Vaccine misses some older adults
Grassroots efforts aim to find and help seniors
PORTLAND, Ore. – Jean Andrade, an 88-year-old who lives alone, has been waiting for her COVID-19 vaccine since she became eligible under state guidelines nearly a month ago. She assumed her caseworker would contact her about getting one, especially after she spent nearly two days stuck in an electric recliner during a recent power outage.
It was only after she saw a TV news report about competition for the limited supply of shots in Portland, Oregon, that she realized no one was scheduling her dose. A grocery delivery service for homebound older people eventually provided a flyer with vaccine information, and Andrade asked a helper who comes by for four hours a week to try to snag her an appointment.
“I thought it would be a priority when you’re 88 years old and that someone would inform me,” said Andrade, who has lived in the same house for 40 years and has no family members able to assist her. “You ask anybody else who’s 88, 89, and don’t have anybody to help them, ask them what to do. Well, I’ve still got my brain, thank God. But I am very angry.”
Older adults have top priority in COVID-19 immunization drives the world over right now, and hundreds of thousands of them are spending hours online, enlisting their children’s help and traveling hours to far-flung pharmacies in a desperate bid to secure a COVID-19 vaccine. But an untold number like Andrade are getting left behind, unseen, because they are too overwhelmed, too frail or too poor to fend for themselves.
The urgency of reaching this vulnerable population before the nation’s focus turns elsewhere is growing as more Americans in other age and priority groups become eligible for vaccines. With the clock ticking and many states extending shots to people as young as 55, nonprofits, churches and advocacy groups are scrambling to find isolated elders and get them inoculated before they have to compete with an even bigger
pool – and are potentially forgotten about as vaccination campaigns move on.
Some of the older adults who have not received vaccines yet are so disconnected they don’t even know they are eligible. Others realize they qualify, but without internet service and often email accounts, they don’t know how to make an appointment and can’t get to one anyway – so they haven’t tried.
Still others have debilitating health issues that make leaving home an insurmountable task, or they are so terrified of exposure to COVID-19 that they’d rather go unvaccinated than risk venturing out in public to get a shot.
In Kansas City, Missouri, 75-year-old Pat Brown knows she needs the vaccine because her asthma and diabetes put her at higher risk of serious COVID-19 complications. But Brown hasn’t attempted to schedule an appointment and didn’t even know if they were being offered in her area yet; she says she is too overwhelmed.
“I don’t have no car, and it’s hard for me to get around places. I just don’t like to go to clinics and have to wait because you have to wait so long,” Brown said,
adding that she is in constant pain because of spinal arthritis. “I couldn’t do it. My back would give out … and I don’t have the money to take a cab.”
To counter access disparities, the Biden administration said Wednesday that it will partner with health insurance companies to help vulnerable older people get vaccinated for COVID-19. The goal is to get 2 million of the most at-risk seniors vaccinated soon, White House coronavirus special adviser Andy Slavitt said.
Slavitt says insurers will use their networks to contact Medicare recipients with information about COVID-19 vaccines, answer questions, find and schedule appointments for first and second doses and coordinate transportation. The focus will be on reaching people in medically underserved areas.
Nonprofits, churches and advocates for older people have already spent weeks figuring out how to reach disadvantaged Americans over age 65 through a patchwork and grassroots effort that varies widely by location.
Some are partnering with charities like Meals on Wheels to distribute vaccine information or grocery-delivery programs like the one which alerted Andrade. Others are mining library card rosters, senior center membership lists and voter registration databases to find disconnected older people.
In Georgetown, South Carolina, a rural community where many of the 10,000 residents are the descendants of slaves, the local NAACP chapter is using its rolls from a November get-out-thevote drive to get the oldest citizens out for the vaccine. Chapter President Marvin Neal said the organization is trying to reach 2,700 people to let them know they are eligible for a shot and to offer help booking appointments.
Many of those individuals don’t have internet service or transportation, or suffer from medical issues like dementia, he said.
“Some are not even aware that the vaccine is even in their community, that’s the challenge,” Neal said. “It’s like they’re just throwing up their hands in the air and hoping somebody steps in. Because all the ones I have talked to want the vaccine. I haven’t had one yet that didn’t say, ‘Sign me up.’ ”
Outreach workers are also identifying holes in the system that prevent the most vulnerable seniors from accessing shots. For example, a dial-a-ride service in a rural part of Oregon doesn’t take passengers beyond their town limits, meaning they can’t get to their county’s mass vaccination site. In the same region, only the largest city has a public bus system.
Such obstacles underscore what outreach workers say is a huge demand for mobile vaccine clinics. Some local governments and nonprofit organizations are partnering with paramedics and volunteer groups that specialize in disaster response to inoculate the hardest-to-reach seniors.
In South Carolina, pharmacist Raymond Paschal purchased a van and a $3,000 refrigerator to start a mobile clinic for underserved areas, but his independent pharmacy in Georgetown can’t get a hold of any vaccine.
“There’s a lot of people falling through the cracks,” Paschal said. “These older people who have still not received their vaccine, they’re going to have all this younger generation they have to compete with. So we’ve got to get to these older people first.”
Ohio has taken a major step toward recognizing the role of serious mental health impairments in our criminal justice system.
