0.45942139625549316, -3.2874979972839355, "you will hoping you would think that Orange County has realized that we need to mirror that culture that the cultures and the people that we serve until that happens, we're still going to have that problem. And that's the barrier. I don't think there's there's enough of us out there that can actually handle right all the services. I can tell you that. When I came I used to run the Santa Ana Senior Center. And when I came to the Santa Ana Senior Center, we had about 35 people coming in regulars and a few stragglers that will go once a month or what have you. Because being gospel, it's it's fun. It was fun for them. That was the one activity that that actually invited people to come in. But I realized you know there's there's a lot of young seniors that want to exercise So why not put a physical you know, so look like we're doing right now that needs assessment needs to be done actually inside also. And if you go right now, we tripled our attendance in one year. And the reason why is because one, I spoke Spanish, immediately, all the Latinos in Orange County came to me, because they wanted to have somebody that spoke Spanish that resemble who they are, who they were. That didn't mean that others left no, one of the biggest things that I realized is that we had a large Chinese group that needed somebody that spoke Chinese. So then I partnered with the Asian American Senior Center to provide that service, and Vietnamese communities as well. So we had Vietnamese, Cambodian, Chinese. And what I did is I actually partner with them, instead of hiring somebody, I partnered with them so that they could provide services, or at least have activities inside the center, a couple of days a week so that those seniors felt like, Oh, we're doing the next step, we're taking an extra step to accommodate them. So I think, the minute that mirrored throughout Orange County, I think that's going to make a big improvement in the in the level of respect, because the the seniors feel like, okay, they don't respect who I am. Therefore, I'm not part of this. And that's why wherever you go in any senior center, you will see the lack of connection. And so, you know, that's how we can improve."]
+[-0.279922753572464, -2.657320499420166, "I think funding it's a big barrier. OCTA, once upon a time, and I'm talking about, I want to say 2005, at a special grant for senior citizens. And what they did is they actually allocated a certain amount of funding. And they said, here's this money. Office on Aging, decide what you're going to do. So some of the senior centers said, Give us vouchers, or seniors love to have vouchers for taxi because they walk. So Huntington Beach, for example, had vouchers. But here in Santa Ana, what they wanted was the ability to go to the supermarket and the ethnic supermarkets and shop and then bring them back home. So what we did is, with the money that they gave us, we actually adapted to buses, to small bus buses. And we hire drivers within the city. So that money that was allocated, you know, we use it for that. So we had trips to the market, we got trips, if you had a doctor's appointment, that was nearby the supermarket, we will drop you off, go to a supermarket, and then come back and pick you up, that kind of thing. I think the barriers are actually, once again, doing a needs assessment within our local groups, and look Abrazar is one of the services that came came up to be very helpful. Because they provide, you know, transportation to the senior center or to their centers. But also if you collaborate with them, they will bring them to the Senior Center, the active senior center. I think it's I think it's in the orange, where the the sidewalk, it's light up, and then the crossing path. Wherever there's a senior home, it's also it has a light so that it gives an extra safety, you know, measure for seniors, just things little things like that. I know. The challenge is it's the investment but I think if if we find out that that's a big need I think all of us could put together and make it happen for them."]
+[-1.7314544916152954, -2.028574228286743, "Yes. Unfortunately, those who those who are generational savvy, right, those who have been in the United States for more than for more than three generations, they have no problem communicating, they have no problem accessing benefits. And fortunately, is those that are new, that do not have access the benefits nor the programs, nor the level of respect that they deserve."]
+[-2.1251635551452637, 0.7792235612869263, "And the what and the mental health and, you know, behavioral health and mental health area, do you feel there's any differences and experiences for different groups,"]
+[-1.52420175075531, -2.232832431793213, "same issues, yeah, sometimes lengthy language barrier, and just the capacity to know where to go, and what to access the benefit. Again, the seniors who are new, newly retired, or newly in that, as a senior, they don't know where to go. And usually they're dependent on their adult children to do research. And so sometimes that, unfortunately, that adult children are living their lives. So they cannot do that additional support, you know, believe me, I'm getting afraid. I'm going to be 55 this year, and it's scary. It's like, Oh, my God, you know, I'm getting into those years, I better get ready."]
+[-1.3752444982528687, -2.5078866481781006, "I think we need to look at the programs that are in existence. We need to bring those who interact with the seniors day in and day out. So again, utilize those avenues. I think that will be step one. Okay."]
+[-0.7308107018470764, -2.486098527908325, "See, that's a little bit more challenging. Because it's easy to pull the data and know how many ethnicities we're serving. That's the easy part. The difficult part is finding partners that can help bring services for the that are cultural savvy, that are by bilingual right, and that understand the need and know how to find solutions. Again, there's a lot of a lot of nonprofits that are doing a lot of that work. But I don't think there's anybody, there's something connecting them. And I know there's multiple meetings and levels, but some of the nonprofits that are out there. Seniors are not their priority, usually is youth. And I'm talking about the the ethnic agencies, their youth or they're young, a young adult or adults, but they're not focusing on seniors."]
+[3.588742256164551, 7.166851997375488, "Yes. Okay."]
+[-0.39815354347229004, -2.3904266357421875, "Again, I think those who are somebody in charge, right, have a of transportation throughout, need to sit down and look at the capacity up making. Like even modifying some of the routes or modifying some of the services so that they are more senior friendly."]
+[-1.1331286430358887, -3.9915595054626465, "Now, this is going to be a little bit difficult because I want you to give me info on access and adequacy and access for various senior services. So please describe how accessible and adequate each of the following care or services is in Orange County for older adults. Yes. So one is geriatric care. Two was long term care. C is mental behavioral health and substance use treatment. And four is human and social services. So again, one is geriatric care to as long term care three is mental, behavioral health and substance use treatment, and four is human and social services. Now adequate and accessible are each of the following services."]
+[-1.998380184173584, -1.0314861536026, "Um, I think direct directly to help that I can say, geriatric care. It's one of the easiest out of the four because of the Medicare. You walk in and you have Medicare automatically. They know you're a senior, or you're you're a special needs individual. So I think that helps. And there, is there enough care, I don't know. Because one of the things that I've seen, and don't get me wrong, I just think it's business and the business communities out there for profit. One of the biggest things that I've seen is that seniors constantly change their provider. And every time they change their provider that the new provider gives them an incentive. And the provider also earns, right because they got new customers, but the seniors don't know how to evaluate one program versus the other. So the level of care. I really don't know, because I see this happening constantly. And some of the seniors, you know, these are the complaints that I get, Gloria, I need you to help me because these new doctor won't give me the same medicine that I was taking. They want to give me the generic form. Oh, because my new insurance doesn't cover my old doctor. Oh, because they were gonna give me a little gift. I'm like, Okay. Yes. Bring it bring the information. Let me read it. And you know, you cannot change again until the following month. So for that month, they're stuck. And it happens so often. And I think we need to look at that, too. So. So yes, the characteristic geriatric care is available. I think that's, that's the easiest one of all of them. Now, long term. There is care out there. But you got to look at the facilities. And one of the mic counseling to the adult children, when they had to make the decision to turn their loved one into a long care facility. I would tell them, look, smell, listen, right. And feel. Don't say much. But use your other senses. If you walk into a long term facility, and he has a foul smell. And I will do tours, just to actually grade a few so that when I recommend it, I knew what I was talking about. And I kid you not. There's a couple of them that are very, very successful businesses because they're always packed. And you'll even have to wait in most doctors recommend them, but I wouldn't want my parent there and I wouldn't be now that I'm getting closer to the age, I wouldn't allow my children to put me in a place where it smells. Or is there support systems around them, right, so that they can not just give up and be in bed, but they can remain semi active, as much as possible. And I even said, feel, because one of the biggest things that I've seen is also, you know, the capacity of getting information for the adult child to make that decision. Sometimes there's no, there's a pamphlet, but it doesn't have concrete information. And so you need to feel it, you need to touch it and see it and read it and ask questions and have that assessment ready, you know, to make those decisions. So there are there are a lot. There's lots of long term facilities, not all of them will be some that I would recommend. And I think the county should do some visits, surprise visits, to kind of find out and base it on that if you open the door in the minute you walk in there smell, there's something wrong because somebody is not. And I know accidents happen, especially with seniors. And I know most of them. When once they make it to a long term. They have to use the adult diapers and all of that, I get that. But if the facility is really clean, they keep up with it. Because there's facilities that are amazing, and that you walk in and it smells beautiful. And it's not that they're the smells are hidden. No, it's just smells really good. And you can see that it's clean. That's the kind of level you know, that's how I was grading it. So I know I'm being extremely honest. But that's that's how I feel. I think it's very important news."]
