BY KORI SUZUKI SPECIAL TO THE BEE

This story was originally published in The Sacramento Bee  on March 5, 2023.

Every day, thousands of older Californians wake up or go to sleep hungry, unable to afford to stock their pantries.

But for many of them, it might not have to be this way.

State data reveal that two-thirds of eligible Californians over age 60 – roughly 1.5 million people – do not participate in CalFresh, the state’s food stamp program, even though they qualify.

This segment of the older adult population is “being denied a basic human right,” said UCSF Professor of Medicine and Epidemiology Hilary Seligman.

The reasons for this enrollment gap, researchers and state officials say, are a complicated mix of factors that include misinformation about the program, a lengthy application process and generational stigma around government assistance – as well as a 1970s decision that had previously rendered many seniors ineligible.

“It’s something that we grappled with for a long time,” said Agency on Aging Area 4 Executive Director Pam Miller, whose organization serves as a regional authority for aging in the Sacramento area.

In recent years, California has ranked among the lowest of any state in the percentage of eligible seniors receiving food stamps.

The state now has made senior participation in CalFresh a priority. Over the last three years, state and federal agencies have made a number of dramatic changes — some targeted at seniors — that have caused enrollment to surge.

Still, the number of older people receiving assistance remains low. As California prepares for a huge increase in the senior population, the state has clear strides to make in ensuring that older residents receive the help they need to eat well.

LOCAL ASSISTANCE TO NAVIGATE THE PROCESS

On a cold November morning, dozens of people lined up down the block outside River City Food Bank in Sacramento. The line was crowded with older people huddled together in the morning light as they waited for the bank to hand out food.

For Leslie Dies, one of the people there that morning, crisis came in 2014. His wife had to leave her job as an elementary school teacher in Sacramento.

Her knees had been aching, Dies said, and she needed replacement surgery. Afterward, however, she couldn’t stand upright. Returning to work was impossible.

Dies, then 60, took the first stable job he could find and started working as a security guard. He had previously worked odd jobs, and the new position meant a steady source of income. Still, it was a challenge to keep food on the table.

“You know what security pays,” he said. “It was very difficult.”

Dies started a CalFresh application, but soon felt overwhelmed by the process.

Many Californians, especially women and people of color, face the same challenges as they age. Nearly 2 million older residents make less than double the federal poverty line – a widely accepted standard below which people have trouble affording food and other living expenses, especially in states such as California where the cost of living is high.

For lower-income people of all ages, enrolling in the CalFresh program is a way to relieve some of that pressure. People participating in California’s version of the federal Supplemental Nutrition Assistance Program receive a monthly payment – around $250, on average – on a debit card they can use to buy groceries. Over 4.6 million Californians currently receive financial help from the program.

The benefits are far-reaching. People with limited access to food are more likely to deal with chronic disease, depression and poor oral health, among other issues. CalFresh can make a real difference, with participants reporting they are healthier and have fewer medical expenses.

THE REASONS FOR LOW PARTICIPATION

But a number of common barriers discourage older people from enrolling in CalFresh. One hurdle is misinformation about who is eligible. Some seniors mistakenly think they will not qualify because they own property or have savings. Others worry that their immigration status will make them ineligible, although many immigrants qualify.

An even higher hurdle is that some older people view government assistance as shameful. The CalFresh program traces back to the federal Food Stamp Plan, a 1930s welfare program meant to help people afford food during the Great Depression. But the longtime stigma of poverty has led many seniors to reject programs such as CalFresh.

A third hurdle is the lengthy process to enroll, which has historically included long forms and processing times. Some seniors simply decide that the benefits aren’t worth the time and effort of applying.

In many cases, informing people about CalFresh and helping them overcome these hurdles falls to community organizations, such as River City Food Bank.

On that cold November morning, Amy Dierlam was running through the day’s appointments for the outreach team she leads.

“It’s just good to know who we’re looking out for,” she said to her two team members, all peering at the calendar.

As other staff and volunteers bustled past, directing people inside or handing out apples, the outreach team double-checked the list of people who signed up to receive help with their CalFresh paperwork, and also checked on those waiting in line outside to see if anyone needed such assistance. Their goal, as always, was to help more people enroll in the program.