People with severe mental illness will no longer be executed by the state, thanks to a bill approved by the legislature and signed by Gov. Mike Dewine.
I am grateful to those legislators who championed this recommendation of the Ohio Supreme Court’s Joint Task Force into law.
During my tenure as a Justice on the Ohio Supreme Court, I long believed that the Ohio General Assembly should exempt people with serious mental illness from the death penalty.
Task force recommendations
Legislation barring the execution of those who were severely mentally ill at the time of their offense was among 56 recommendations issued by the Ohio Supreme Court’s Joint Task Force to Review the Administration of Ohio’s Death Penalty in 2014.
That task force was charged with recommending changes to make Ohio’s death penalty system the fairest and most reliable system possible.
Yet only a handful of its recommendations have been enacted.
‘Diminished capacities’
Under the Eighth Amendment’s “evolving standards of decency,” the execution of juveniles and those with intellectual disabilities is prohibited because their youth and disabilities in areas of reasoning, judgment and impulse control diminishes their moral culpability to a degree that asserted state interests are not served.
Restrictions of the new law
Similarly, as Ohio’s new law recognizes, those with severe mental illness act with diminished impulse control and planning abilities, and do not act with the level of moral culpability required for imposition of the death penalty.
They, too, act with “diminished capacity.” Offenders who are exempt from death under the new law can still be sentenced to long terms of imprisonment, including life in prison without parole, in essence a natural death in prison.
An inmate now on death row has a year to raise a claim that he was seriously mentally ill at the time of the offense and to ask for a sentence of life imprisonment without parole based on this new exemption. The new law has no effect on the death-row inmate’s judgment of guilt, and it allows only life without parole as the new sentence.
Major cost savings
The new law is also a significant cost-savings measure. If the judge decides in a pre-trial hearing that the defendant is seriously mentally ill and therefore ineligible for the death penalty, the case proceeds without the enormous expense involved in death penalty litigation.
As the Legislative Service Commission’s fiscal note to the bill stated, capital cases cost 21⁄2 to five times as much as a life imprisonment case ($1 million to $3 million more).
Ohio will save potentially millions of dollars through this law, and recognizing that those with serious mental illness are vulnerable will hopefully improve access to critically needed mental health care.
Work remains to be done
One question remains: What about the other recommendations of the Ohio Supreme Court’s task force? Seven years later, most are not enacted.
The task force recognized the desperate need for changes in the law that assure we do not execute the innocent (we already have nine death-row exonerations and several innocence-focused commutations). Equally importantly, the task force called for measures to assure against racial discrimination.
And it called for measures to address arbitrary application.
The task force was not charged with considering repeal of the death penalty, but seven years have now passed since it finished its work.
We urge the legislature to take up these additional recommendations and ensure a fair and equitable system, if Ohio insists on still keeping the death penalty.
Evelyn Lundberg Stratton is a retired Ohio Supreme Court justice.
The Parade of Homes will return to central Ohio in a new format this year after a one-year absence.
Instead of being held in one location, this year’s Parade will be scattered throughout the metro area. The arrangement will allow for a much wider range of homes — showcasing different prices, styles and locations — than traditional parades, which feature homes that have grown out of reach for most buyers, said event organizers with the Building Industry Association of Central Ohio.
“Through this new format and a strong digital presence, we are bringing the central Ohio homebuilding industry to your community and your fingertips,” said BIA President Jeff Yates, a partner in Manor Homes.
The event will be held over three weekends from Sept. 25 through Oct. 10.
Organizers are still planning the event and do not have a list of participating homes and communities, although the parade will include more than the 10 to 15 properties showcased in past parades, said BIA Executive Director Jon Melchi. The BIA said homes throughout the region, including condominiums, patio homes and singlefamily homes, will be eligible to be included.
In addition to builders’ conventional models, the Parade will feature “a small number” of “dream homes,” according to a release announcing the event.
“You will absolutely see builders put their best foot forward in showing the latest trends and styles,” Yates said. “The parade will provide everyone the opportunity to see what’s hot in every market and at every price.”
The newly styled parade will also feature virtual tours of the homes at biaparade.com.
Melchi said builders chose the new format in part to allow the parade to get back to its roots after growing increasingly expensive the past two decades. The most recent parade, in 2019, featured 14 homes, all of them above $750,000.
“Our goal is to connect home buyers with homebuilders,” he said.
The BIA discussed the format with organizers in other cities, including Minneapolis and Raleigh, North Carolina, that operate scattered-site parades.
“We’ve spent a lot of time talking with builders in those markets, and we’re confident this is the right format for us,” he said.
The new format also helps builders remedy a problem that has hindered some past parades: a glut of deckedout, million-dollar homes in one location that builders have struggled to sell.
The BIA canceled last year’s Parade of Homes, scheduled to be held at Beulah Park Living in Grove City.
The event was canceled in February, before the pandemic, and may not have survived COVID-19 shutdowns anyway.
Homebuilders are eager to use the parade to build on the momentum they’ve enjoyed during the pandemic. Last year, 5,244 single-family homes were built in central Ohio, the most in 14 years.
“The demand for housing has never been stronger,” Melchi said. “By expanding the Parade of Homes, we will be able to highlight more homes.” jweiker@dispatch.com @Jimweiker