+[-3.014392375946045, -0.20589779317378998, "No, please continue. Now I wanted to go back to geriatric care, because you think that it's adequate. You said it's accessible."]
+[-1.9289416074752808, -1.845302939414978, "I don't think so. And it is not adequate to the amount of seniors that we have here. And there's a senior tsunami, I heard this a couple of in a couple of meetings. There's a senior tsunami that's coming on. Yes. So yes, and we're not ready. I don't think we're ready. I don't think a lot of our doctors are ready for what's coming in. And especially because this new wave of seniors that are coming into the senior population, are going to be the ones that have been exposed to the social media and the advances in technology. And I don't think that I don't think the medical community is ready for that."]
+[0.985171914100647, 2.422201633453369, "Thank you. How accessible first, and then adequate,"]
+[-1.5551156997680664, -2.4366931915283203, "It is nearly impossible to find support nearly impossible. When you ask for something like that. They refer you to triple A and say, Oh, look at their listing, or I mean, a look at their listing. And you're like, that's not what we need. The senior doesn't need that. 12 steps. Well, some of them do. But it's a mixture, but it's medicine. That's where they're getting their high. And now again, these new wave of seniors, we have been exposed to the benefits of cannabis. So it's a different level of needs that we're going to be having."]
+[-2.1850197315216064, -0.3338427245616913, "No, to be honest with you, I will always refer them back to their doctors. So that the doctors can actually suggest a program that one is covered by their insurance and two that can provide the services immediately."]
+[4.931684970855713, 8.189294815063477, "Well, okay."]
+[-1.7108967304229736, -1.7985693216323853, "There are not as accessible as they could be, and are not adequate, because they do not provide services to underserved communities. And I talked to you about the language and cultural detachment. Let me let me say something about the substance abuse. Because this just happened and I want you to go, I know me and my stories, but the senior lives by himself, rent, rent and garage. Okay, so he lives by himself, rents a garage, get socials, Social Security. So that's how he's able to survive. So he was drinking with his friends, they run out of beer, and he's driving, he's still driving. He's 78. He's still driving. So he volunteered to go to the liquor store. The next phone call that we get, is the son calling us asking for help, because he drove through the liquor store, because he was that drunk. So he's taking his meds he's drinking, he's depressed, of course. So there's mental health and all of these needs. Now, I'm laughing now because the son doesn't know what to go what to do. He called him and he asked, please let me call my son. And of course, PD allow him to detain him, he's going through the DUI process. And yet, no one has stepped up to give him help. i We don't know. We don't know what to send him, where he's going to feel comfortable, where they're going to talk to him in Spanish, where they're going to be able to tell him you know, if you mix this medicine with alcohol is not going to be pretty, so you'll get drunk faster, or what have you. Anyway, so he's been with his social security check. He's paying all the fines, he's going through all the classes. So you know what that means. That means he's not buying something. He's not buying, rather than food, whether it be food, or rather be medicine, but he's not buying something. So now, there's no additional services to prevent this, because the easiest remedy will be take away his driver's license. But then the guy will not be able to be mobile, though, when he sober he can drive. He's responsible driver. The problem is that mixture, right, so"]
+[-2.330202341079712, -1.7505067586898804, "So you know, that's the story, because I hear it often. You know, I hear it often, and especially for the seniors. And yeah, I mean, his his ability to, you know, move around and drive as he's older is less. So then when you mix it with alcohol, and you know, medication that's going to even be more impaired. You know, his reflexes may not be as fast, but he's still responsible without that, you know, the other elements. Yeah."]
+[-1.0487960577011108, -2.2341442108154297, "And he's an asset to other seniors. It takes other seniors around. So yeah, so in the social services, I think, I think one of the biggest and most successful program in the social services arena, is the food and commodity program. I think that reaches a lot of seniors. And that should be a connector to other social services. Again, I think as you give him a box of food, you can actually have some intake, have him sit down just like the web, what is it the wick, you know, how they give food to parents, but before they get give them a box of food, they actually sit them down and talk about nutrition and talk about you know, they have additional classes going on, without the parent knowing that they are attending a class, you just get there and you sit down, and therefore your captive audience, right. I think the seniors should do something like that, to promote you know, activities and socialization and social services that are available that seniors might not know, in just just one city in Orange County, in Santa Ana, we have seven senior living facilities, okay, these are active seniors that live on their own. Most of them have companions, you know, like in home support services that go in and, and, you know, clean their homes or cook for them or what have you. And they are connected to a senior center in the city, but not all of them. And so I think somehow we need to connect those seniors to whatever else is available. Okay,"]
+[2.6056067943573, 8.78012752532959, "Ah,"]
+[0.12225374579429626, 3.4240622520446777, "I think I think the biggest challenge is going to be inclusion. I think we forget, forget about them in a lot of conversations. I think looking at everything, this is the first time that something like this has been done, and I think is long overdue. But I think you know, they're not included in the long term conversations. I know the county does, because, because we have to, I'm sorry, because there's budget for them. There's allocations for them, like, look, any government in the city government, they're not thinking about seniors, they're not thinking how to surf. They're looking at what they have, and they think it's enough, because they're checking a box. So I think inclusiveness is going to be one of those big, big challenges. And right now, there's there's three, four words that that are very popular, and it's diversity, inclusion and equity. And those three are going to be the biggest challenge for the next senior wave that's coming in."]
+[3.768531322479248, 9.709859848022461, "Hmm. Okay."]
+[-0.4606660008430481, -3.0797970294952393, "In your opinion, what do you think government's role should be in meeting the needs of older adults in Orange County,"]
+[-0.78541499376297, -2.0242700576782227, "I think we have pay our dues, I think it's time for for for them to care. And these are seniors who, again, the new wave, it's gonna be so much difficult, because I think we're more outspoken. And we have the technology, at least we know about the technology. But I think that's why the challenges are going to be there because it each local government should acknowledge, right the same way they look at youth the same way they look at adults, the same way they looked at other, you know, groups, they need to look at the seniors that are coming in into their cities that live in their cities, that still pay taxes in their cities, and that, you know, vote in their cities, because the seniors are one of the highest population in the elections that actually vote. So we need to look at that. And it's all seniors. And the only reason why they got together and made that a CD of seniors. It's because these are an ominous. I hate to say it, but these are the English speaking, strong, educated, and somewhat. I want to say wealthy, but not wealthy, maybe secure,"]
+[0.3809666037559509, 1.427200198173523, "about Leisure World"]
+[-0.5492868423461914, -2.031909465789795, "economically secure. That's why they became a city because they, they were able to interact and actually create that notion. Look, that's going to be a challenge for all of us, because we all want to we all want something like that. And what's happening right now, in the seven, just just one city, I'm telling you seven buildings full of seniors, and they're detached, they're not connected. And look, I know that the Office on aging does an amazing job at least tries to do an amazing job. I know that the number to call and make a complaint, or make a report. It's now in multiple languages. That's not enough. The Office on Aging, they don't know. No. So it's that lack of connection. We're not telling people who we are. We're not promoting who we are, and Health Affairs and information affairs and all that good stuff. It's good. But it's only a bandaid. It is not enough. We need to make a stronger effort to connect the community to the services."]
+[0.05382298678159714, -4.922829627990723, "Now thinking about all the older adult residents in Orange County, who is getting the least amount of attention,"]
+[-0.7693785429000854, -1.3220103979110718, "unfortunately, are Latino, Hispanic so seniors because they're not in in. In that big, big mix. Majority of Asian American seniors are connected to Senior Centers. The Latinos are not because it's the grandma and grandpa who live at Home. Yeah. So they don't know. They are the underserved, that truly underserved. Okay."]
