Paying Dues, Getting Care

It’s a brilliant new idea for a rapidly aging population: a health center serving older adults that offers wraparound care spanning medical, dental, vision and mental health. Add specialties like dementia and end-of-life care. Finally, blanket patients with case management to connect them with important social services like housing, food, and other social programs for nutrition advice and abuse prevention.

New? Sure, in 1976.

The Over 60 Health Clinic in Berkeley was established during the revolutionary heyday of Bay Area politics by the Gray Panthers, an activist group paying homage to the far more radical Black Panthers, whose socialist agenda included better healthcare for the underserved.

Today, the Over 60 Health Center has blossomed into a thriving facility that last year served more than 3,000 patients, nearly half of them African-American.

The Age of Innocence. Life , death and the new world of Aging. For a complete archive of Matt Perry’s columns, click here.

As a young man, Willie Posey, now 73, hung out at the Black Panther Party office across the street from Oakland’s Samuel Merritt University and listened to Huey Newton and Bobby Seale discuss “how we were getting third-class healthcare.”

Today, after a lifetime of impersonal care at county clinics and Kaiser Permanente, Posey says the past nine years at Over 60 has returned his faith.

“We need to be treated as if we’ve paid some dues, and the only place I see that is Over 60,” says Posey reverentially.

Marty Lynch, long-time executive director and CEO of LifeLong Medical Care, which operates Over 60 and five other health centers plus a dental clinic in the East Bay, says Over 60 was ahead of its time.

“There’s a lot of emphasis today on chronic disease management that’s more relevant to the middle age to older adult population,” he says.

In a single day at Over 60, a patient might see a doctor about her diabetes and chronic heart condition, receive mental health counseling, have a cavity filled, and talk to a case manager about housing opportunities or welfare.

“This is a model for what healthcare should be,” says geriatrician Carla Perissinotto. “It’s really looking at the complete older adult.”

“Over 60’s the best!” exclaims Arkansas native Johnie Mae Poindexter. “It don’t get no better than that.”

For fragile older adults who often struggle with finances and transportation, one-stop healthcare like this is a godsend.

Nationwide, only a handful of community clinics target older adults, according to the National Association of Community Health Centers.

Yet this movement is expected to gain momentum as most provisions of the Affordable Care Act take effect next year and reward more efficient care.

Poindexter says Over 60 offers that personal touch, especially important listening skills.

“She didn’t have to listen to me but she did,” says Poindexter of one former physician. “And that means a lot when you get older. That’s a healer right there.”

“The doctors here seem dedicated,” says Rose Ellen, 70, who declined to offer her last name in the Over 60 waiting room. “Do you want to hear the negative? Sometimes they’re in a rush a little.”

Staffers say some center workers are overworked and stressed out, especially in social services.

Still, when the health center works – as it often does – the results are impressive.

The only certified geriatrician on staff, Perissinotto chose to practice at Over 60 because it serves a broad spectrum of needs from the physical to emotional.

An assistant clinical professor at the University of California San Francisco, Perissinotto says medical students performing residencies are veering away from profit and speed as career motivators.

“The residents I see coming through are much more thoughtful,” she says.

At times, the Over 60 center falls victim to its own success. Although coordinated care is its critical glue, private health plans and federal programs don’t typically reimburse for time spent by a care coordinator.

And so, like many community services, the health center has faced tough economic times.

In late September, the health center closed one of its two adult day health centers.

In addition, it ended physician visits at Alta Bates Summit Medical Center last October because none could shoulder the additional burden.

Still, two center physicians make regular house calls to 40-50 patients. And the center continues to help house 600 tenants at seven different East Bay housing facilities.

“The people who work here really have a passion for seniors,” says clinic director Dr. Gwendolyn Gill. “If you’re here, you have a heart for working with this population because you enjoy serving and are able to be patient and listen.”

Posey and Poindexter are more than just patients – they both volunteer on committees ranging from food distribution to making the center a better health experience.

“I’ve never felt a ‘we’ like this before in my life,” says Posey.

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