“I really liked helping people,” Dierlam said. “It’s a governmental system. You have to know how the system works. You have to know how to navigate it.”

Across the state, independent outreach teams such as River City’s are critical to helping seniors enroll in CalFresh. County governments are tasked with overseeing the program on a local level and conducting their own outreach, but advocacy organizations fill a crucial role by walking people through the application process and helping them troubleshoot any issues once they’re enrolled.

“We do really depend on some of the community organizations,” said Sacramento County program Manager Vanessa Mitchell, who works at a county office just across the street from River City Food Bank. “It just helps the customers get a little bit farther ahead.”

EFFORTS TO INCREASE THE NUMBERS

Researchers and advocates say the state has made some significant strides in recent years, beginning with a dramatic expansion in 2019.

Since 1974, California had barred residents from CalFresh if they were receiving Social Security Income – the modest federal wage that supports low-income people who are 65 or older, blind, or disabled. The state’s reasoning was that it was already giving SSI recipients an additional financial benefit called a State Supplementary Payment.

In reality though, that combination of federal and state support was not enough for many people to afford basic needs, such as food, as the cost of living rose.

And nationally, California’s approach to CalFresh and Social Security stood alone. In 2019, it was the only state in the country to exclude SSI recipients from its food stamp program – a major reason why it fell so far behind other states in senior enrollment.

That year, after a yearslong campaign by advocates, state lawmakers agreed to reverse course and opened the CalFresh program to SSI recipients. It was a historic expansion that meant an estimated half-million low-income seniors and people with disabilities could now apply for CalFresh benefits.

State authorities also took extraordinary steps to get the word out. The Department of Social Services implemented a first-of-its-kind outreach campaign targeted at older people, as well as people with disabilities and caregivers. Workers sent out pamphlets, ran radio campaigns, and published ads on social media. The combined policy change and outreach campaign triggered a surge of applications.

“The floodgates opened,” Dierlam recalled. “We had thousands of people applying.”

It was the beginning of a tumultuous time for the CalFresh program. A year later, the arrival of the pandemic upended things once again, as state and federal authorities scrambled to handle a new flood of applications and increase the benefits available to people. Outreach took a backseat as local governments focused on simply getting food into seniors’ hands.

As the months wore on, though, funding for meal deliveries and other emergency measures dried up, revealing a stark reality: Hunger among seniors was common.

“When the money ran out,” said Miller, from the Sacramento area Agency on Aging, “I think that the pandemic really showed us the amount of food insecurity there are among older adults.”

LESSONS FROM THE PANDEMIC

What the pandemic revealed, Miller believes, is a big reason why the state has turned its attention to boosting senior enrollment in CalFresh. Both state and federal authorities have moved to streamline the process for older people through the Elderly Simplified Application Project. More recently, the state Aging Department has made grants available to fund new CalFresh outreach programs at agencies such as the Agency on Aging Area 4, which Miller oversees.

In October, Miller’s agency received the news that it had been approved to receive one of the outreach grants. They recently brought on a new employee to handle their new outreach team, which is up and running as of late February.

Still, seniors such Dies – who initially gave up on his CalFresh application – remain in a tenuous position, lacking the confidence to navigate the program.

It was December 2015 when Dies decided he needed help. It had been over a year since his wife had lost her job, and they were barely scraping by on his wages.

That was when he found out that there was a place in Sacramento to assist with CalFresh applications – River City Food Bank.

Dies was nervous at first. He was still relatively new to the area, having only recently moved to the U.S. from Pakistan.

“I delayed, delayed, delayed,” Dies said. “I didn’t know people, how to approach them and all that. But then one day, I made up my mind and I came.”

Dies took the light rail from his home in Folsom all the way to River City Food Bank, where he met with the CalFresh outreach team. They helped Dies fill out forms and apply for the program. His application was quickly approved.

The financial assistance has made a tremendous difference, Dies said, especially as the pandemic and inflation have driven up grocery prices.

“So it’s good,” he said. “But we keep within our limit.”