+[-1.3173761367797852, -2.371403694152832, "Again, that sense of dignity and respect. I think one of the most successful programs I've ever seen was the senior work program. Imagine the Youth Work program, but with a senior emphasis. They can lift, right, they can push, they can pull, you cannot have an overwhelmingly mop or sweep or nothing like that. For a couple of hours, because that's all what the program tells you used to tell us, we could not work them more than three hours, because that was the capacity right that they had. But it was so nice. One, having everybody applied, very simple application, they will dress up for it, just you know, and every three months, you will do an evaluation in you'll have to let go of that senior and hire new one. Because that senior needed to go somewhere else. So we can rotate it among programs. Wow. For me, that was the best program ever. Because the senior will dress up, bring the level of responsibility. They knew what they had to do in the receptionist. Assignment, they always have to smile, welcome, everybody, make sure everybody signed in. And they became friends with other seniors. So even though we have to rotate them out, that senior will come back, they will go work for our somewhere else, and then come back to the senior center because they knew everybody. And then I want to be a volunteer. I want to be a volunteer because I know everybody. We had, you know, the other job assignment was the coffee. It was only 24/25 cents a cup. But the person had to be there, set up their coffee, make sure that they had cups and sugar and cream and whatever, and be in touch with the money and walk around with their coffee pack. Would you like Mocha, that kind of thing. It gave them that dignity, to say, oh my god, I can work still, because I do a good job. And look, some of it doesn't have to be paid. Some of it can be volunteer, because one of the biggest programs that was very successful was with the Santa Ana Police Department. We had some seniors who were trained to be intake workers. So when you go to the window, if you I think they still have it. The people that are sitting there are volunteers and their senior volunteers. But they work for the police department Imagine that. And they're there to say good morning, you have a ticket, what is the purpose of your visit, and then they will just guide them. If you're here for ticket, got that window if you're here for this cola window. I'll find out that as easy as that. And the police will give him a nice official shirt. And to for them, that was enough. Oh, I can go to the dance today because I have I have to go to my job with a police department that is dignity. They belong there still, they feel that they are doing a good job. They have that sense of pride because they're putting all of their skills and their knowledge back into useful you know, connections. And look, we have so many programs. Why are we not utilizing them at the libraries. Any any government office shall have a senior greeting everyone that walks into that office. I know I know it's an extra it's an extra level of work. Because some of them need a lot of loving, caring and they're gonna have a million questions. But I think that's that's what we can do for them. Let's bring that back that dignity back"]
+[4.730367183685303, 3.1801857948303223, "Well, thank you so much for scoring. Yeah, this concludes our interview. Thank you so much for your time you have been incredibly helpful, especially with all your recommendations to our research. And if you find that you have anything else to share, please feel free to reach out to me to contact us on either through our website events oc.com or you can leave in an anonymous voicemail on our telephone line 949-415-6898 at anytime."]
+[10.619603157043457, 8.473379135131836, "Thank you."]
+[5.286617279052734, 3.62489914894104, "Once again, I will stop sharing and stop recording now"]
+[4.4223527908325195, 7.15042781829834, "Okay, great."]
+[3.577538013458252, 6.8754096031188965, "Um, no, no questions. Okay."]
+[-2.661118745803833, -3.2298643589019775, "Sounds good. So the primary goal for today is to identify what needs do you think are most important to older adults, the older adult population you serve. And that's defined as those who are 60 years and older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their communities. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. And please take a few minutes to read through the list and let me know when you're ready to begin. So I will share that list right now."]
+[3.708498001098633, 6.5389885902404785, "Yes, yeah. Okay, I can see it now. Cool."]
+[3.694153070449829, 6.447662830352783, "Yeah, I can see it. Okay, great."]
+[3.7031478881835938, 6.14932918548584, "Let me write some things."]
+[3.4994993209838867, 5.475811004638672, "Okay, I think I'm ready to begin. Okay."]
+[-3.432131052017212, -3.0063583850860596, "So for our records, can you please tell us your role and how you interact or engage with older adults."]
+[-0.948462188243866, -3.308483362197876, "My role is program manager at HOPE Commmunity Services, a nonprofit organization. And my role, the tasks that typically, my role is to support other program manager who leads in the senior programs, and I help support him through, you know, giving feedback with the senior adults and including our ESL citizenship classes, our food pantry, and our other community workshops and programs. And I also have direct day to day contact with the seniors. So every day whenever they need help, or whether it's through the program that interaction or just like when seniors come after the church. So that's how with the seniors."]
+[5.488339424133301, 6.3979082107543945, "Okay, thank you."]
+[-2.8241965770721436, -2.3309950828552246, "Um, no, I think this covers a lot of what impacts the older adult."]
+[2.5011167526245117, 3.859919309616089, "Thank you. And other needs on the list, Please rank the top three that you feel are most important."]
+[-1.331953763961792, 1.0153802633285522, "The top three I would say are the diabetes and obesity. Just because of the population I work with, it's primarily Vietnamese, so a lot of the foods they eat. And I would say that diabetes and then nutrition kind of go hand in hand. But diabetes first, and then nutrition, basically access to nutrition, and food, and then healthcare access. Thank you. Yeah."]
+[3.190999746322632, 4.471109390258789, "So the next set of questions will be related to these three that you listed. So we'll go through each of the three needs that you listed, and we'll go through all the questions."]
+[-1.499044418334961, 0.5076984763145447, "For the diabetes and obesity, I think I was weighing heavily more on the diabetes and I feel that if they don't learn about the foods that they eat early, then later on it kind of carries with them like the habits and the patterns. But then on top of that a lot of the foods that they're used to, as a child or like growing up, especially if they're from a different country, and then they come here. And they're, their probably foods are being made differently, or they have access to different foods, then they don't know that if they don't kind of take control of their health or like, know of like, you know why eating too much rice isn't maybe too good, or those little different, like rice cakes or different meals or having too much salt in their meals like that can affect their health."]
+[3.963998317718506, 7.426839828491211, "Sorry, that"]
+[-1.7353190183639526, 1.161962628364563, "was the first one. Okay. Yeah, yeah. Okay, for the first one. Specifically, diabetes,"]
+[-1.6466165781021118, -1.2205699682235718, "or diabetes, it's information education on it. And the barrier there would be language, so or language and then also understanding so sometimes that you can educational information on diabetes is translated, but the community members might not understand. And another barrier would be kind of reluctance to change their habits. Or maybe they don't feel that it's that big of a need, or they're ready so old, that they don't want to like change their minds. Maybe they feel like it's too late. And probably like for checkups, or it would be like even deeper dive into kind of maybe transportation like getting to the checkup, or maybe they don't know, or maybe they have symptoms, and then they're not really sure what to do, or, yeah, but I think overall, a little must be a major barriers, probably just, that's how they're living their life. And it's hard for them to like, change it. Yeah."]
+[7.173606872558594, 4.651440620422363, "Thank you for sharing."]
+[3.7792561054229736, 15.455615043640137, "Yeah."]
+[-0.2590321898460388, -0.13275597989559174, "Yeah, I think most definitely, probably where they live, if if they're kind of surrounded by same culture or like same environment, or they lived there all their lives, that maybe that's how they will kind of view their health and then definitely, like transportation, where they live and where they can access. Yeah."]
+[-2.1220667362213135, -1.0456312894821167, "I think, first is education and seeing how it can be how it can be addressed in an easier to understand way and also to maintain like a cultural competency. I feel like a lot of health information mostly is kinda like black and white, where this is the information, this is what you should do. But maybe it might look differently for either different culture or even different older adult. And then after that would be sort of like so after all the information like what to do then diving into that action plan, like seeing, like assessing how, where they are right now, and how things can be changed if it can be changed and definitely like following up having to make content follow up, whether it's teaching the like a family member to follow up or making sure that they check up with the doctor."]
+[-1.1530917882919312, 0.6870697736740112, "Yeah. Thank you. So now moving on to the second topic of nutrition. So I'll go through the same questions."]
+[-1.305536150932312, 0.4470888674259186, "so kind of already talking about, I guess like foods that they eat. A main thing about nutritious food is probably like access to access to markets, in places where there are healthy and like affordable food options. And not only that, but there are like certain foods that maybe they are used to eating. So then even when they have access to the nutritious foods, or groceries, they might not know what to do with it, or they might think it's unfamiliar, or they don't know if it's like healthy, or even if it is healthy, they want something that's good. So I feel like that is kind of the issue there."]
+[-3.863691806793213, -1.9868519306182861, "Yeah, definitely. And I think definitely, in terms of social, social economic status, and also like who they're with. Or are, provide them with food or things like that. So I think that there are definitely different experiences for those older adults."]
+[10.625723838806152, 8.454187393188477, "Thank you."]
+[-0.9308862090110779, -1.939397931098938, "I, again, like advocating and creating more of like marketplaces, it targeting certain areas where it might be a little farther for so like, if there is like a section of a bunch of older adults living probably either in like an apartment complex or, or if there was like data on where there are certain crowds of older adults, like making sure that they have access to a market with familiar foods. And if not, and on top of that, like education at maybe a community center, about why it's important to, to have nutritious foods, and maybe like how to cook them or, you know, a lot of different cultures, they can like food is their main source of social comfort as well. So like maybe getting them together, and eating once a month or something like that. Yeah."]
+[-2.376676559448242, -1.2884372472763062, "Thank you. And we're the 3 need now that you identified, so thinking about health care access, How or why are older adults struggling with this issue."]
+[-2.0916295051574707, -1.1937049627304077, "For health care access, I feel that most of the older adults are aware that, you know, they, they're getting older, through my interactions with them, especially when we host like health fairs or do health related workshops. A lot of them are taking medicines, and so they know what to do. But I think that there are still a good number of them who are not sure what their insurance covers, or are not maybe remember to go to their annual checkups or go to go to the doctor when they need immediate help. Or if they see like some symptoms, a lot of the time, older adults, they might not know what to do next. And then I would say that another main issue is transportation and getting there. Yeah, that's all I'll say for the first part."]
+[-0.8104487061500549, 2.38132643699646, "Thank you, and what barriers exist to seeing improvements in this area."]
+[-2.004239320755005, -0.4416317641735077, "So transportation, getting to the appointments, sometimes when you family members can't help get them there. Or taking the bus, maybe they're unable to on their own. And with that comes with the high cost of insurance. Even if it's available to them, there still may be extra fees that they don't know, and it'll come back to them. And also language barrier. If If an area is kind of crowded with everyone who's the same from the same background in terms of culture, then it might be hard to get doctor's appointments. And also like the quality of the service might not be as good as others in terms of health care and health insurance. So that's also an issue for or So those are all barriers, I would say. about health care access."]
+[10.680859565734863, 8.421875, "Thank you."]
+[-2.8189034461975098, -0.8087618350982666, "Yes, yeah. For for sure in terms of having the family support versus older adults who live on their own or have to get to these appointments and older adults who maybe know more English versus those who know a little bit to get by and those who are monolingual. So and with that is why it might be hard to make the appointment or even being scared of going. In every all I feel like all older adults or people in general, they just have different perceptions of going to the doctor. So they might be fearful or may not trust them or trust them a lot more. So. Yeah, those are all the different experiences I would feel."]
+[-2.076749086380005, -1.0457239151000977, "Again, I think it starts with education on health insurance, a lot of older adults, well, all the old orders will fall into the under the Medicare medical, but I guess, how to navigate it. In making sure to, like translate all that information and make it understandable, and kind of explaining why certain checkups are needed and why it's important in a lot of the awareness with transportation to to make it like whether it's through other CBOs or just like county grants, like being able to have that transportation for them specifically for getting them to like the certain health appointments, making it easier for older adults to get there."]
+[-2.875096559524536, 0.027437390759587288, "Yeah. Yeah, thank you for sharing. So that is it for the list. There are a couple more questions, but I will stop sharing. Okay. So the next question goes through a list of different care services."]
+[4.0452680587768555, 7.337826728820801, "Sorry."]
+[3.3566231727600098, 8.938132286071777, "Oh, yeah."]
+[3.170140027999878, 8.912225723266602, "Yeah,"]
+[-0.6991546750068665, -3.335857629776001, "Yeah, I think it's, it's pretty, it's pretty accessible. It's just in Orange County, it's just the matter of finding it. And I think in Orange County, we're really lucky to have a lot of organizations that are based on culture and based on certain needs, but I think the difficult part is seeing as part of the older adults to find those services, the ones that when when they find them, or when they're able to refer to each other, then yeah."]
+[2.743105888366699, 5.077690124511719, "I don't have too much knowledge. I will say that"]
+[1.5126924514770508, 7.458494663238525, "I"]
+[-2.1048874855041504, -1.5804345607757568, "feel like there's never enough with mental health. And especially for older adults. I, you know, like, I do know that there are services, but again, or not again, but like that, there's the problem is that the older adults aren't using them, or maybe they don't find a need. And so then, therefore, I think there could be more. Yeah."]
+[5.496020317077637, 6.414477348327637, "Okay. Thank you."]
+[-0.33019566535949707, -4.11810827255249, "I think there's a decent amount in Orange County. Yeah."]
+[10.596494674682617, 8.438652038574219, "Thank you."]
+[-2.2588860988616943, -1.4027045965194702, "I feel that. I know the 10 years is like really big change. But I think that there will definitely be a need for more of those mental health services. And I feel like a lot of the health care needs will catch up to them. So to me, it's like very important that we know this now, or we tried to. I mean, there's so many issues that could face older adults. For me, it's definitely the health and behavioral health, and trying to pinpoint like patterns that are happening now and maybe seeing the support that those other adults in the future will need. And then the upcoming group of older adults, like, what they'll be facing and being ready to kind of help them with that."]
+[-0.5683865547180176, -2.424912214279175, "I think the government should definitely kind of make a better plan a budgeting and seeing who was actually doing like the work with the with the older adult population, and allowing them to because of a lot of the time the ones who are doing the work, have the relationship with our adults and or maybe have a connection. And, you know, it can be just easy to like, throw money somewhere and then open a program and saying that we ran a program, but it's way different than actually making the effort to have older adults come to the program, and actually falling through the like, did that even work, because a lot of time, it's just like we do things, but we don't really see the result or are able to know that it helps like that's the best we can do. I think it'd be helpful for the county to kind of just let the ones who kind of have the expertise and the knowledge, run these programs and be there for the older adults."]
+[10.583467483520508, 8.494680404663086, "Thank you."]
+[-2.696251153945923, -2.1717782020568848, "So I think, to answer that I'll say like, the most is a lot of the older adults and the kids. So right in the middle kind of like the gray area of people who kind of need support, but maybe they don't fall under certain criteria. So I would say like, middle to old adult, and then the young youth adult population."]
+[0.1826123297214508, -3.9767208099365234, "Thank you. And thinking about all the issues facing older adults in Orange County, what issue is being overlooked"]
+[-0.44450774788856506, -4.166550636291504, "for older adults in Orange County"]
+[-2.2411322593688965, -2.215214252471924, "It's hard to pick. But if I would have to say I think the issue being overlooked is older adults who are being left alone, and then that could that kind of is as simple as like the neglect and and with that, like the ones who are living alone, there seem to like be to do things on their own. But that's not always the case. And so like, therefore, I think that they also need just as much support as other older adults who maybe have more economic status, or they have family around them like that. Those are the ones that are being overlooked."]
+[1.1418787240982056, 0.7369159460067749, "Thank you. And so in addition to what we've already talked about, let's dive a little deeper into your, your area of expertise. So we have HOPE for protection from poverty and hunger."]
+[-1.9649890661239624, -2.694594621658325, "Um, yeah, at least one of them. But the thing is seniors Yeah."]
+[-0.7096459269523621, -2.1743645668029785, "Yeah. So one of our programs that one of our main programs that really aid with this is our monthly distribution program, and we make sure what's working for is that it's cultural competence. So we have like Asian dry food groceries that we package per month. And right now we have about 125 to 130 packages that we distribute every month and older adults who want to sign up. They sign up as needed they can come with any month and we kind of track them for data through. We give them like a card name card. And that's been working so So far in terms of what we're able to pass out, and, you know, we have, we've had good feedback. But obviously, I think what we need is more of a bigger capacity, because right now we're being held by one, one program manager in charge of that program, and volunteers. But we kind of only do to the extent of our capacity, and with every month, we kind of do bigger. And so that is tackling the hunger part. And we also allow, like, anyone who's homeless also come in as well. What's we what we can work on. And of course, it's like with, if we have, if we could build a capacity, we need to work on building capacity, and also figuring out a way to kind of solve far unreached people, right now we kind of have a radius of just our surroundings, or whoever is able to come. But if we were able to provide a transportation system, or offer those services, that would be even more beneficial to the community members who utilize our service."]
+[5.459488868713379, 6.942770481109619, "Thank you. Yeah."]
+[2.9932076930999756, 0.06333636492490768, "Yeah. Yeah. Um, I feel that, um, in terms of for policies that I feel need to kind of be revised is probably."]
+[-0.8669588565826416, -2.035794734954834, "I don't know if this would be under but like, just how kind of the support in terms of food and nutrition like food stamps, or like the EBT cards, like, how or and then like, the whole, like, CalFresh Cal benefits, like applying for that. I think making it a little easier for older adults to understand there are some that are still like, Hey, can I use this for this, and like, they don't really know. So I guess, like making sure that the language is easy to understand and also translated, and maybe making sure that they kind of have an idea of where they could go in, or making sure that the places they can go are culturally competent to their palate, and what they're what they're kind of familiar with. And then also, I guess, like, more. Having better accountability for the places that do provide maybe free food services or packages, that there are more places that have different culture, like variety, our, or if a place offers it, like kind of having a check on like, like, is this familiar to them and more like explaining, like, explaining, if it's new foods, like explaining, like, Hey, this is we're changing it up, because you know, this is healthier. And this is how you can make this or try this food, because it might not be different, but it's still nutritious. So like, really making sure that we're not just giving older adults, or people food, just extra food, or like, hey, here, food is food. I think that that's good. But the next step that I would like to see is like, Okay, some sort of quality or some sort of meaning to it, because I feel like everyone should have good food to eat."]
+[2.7176318168640137, 1.7531368732452393, "Yeah, and who or what entity is best suited to address this issue."]
+[-0.680579423904419, -2.7484116554260254, "I'm, of course the county to, you know, for more money for, you know, existing food pantries. And also see, kind of like so so the county to, for that to help the food deserts and food pantries. And then pantries are like people who distribute food or like marketplaces to kind of collaborate more with other organizations so that way, so that the ones who are producing it, who are able to have the resources can kind of speak with community members and then vice versa, like community organizations, I would refer out to different places."]
+[1.3672404289245605, -0.32401570677757263, "What's helpful is in terms of the programs we have is tracking like where they're from, like zip codes, all the time. And even from from the census data, like if we were able to see those those would have been helpful in and also data in terms of like their housing or where they're located is helpful. And also in seeing where, if they're available markets or like restaurants around them, like that's also would be good to know. And another thing with the housing is maybe like household size, and like some of that some of that information will be helpful."]
+[-1.1160657405853271, -2.6289634704589844, "Yeah. I would say if not already. A SCSC Abrazar they work a lot with seniors for poverty and hunger. Anyone who is involved with food, and also probably like housing, so there's Meals on Wheels. Hope through housing. Those are just some examples and and definitely any senior citizen or older adult organizations. Yeah."]
+[10.675067901611328, 8.395102500915527, "Thank you."]
+[3.5889079570770264, 7.207327365875244, "Yes, yes. Okay."]
+[4.944333076477051, 3.345791816711426, "Thank you. So, this concludes our interview. Thank you so much for your time, and you've been incredibly helpful to our research. And if we find if you find that you have more to share, feel free to reach out to us our contact information is available on our website, and that's WWW dot advanced oc.com or you can leave an anonymous voicemail on our telephone line at any time. So I will stop the recording now."]
+[3.6038150787353516, 6.875211715698242, "No questions. Okay."]
+[-2.6601669788360596, -3.2354395389556885, "So the primary goal of today is to identify what needs you think are most important to the older adult populations you serve. That's defined as those who are 60 and older. We want you to think as broadly as possible, taking into consideration the older adults, caregivers, families and their community. I'm going to share my screen so you can see a list of common issues and concerns impacting older adults. Please take a few minutes to read through this list and let me know when you are ready to begin. So I will share my screen now."]
+[3.989837884902954, 5.2781662940979, "Yes. Okay. Great. So please take a few minutes to review and let me know when you are ready."]
+[5.482405662536621, 6.421409606933594, "Okay, thank you."]
+[-0.7453539371490479, -3.396559953689575, "Yes, so my name is Alejandra Lupercio. I'm the Vice President for social services for Meals on Wheels, Orange County. And the way we serve the current population is that we currently have different programs. One is a congregate meal program that we serve just about 23 sites, congregate meals for all our senior centers in the northern and central County, Orange County."]
+[2.108438730239868, 4.035440444946289, "the center, so we have a partake in that as well. And then lastly,"]
+[-0.8813961148262024, -3.0378425121307373, "I don't have a direct oversight. But I know we do interact with the adult daycare centers that we have really three across the county as well that we're currently serving."]
+[0.12433593720197678, -4.151463985443115, "Thank you. And thinking about Orange County and looking at the list of common issues and concerns affecting older adults."]
+[3.6059317588806152, 6.430798053741455, "Um, yeah. I think let me see."]
+[4.082850933074951, 5.946326732635498, "Let me take a moment go ahead."]
+[-1.1016874313354492, -0.2981729507446289, "The The only thing that I would be the only other area that I would that I would see and this was related when I was in nursing home administrators probably legal counsel, you know, those that are able to provide some type of aid for kind of directions on how to provide resources probably end of life planning. Yeah, and just just more. The way that I will see is that is that how is it that they're able to get these resources"]
+[3.079068422317505, 6.226502895355225, "in time, right, as opposed to wait to the last moment."]
+[5.9044599533081055, 6.744299411773682, "Thank you,"]
+[2.4673781394958496, 3.890406370162964, "Please rank the top"]
+[2.3608741760253906, 4.023431777954102, "Three that you feel are most important and that includes the ones that you just mentioned as well"]
+[4.754006385803223, 8.039138793945312, "okay"]
+[2.477616548538208, 3.9438812732696533, "you said top three right yep"]
+[3.208324909210205, 5.505560398101807, "we'll start with one"]
+[-1.4202780723571777, 1.5134245157241821, "would be emotional well being"]
+[-1.4457515478134155, 1.5329853296279907, "emotional well being, I would rank"]
+[3.050589084625244, 4.520675182342529, "so many good topics"]
+[-4.135717868804932, -1.8420350551605225, "I'll say that and that's what makes it a bit a bit difficult because you know they can be kind of interchange depending on the person so."]
+[-0.5131452679634094, 1.2214196920394897, "emotional economic security"]
+[-1.9513154029846191, 1.2726171016693115, "and also behavioral and mental health. Thank you."]
+[3.1579980850219727, 4.5387420654296875, "Thank you. So the next set of questions will be going through each of the three that you just mentioned."]
+[3.302652597427368, 6.276947021484375, "You repeat the question one more time."]
+[-2.8709678649902344, -1.6622109413146973, "Sure. So thinking about emotional well being how or why are older adults struggling with this issue."]
+[-1.5940208435058594, -1.125954031944275, "The way that they're struggling with this issue is is also something two different factors, I would say trust is number one, trust is, is an arena that I would say that when we interact with individuals at a certain point in their life, right when sometimes, you know, and again, I probably based on nursing home experience, and also experiences that I've had in centers as well is that these individuals already have a life, and they've gone through other experiences in life, and we're just trying to get, you know, have a sense to kind of understand where they're coming from, because we don't have much time with them. So in that sense, creating that trust with them and being able to, to understand what their what what they've experienced in life, what the current family situation is, how the community is how they interact with others is, is, is is very, it's very different for each one."]
+[-1.3695731163024902, -1.371568202972412, "and that and that takes time, which means that if we don't, if we don't reach at a point, then you know, we're losing track, which causes the individual to, to, to decline, you know, not have a sense of willingness to continue with life, not wanting to eat, you know, just the sense of just kind of just wanting to kind of give up. So that, so that is intense, will probably be trust. The second point that that comes across is also having having an understanding of what you know, what is available to them, having that available to them, and having that understanding of what they're able to, to, to get, you know, resources, you know, how they can, how they can interact with others. You know, I think that's a very important portion of what of what also contributes to emotional well being is to get that at an early segment to get them involved in an area to make it easier for them to have that, that, that exposure with others that sense of trust, that sense to kind of expand and that's and that's what I feel, you know, that that makes me"]
+[-1.4194715023040771, -0.8313835263252258, "throughout life, and sometimes, you know, individuals outlive their, their actual siblings, you know, and you know, and that's in that,"]
+[-1.4760109186172485, -1.7083381414413452, "that kind of comes about. So not not being involved in not having that, that understanding to know what the information is available for them beforehand is very critical. And then by time it happened, and they need someone, either it's normally family member or word of mouth or something that comes out, but it's not really explained to them. So they're trying to get to it as quickly as they can, which was also I mean, if they feel already, in a sense about being empty by not having anyone, this is, you know, this just makes it harder, because then we're, you know, we're having to create, you know, there's forms to fill out, there's, you know, there's a lot of things that, you know, as people get older, they don't want to figure out how to how to fill out all these forms, you know, they, they just want to get the service done, so that way they can benefit themselves and, and if they feel like they don't have that, then you know, then then you start losing, like the quality of life."]
+[-1.363274097442627, -2.0410397052764893, "For the emotional well being, yes, I think I think a much stronger support effort has to be done to to educate our oncoming population, if we know that our incoming population is going to be over 60, by 2045, where you have I think, I heard it was maybe one in three, or like one in four, especially like in Orange County, that the amount of people that are going to get into that population is going to be coming at us pretty quick. And I That's a, that's a very important factor for us to get a head start for us to teach our younger generations even, you know, even those that are younger, in, in, in schools, you know, just to get the exposure, because they all come in different dynamics, and there's no, there's no one way of, there's no one simple cookie cutter, that that makes it but but but we have to get at all these different components, and involve all age groups, and have that exposure and have a very strong understanding, we have to make that process simpler, we have to make it a lot more reachable, a lot more attainable for them. And, and we have to gain their trust, we have to gain their trust in in some type of effort in order for us to have that interaction that we're able to be able to, to take care of these individuals and, and provide these means to them in a timely fashion. Because if not, it's just it's just a recipe for for increased costs for increased health care costs, you know, and it's just a cycle, that, that unfortunately, a lot of our population, you know, is is getting into, you know, they just go through that cycle where they're going from home to nursing home to, to hospital system rotation that makes it very difficult and very, very difficult for for, for a population to handle, mentally. So, on top of that, I see that we can do better in emotional well being."]
+[-0.5607903003692627, -0.6018736958503723, "Yes, culture, cultures are also very important because they're all different, right. And again, I emphasize back as to being able to help, you know, I've, I've had a lot of families that help language barriers, cultures and food, you know, things that they used to do at home, you know, and, and it gets, and it gets, and it gets very, very frustrating for some of these participants or clients or patients as well, you know, just basically just kind of our population that, that, that once they lose that ability to perform a task, mentally, they, you know, they, they have to overcome it. And it depends on their posture, right, how they grew up, what their culture is, but if we don't have that connection with their culture, in that sense, whether it's food, you know,"]
+[-0.588930070400238, -0.572130024433136, "just being able to talk someone kind of in your own language, you know, and then, you know, we, we lose that sense of, of ability to again, gain their trust, being able to kind of speak to someone, you know, have a sense of wanting to move forward and just continue with life, you know, that, you know, those are the things that I felt that, that, that that culture has. Food is going to be always a main component. It will make people happy. It will make them frustrated. If they, if they don't if you put something on their food that they don't like, we all, we all kind"]
+[2.467724561691284, 4.837486267089844, "of know about it, and we're, we're very vocal about it."]
+[-0.6861085891723633, -2.077822685241699, "a type of meal. And then we're just kind of moving forward, I feel that we have progressed quite a bit. And I would say from from from our from our goal organization years that I love to be very active and have comment cards and have suggestions and changing up the menus and doing things that are different, and also particularly cater to the, to cultures, you know, and that's something that, you know, that we do introduce is that we have Vietnamese meals that I felt, you know, that we're that we're trying to focus our attention on the Vietnamese population, but also incorporate an Asian meal, changing it up a bit, you know, and just, you know, have that expanded upon, to, to help kind of solidify at least one component of it to help get things kind of moving along."]
+[1.0896763801574707, 5.398850440979004, "For"]
+[3.716796636581421, 15.011945724487305, "Sure."]
+[0.5801131129264832, -1.4386003017425537, "That's a very good question, I think there has to be a system that we're able to be able to touch each one of our population that's going into we need to have a system in place that is already working with those that are in need, maybe then that is identified maybe in a"]
+[-1.153692364692688, 0.3356894254684448, "in the hospital setting or some type of arena as to how, how the projections of the population is going to be looking like whether we can have an address by by,"]
+[-0.9679778218269348, -0.6939037442207336, "Normally nursing homes will be looked at as those that are 60, over 65. And over and more and more and older. Now."]
+[-1.7653628587722778, 1.0664563179016113, "contributes that happen to them, whether it's mental health, behavioral, there's medication, there's change conditions that happen, how they grew up, you know, food and nutrition, you know, they they're all kind of correlated and all,"]
+[-1.9792851209640503, -1.547837495803833, "all at the same point, you know, reaching reaching these individuals, which which are causing, you know, causing harm kind of, to themselves. And now, and now you see that the that the average age of someone coming into a nursing home is younger, it's not, it's not 65. And older, now it's 50 40, I've seen some that are 30 that have made that so there has to be a way for us to, to get a head start have have a good way to to somehow project,"]
+[-1.0848690271377563, 0.6291012763977051, "how the population is going to go depending on diagnosis, I would say on on the current standing of food and insecurity on, on what their economic security is on what they're able to afford, because that is also connected, and what they're able to afford with regards to food because if they don't have that they're gonna choose the most easiest one."]
+[-2.9604671001434326, -2.3501100540161133, "to address the elder, which you know, there is a tension to it."]
+[-1.4317386150360107, -1.1016908884048462, "But it's not. It's not the way that I see that it should be. In nursing homes, you have things that are pretty much dictated by by CMS and kind of regulators In that sense, but being in a nursing home and experience in it as well, it's not, it's not always what's printed on paper, but it's what's seen in there. And it's, and it seems like it's that at times, it feels like it's a cookie cutter for all and it's not. Really put investment on those and really have a very good assessment on those and kind of projections toward that in order for, for us to be able to do our job for us and be able to care for them, for us to be able to get them back on their feet. In a you know, just I would say programs are always looking as to how to cost save, and how to get things a lot, a lot more quicker, easier. And regardless of what it is, you know, if there's a change condition, you know, this is this is as much as you have, and then from there, we just kind of move on and obviously kind of on to the next person. And we you know, we forget about that person, you know, unless unless they continue to kind of vouch. I mean, we always touch different people, but we really don't know. So there's no real, you know, I kind of bounced around it around there as well. But I do feel knowledge is very important."]
+[0.11054522544145584, -0.7677904367446899, "Thank you for sharing. So now thinking about economic security, how or why are older adults struggling"]
+[3.4723916053771973, 6.55635929107666, "say say that again, I'm sorry."]
+[2.6034703254699707, 8.77647590637207, "Ah,"]
+[0.19003108143806458, -0.9555177688598633, "okay, economic insecurity, security is, is at the very interesting topic, I would say for those that are those are at the poverty or cost of living, I think choices is very important. How they choose what to do, you know, what the current setup and where and what they're getting. Is, is different for each, sometimes they don't make the right choices. But again, I don't know how much of the population is sometimes what you see, what you hear. Being able to afford, I think, as you get older, and, and the way that the current system is, especially in California, the cost of living is pretty high, you know, and, and it makes people stuck in their, in their environment where they can probably be off in a more comfortable environment, or they have a lot more resources that they're able to, but sometimes to get people to change at an older age makes it makes it difficult. You know, and, and with that comes the economic security because then because then those individuals have to choose how to use their funds. But as"]
+[0.956365168094635, -1.059775471687317, "as we started having an increase in utilities, and increase in taxes and increase that everything that's coming about it makes it you know, it's getting a little bit harder"]
+[0.7240963578224182, 0.3489457666873932, "are a way for you to use your money and really enjoy."]
+[-1.2124179601669312, 0.621245265007019, "Enjoy, to take care of yourself and have a healthier life and being able to choose the food that you'd like it's changed. You don't"]
+[2.4131977558135986, 6.90569543838501, "if you're"]
+[0.876951277256012, -0.4406147301197052, "if your utilities go up by $200 and someone only makes $600."]
+[-1.2832063436508179, 0.6317062973976135, "That's for them, That's a huge change and and what and what they choose to eat is going to change because because that's only factors as well you know, I have to I have to survive, so I have to live in"]
+[-0.6744566559791565, -1.0497394800186157, "especially like in this, in this, in this type of cost of living people, people have to make those decisions, and then next thing you know having to change the condition. And I would say that, that, you know, I have seen plenty of individuals that, that have lost that interest in there as well. And then they become homeless, they come to nursing homes for certain time, because, because they see, you know, that's probably their only resource they weren't able to eat, and then they got wounds and"]
+[-1.5297572612762451, -0.9324835538864136, "a basic need to heal a wound, is always going to be food. And if they don't, and if they can't feed themselves on there as well, then then they're never going to heal, and then next, you know, they're going to be rotating through to health care, and which is, which is a vicious cycle, you know, in life as opposed to trying to get them back to the home, and they're going to struggle, and then you know, in and then it just makes it difficult. So, so, you know, though, those are, thing are always connected, those that are in the medium."]
+[-2.98626971244812, -2.104241132736206, "Those are that in the in the medium range group, then you know, then kind of decisions happen, you know, there, there is a median as a middle aged worker,"]
+[-1.5492929220199585, 0.7347884774208069, "having anxiety, behavioral, you know, just everything that's on this list here is tied in in some way. And it has an effect because it bounced just from from back and forth. what they choose to eat, what they do then, you know, you can become obese, you can have"]
+[1.5342247486114502, -2.179969072341919, "drug and alcohol issues, you can have homelessness, you know, affordability, housing, you know, though, they're all they're all tied into it, and they're they're all creates, creates an environment for someone that is in a healthier population to fall into, and decline and decline and, and be able and coming to an area that we are difficult finding and more difficult to handle because the problems only going to become bigger if we don't take care of it already."]
+[-0.7159259915351868, 2.1875104904174805, "And what barriers exist to seeing improvements in this area of economic security."]
+[-0.13269270956516266, 1.781859040260315, "You know, the, the barriers, the the only thing that I would say is of course, the individuals that are responsible for making the decisions on the funds have most of the control. It makes it very difficult because"]
+[1.6786048412322998, 2.9442834854125977, "because we're only one small segment of it as well, and in a whole vast amount of things that are currently currently happening in the world. But"]
+[1.6960663795471191, 2.893930196762085, "we put it into spotlight a lot more once once we noticed that there's a growing trend."]
+[1.6909518241882324, 2.9586753845214844, "And if people don't see that or don't put on the news or don't hear about it, then it just often goes kind of"]
+[-0.1830042153596878, 1.709021806716919, "under that right. So that is our what I would say the biggest barrier is those that are making those actual decisions to have to have funding or to provide these types of programs or emphasis or push you know, to to advocate to to make them a lot stronger"]
+[-2.544952630996704, -2.2206411361694336, "and a lot more prominent because I mean we're all headed that age. We will all be there at one point in life."]
+[10.67635726928711, 8.415355682373047, "Thank you."]
+[2.3068017959594727, 9.508987426757812, "Yes"]
+[-1.896951675415039, -2.1182360649108887, "for the for the different backgrounds, it's just you know, I wouldn't say it just depends on how the person grew up. I can tell you that, you know, as the person myself, and I always give myself as an example, because, you know, I, I've seen, I've worked in a lot of professions in, in different environments at such a young age as well to, to kind of where I'm at. And, and being able to roll into it as a background makes it very difficult because, you know, it's ultimately the the actual decision of the individual, and what the current status is like. So I'm glad I said, I'm a person that likes to be informed. So I read, I would like to see data or see, you know, just kind of pick up things, I think we're in a very good stage with technology and how things are progressing within the last 10 years that I would say that will make it a lot easier coming up with those ideas, I think is, is"]
+[0.2480745017528534, -0.5892470479011536, "is, is going to be a good challenge, but a good challenge to have. But But backgrounds, I think have have a huge effect as to how they choose how their economic security is right. And if they do go down, I mean, I will say that me myself, I, you know, after the experiences that I've lived had experienced with that, and just seeing how much people that are taken care of, especially in these populations"]
+[-1.6280056238174438, 1.2118455171585083, "how i'm able to to live, you know, and I think I have my median as to where I see my and and how comfortable I've been. And my mindset is already set in those kinds of parameters. So I can be comfortable"]
+[-2.321650743484497, -2.227447271347046, "as I get older, but again, that's only me, I'm only one person at just over 40 years old. And I'm you know, and I'm trying to think ahead, and if I'm able to get a lot, a lot more people to kind of think of think ahead, kind of in these type of categories, and just get it out, especially to the different populations in, in those in the in the different brackets, you know,"]
+[7.179040431976318, 6.156371116638184, "it could be key. And what do you suggest is the best way to address this issue"]
+[1.2047302722930908, 1.3404536247253418, "I think continue to provide experiences and have and have people positioned to see it for themselves"]
+[-4.15192985534668, -1.727554202079773, "I think I think there might, I think the mindset needs to be a lot more open to kind of accepting what makes it difficult I from my point of view is that if you haven't experienced it, or you haven't lived it, then it makes it very hard. I think having those experiences and being able to see it for yourself hand on will allow you to kind of feel of what it gives you a snapshot of what what, what these individuals are going through. They, you know, being there, day by day, seeing the different experiences and see how, how sometimes people are, are left"]
+[-2.1262285709381104, -0.9303849935531616, "A lot of us, you know, we have plans and it's easy and probably there's you know, there's a lot more physicians and everything is fine, you know, that their their parents or their loved ones or their older ones are are doing great. And and they have a very good time. But there's a lot more that don't have that plan that don't, that don't have that. So experiencing experiencing it info for themselves. I think it's important. I think it has to open up a lot more. There has to be"]
+[0.23503941297531128, -0.8488142490386963, "to have it addressed as, as we are seeing the age of the Social Security also been added. Right."]
+[-2.6310842037200928, -2.5641725063323975, "reaching, reaching your actual benefits at that point of what it was before 10 15 years ago as to what the average age right now I think at 67. By the time I would say that I that I get to the age, you know, it'll probably be over 70"]
+[1.6459921598434448, 7.463212013244629, "which"]
+[-1.291189193725586, -2.8957338333129883, "which is good. You know, I think I think I think also keeping people working, especially in the in the in the elder population, I think is very important. There's a lot of years of knowledge, keeping them actively engaged"]
+[2.242982864379883, 3.959841012954712, "important and for them to be"]
+[-0.04981732368469238, -0.14579911530017853, "benefited from it, you know, we, you know, those are the things that I that I feel that we can still learn from it as well as opposed to kind of judging, and then looking for, for, for other avenues to see how our business kind of grows. So you know, those are those are my two topics is that, you know, just keep them, keep them employed, keep them busy continue with those actual benefits and also being being aware of what those benefits are."]
+[5.488125324249268, 6.790372371673584, "Thank you. Then"]
+[-0.482241153717041, 2.572005271911621, "I think this also touches base to the other areas that I have, I would say the one thing that we're going to have to cope with is is is apparent"]
+[1.2187037467956543, 3.2351033687591553, "it's COVID, right, you know, the most recent, you know, start with the most recent COVID"]
+[-2.2238881587982178, -1.3999449014663696, "how much work it drives, going through a pandemic and not having one for the last 100 years, there's no playbook. And there's a lot of uncertainty, a lot of repercussions that probably happened, a lot of feelings, a lot of senses, and then also what our younger, what our younger population has gone through, you know, to kind of not have that connection during those last couple of years especially like in the in the learning environment as you're growing, right so so you know, so those are the things that we have to prepare ourselves for how the younger population is going to come into effect and how that's going to have an effect on behavioral health as they age through"]
+[-3.1154284477233887, -2.1562306880950928, "through their facets in their in their age group"]
+[-1.8735297918319702, 1.1846528053283691, "medication drugs, stress the amount of responsibility that an individual has for a loved one, you know, just changing the conditions food making the wrong decisions, you know, just there's a lot of facets that that affect the behavioral mental health of one person and you're starting to have an effect at the younger population"]
+[-2.621877670288086, -2.221787929534912, "which means that at the start of young age and then by the time they reach 60, they're already going to be they're going to be handed off"]
+[-2.800747871398926, -1.3855150938034058, "I would say our mind is our own our own worst enemy and we you know and everyone says you know I think you have this you know issue then this person doesn't recognize he's not able to recognize that or kind of do that reach out and makes it very harder hard at a younger age to to get that help you know needed in order to in terms to become better in their in their mental health and behavior so"]
+[1.7215155363082886, 2.1836252212524414, "I think its resources"]
+[1.7329438924789429, 2.180894374847412, "resources"]
+[-1.7856682538986206, -2.489612579345703, "resources and that can entail finding people to be to want to work with the with the aging"]
+[0.057698167860507965, -0.31101101636886597, "And I think that's something that I have seen that it makes it very hard for people to stay a in these types of fields, especially for the for for those because because of the amount of challenges you know, we there, there isn't enough resources, there isn't enough funding you have to do more with less and, you know, at the end of the day if it's, it's not it's not the people that work with them. It's ultimately it affects the person that we're that we're ever servicing"]
+[-0.14714698493480682, -0.2175479382276535, "they have to meet certain requirements, but the resources are not there, monetary wise, it just, it makes it very difficult, you know, and, and it makes you prone to overwork. And also make them think about what the profession is and not having to deal with these type of, with you having issues with which we should have a lot of, we should have more,"]
+[-2.9530413150787354, -1.1785277128219604, "the middle ground and recognizing it, and having having recognizing time, I think is is a hard part because then you start going into other parameters that can include Alzheimer's, or kind of dementia."]
+[1.5066051483154297, -2.353480815887451, "But, but also allowing them to get the help that they need. So as an administrator mental health, and behavior has become so prevailing right now, and it's out, you know, combine whether it's with homelessness, it's, you know, tied into how to how we eat, but being able to find a resource to provide the health, you have to have certain parameters in order for them to be able to get the help, if they don't meet that, you know, the -------"]
+[-1.63761568069458, -0.9697354435920715, "it doesn't happen well, and then you kind of move on. So so we're kind of stuck trying to figure out how to help this individual. And sometimes you don't have that, you have to have information, you have to have a better a better information system in order for them to know that that is connected, that kind of has an understanding in order for us to be able to help them together. Because it can be one there has to be,"]
+[2.009396553039551, 4.569002151489258, "has to be multiple, so you to still see that's a bit kind of disconnected"]
+[-1.4377110004425049, -0.03218503296375275, "so you know, so it makes it hard to get someone help if they need it, especially if they have a mental health condition or having that identified timely as well."]
+[10.596829414367676, 8.480461120605469, "Thank you."]
+[2.3088014125823975, 9.51182746887207, "Yes,"]
+[-2.0452470779418945, 0.9098823666572571, "into the backgrounds, especially with, with mental health is dependent how everyone, I think kind of grew up experiences in life"]
+[0.10716696828603745, 1.1060941219329834, "the route that, that individuals took to to where they got to you know, until someone became kind of"]
+[-3.23268985748291, -2.4981820583343506, "elder"]
+[-1.775572419166565, 1.1405729055404663, "And that has a sense as to how their mental health and well being is, how the current environment is"]
+[-1.4333378076553345, -0.8525421023368835, "How is their relationship with their other loved one How is, you know, the, there's a lot of"]
+[-0.5308432579040527, -0.5055838823318481, "cultures that we also have to understand and at bringing those cultures, as you know, I, I kind of have those, those actual experiences based on how my parents are based on the cultures of what a hispanic culture was. And each country is different, you know, how they're brought up how a woman is supposed to be how a male is supposed to be what is their type of work that they're supposed to be doing. But, but at the same time, now, being here, I mean, you you merge those backgrounds with others, and you start creating a breed that's different."]
+[1.5750313997268677, 8.697178840637207, "And and and then also having,"]
+[-2.101423740386963, -0.902458906173706, "figure things out, you know, for each of them, you know, and I mean, i mean we that's what we do, as we get older is that is that we're trying to understand from where they're coming from. The only problem is, it's, it's, you know, they have a lot of years experience, and getting that information in a timely fashion only helps us to kind of help create a good care plan."]
+[7.134969234466553, 6.18887186050415, "Thank you. And what do you suggest is the best way to address this issue"]
+[3.2010459899902344, 6.2030863761901855, "I will say it will be the same response that I gave on my previous"]
+[-0.7202144265174866, 0.21156685054302216, "I think the support from from those that are gonna make those actual decisions, because"]
+[-0.7281439304351807, 2.3175737857818604, "There has to be a lot more notification, there has to be something more nationwide, a lot more prevelant than"]
+[1.4210171699523926, 5.318355560302734, "in our minds to make it stick."]
+[2.160055160522461, 5.370778560638428, "There has to be"]
+[-2.629896879196167, -3.0188989639282227, "a good way to kind of give this information to our, to our elder population,"]
+[-1.6165798902511597, -1.2206233739852905, "having them understand and then giving them a good avenue for them to vent and for them, for them to be able to trust is something pivotal that we need to formulate something more, where they create that bond to be able to talk about it if they want to help themselves."]
+[1.072558045387268, -0.20068682730197906, "That that is something that I feel that we can definitely work on getting some help in. And then also, of course, I mean, I mean funding is always going to be the key. I mean, if you don't have funding, or we don't have those programs in place, or or these reinforced ones,"]
+[-2.26639986038208, 0.2429586797952652, "then it makes it hard for us to kind of move ahead on the actual needle and make a positive impact. Thank you."]
+[3.7362663745880127, 5.268322944641113, "I know we're coming up on the hour, we do have a few more questions that I want to make sure we're respectful of your time. Thank you. Yeah."]
+[3.9274051189422607, 5.55950927734375, "Maybe 10 15 minutes more Okay, sure. That would be great. Thank you."]
+[1.8480502367019653, 7.269716262817383, "You said how"]
+[3.622983694076538, 7.985906600952148, "Oh, sorry."]
+[5.576535701751709, 8.798656463623047, "Okay."]
+[0.18967218697071075, -2.8882036209106445, "So accessible. There is there is, from my point of view, there is accessibility in, in Orange County. From what I can see that people are able to do, I feel that everyone is able to go to a senior center and participate in our congregate programs and have a meal there as well. We do provide subsidies with regards to transportation in order for them to go back and forth. Some of the cities have their own transportation. So from from our area, we're able to provide these meals in a very good fashion with an increasing population. That's no problem on the accessibility of course, transportation getting there, that would vary by person and by type of condition. Right and, and having that"]
+[0.8698315024375916, -0.3794245421886444, "also has had an effect monetary wise, and there's any costs, you have access, you have a lot more resources, but again, it just depends depends where you live at which sector of the area, and if there's something available for you to go back and forth."]
+[4.284764766693115, 7.271732807159424, "Okay, adequate."]
+[1.2273895740509033, 2.973386526107788, "Adequate is, is something that we need to work on. I would say having a"]
+[1.1428982019424438, -0.15588997304439545, "for some of our clients. I would say that some of our funding"]
+[-0.04864687845110893, 0.7427018880844116, "before that, getting to that, getting to those clients, or to that population in a timely fashion beforehand, would have helped before before reaching the stage where they could have had that prevented."]
+[0.16131114959716797, 3.456244707107544, "And what do you think will be the biggest challenge older adults will face in the next 10 years"]
+[0.4579252600669861, 3.5761332511901855, "the biggest challenge"]
+[0.4540072977542877, 3.1602578163146973, "10 years"]
+[0.7666424512863159, 0.1994948536157608, "I would say to what they're able to get for the dollar, the quality of their dollar"]
+[0.7746475338935852, 0.1078692227602005, "quality of their dollar, how much they will how much people get 10 years from now"]
+[0.7680658102035522, 3.6259241104125977, "makes it makes it very difficult. Because it's, it's"]
+[2.1708765029907227, 7.204105377197266, "it's not"]
+[0.0731392428278923, -0.4460599422454834, "lose so much information and and and also be you know, having to choose how to spend their money is going to be very difficult and how they obtain it. And if they're able to attain it by by maintaining a job, so"]
+[-0.3714855909347534, -1.4735872745513916, "I presume that there's going to be a lot of the elder part of the population are going to have a lot of struggle, which can"]
+[1.4716771841049194, -2.377373456954956, "increase our homelessness just you know, a lot more depend on family and create a bigger issue with economic well being. And, and also mental health support. So you know, if you're not ready for it, and you're not prepared for it is going to be very hard because once it comes to you, it'll be you have to react a lot quicker in order for you to do something for for yourself in order to survive."]
+[-0.4857744872570038, -3.1734936237335205, "Thank you for sharing. And in your opinion, what do you think the government's role should be in meeting the needs of older adults in Orange County"]
+[-0.21052637696266174, -2.022758960723877, "they have to be equally involved, there has to be some type of committee or something that that's only directed towards them, and then it has to be communicated a lot more consistent, there has to be a good sense"]
+[-0.5179782509803772, 0.20790062844753265, "between between the government and the entities that are providing these kinds of supports for that and, and also being you know, what I call boots on the ground, just know they have to be present there, they have to see it for themselves, they have to experience it they have to experience these the these areas and have a have a lot more in depth discussions."]
+[1.9158679246902466, 0.9577332735061646, "Sometimes the data doesn't reveal  everything in and oftentimes we push ourselves towards data, but sometimes we really have to dig a little bit deeper to kind of see what the root of the problem is."]
+[0.06838980317115784, -4.967466354370117, "And thinking about all the older adult residents in Orange County, who is getting the least amount of attention"]
+[0.4141141474246979, -0.021981094032526016, "the middle class,"]
+[-0.10358015447854996, -4.2486138343811035, "the middle class of the Orange County population is a the one being in the"]
+[0.6308854222297668, -0.07070790976285934, "Income is one, if you don't say and if they don't meet it, then they don't qualify. So So"]
+[-0.4362494945526123, -0.8513221144676208, "That's it, it's almost the same way with us, you know that if they have a certain, you know, certain amount of support that already been provided, then of course, they can overlap with another type of support. But also if they don't, you know, meet the Meet the median kind of requirements, which makes it very hard to also to kind of put them on these types of programs, even though we still have a congregate, but more, you know, on those that actually have need or don't have the accessibility for that transportation, or can't leave their home. If they have a certain amount of income, and they don't, you know, and if they're not in that category, they get denied certain benefits and they have to pay out of pocket they to pay out of pocket and it's just unfortunate that you have to spent down"]
+[-0.05406936630606651, -0.4283258616924286, "that they have to be spent down in order for them to qualify for certain benefits and that's the sad part there are so much people you know, what people do to kind of work and make something out of their life"]
+[0.1537637710571289, -4.011312007904053, "Thank you. And thinking about all the issues facing older adults in Orange County, what issue is being overlooked."]
+[2.2722179889678955, 2.857961416244507, "Overlooked"]
+[1.6914323568344116, 6.674943923950195, "I would say"]
+[-1.6078771352767944, 1.548531174659729, "being overloaded to be"]
+[-0.330457866191864, -1.5366308689117432, "the mental and well being of those of that of that elder population. That's, that's, that's coming of age. Yeah, there's just a gap. There's a gap and they just don't recognize it and causing a lot more costs, cost increases and of course, seeing all this, it just, it just keeps dragging everything towards the right. And it should be just causing things to become a little bit more unattainable for for some of our population."]
+[10.503918647766113, 8.338509559631348, "Thank you. So"]
+[4.864454746246338, 3.477386236190796, "yes, so This concludes our interview."]
+[5.0652947425842285, 3.4132518768310547, "Thank you so much for your time, and you've been incredibly helpful for research. If you find that you do have more to share, please feel free to reach out to us. Our contact information is on our website, which is www dot advanced oc.com And you can also leave an anonymous voicemail on our telephone line at any time. And I will now stop the recording"]
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