Position: Executive Director, Over-60 Health Centers
I was there when Over-60 opened up its little storefront next door to my café, "The Bus Stop." I'm proud to say that I helped start it—I walked the neighborhood to tell people about it. I've been involved in many community organizations and I know that you've got to really work at it, and that's what Marty does. He's got heart, and spirit, and he cares.—Member of the Community
Marty confronts the expedient myth that entitlement programs alone provide for elders' needs. I can't imagine the state of long-term community-based care were it not for his efforts. He has devoted his professional life to protecting the rights, choices, and dignity of older adults.—Member of the Berkeley Gray Panthers
In 1979, when his elderly father got sick, Marty Lynch was a community health worker, serving as program coordinator at the Alameda Health and Dental Project in Oakland, Calif. To his surprise and dismay, he soon found out how difficult it was, even for someone in the health care field, to secure the complex web of services his wheelchair-bound father needed in order to continue living independently with his wife. The elder Mr. Lynch, facing the prospect of living out his days in a nursing home, lost his will to live, and quickly succumbed to illness.
Marty Lynch's grief was mixed with anger and frustration. Clearly, something needed to be done to provide elders with the comprehensive, affordable, flexible care they needed. Galvanized into activism, Mr. Lynch demonstrated in the streets of Berkeley against county cuts to health and social services mandated by California's Proposition 13. That's where he met the Gray Panthers. "The Panthers had a whole different view of what aging is all about," he later recalled. "It was about seniors being active and independent." He began attending the Berkeley chapter's potluck dinners, and volunteered to write grant proposals for them pro bono.
The Gray Panthers had opened a community clinic in Berkeley in 1976, called the Over-60 Health Center, whose mission was to maintain the health and independence of low-income elders by integrating affordable medical care and social services in one-stop-shopping style. "It's very hard for older people to get the care that they need when they have a stroke or become disabled," Mr. Lynch explains. "When they have to go through 5 or 6 or 10 different systems and 5 or 6 or 10 different eligibility processes—none of those systems talking to each other or coordinating with each other."
Mr. Lynch had never seen anything quite like Over-60, and no wonder—the tiny, rented storefront clinic was the nation's very first community-based geriatric health center.
"If you ever have a job opening," he told them, "I'd love to work with you." In 1980, the Gray Panthers took him up on his offer, and Mr. Lynch soon became the Over-60 Health Center's executive director. Immediately, he set about shaping the clinic into the embodiment of his vision: Affordable, comprehensive, easily accessible, flexible care that keeps elders living independently. Under Mr. Lynch's guidance, Over-60 bought its own building—a converted post office in Berkeley—and expanded its capacities to include a full range of services: primary medical care, mental health care, dental care, health education, advocacy, case management, social services, dementia care, care for homeless elderly people, and substance abuse care. Over-60 soon came to be regarded as a national model for community-based, integrated elder-care.
While Over-60's budget was small, and there were not a lot of funds to devote to advocacy, Mr. Lynch found the time and resources to do it. He knew, as did the Gray Panthers, that health care is political. He challenged the city of Berkeley to address the housing needs of its disabled, low-income older adults. He convened the National Association of Community Health Centers' Task Force on Aging, and was asked to produce a memo on long-term community-based care for President Clinton's Health Care Plan. He brought to the US Congress's attention the dishonest marketing practices of some "Medicare HMOs," which promise indigent elders financially attractive but inadequate health care coverage. In line with the Gray Panthers' approach—justice and services not just for the elderly, but for all the people—Mr. Lynch also became an eloquent, resolute voice in the successful 1990s campaign to get the city of Berkeley to provide perinatal health care services for low-income women.
While working on the big picture, Mr. Lynch still made time for the individuals he served. When a member of Over-60's board suffered multiple strokes, he drove her to meetings, arranged for her to testify before the city council, advocated for her medical care, and made sure that she remained active and involved as she approached the end of her life.
During this period (1986–95), Mr. Lynch also continued his education in an effort to improve his own capacities, skills, and understanding. He received a master's degree in public administration, emphasizing health policy, from the John F. Kennedy School of Government at Harvard University, and a doctorate in medical sociology from the University of California, San Francisco.
In an atmosphere of dwindling resources, where interagency competition for scarce funds threatened to cause friction and impede care, Mr. Lynch worked cooperatively with other agencies to create the Center for Elders' Independence, a mini-HMO serving disabled elderly who were nursing-home eligible, but who, through the agency's help, could now remain in the community. The Albany-Berkeley Independent Elders Network, a coalition of formerly competing agencies, was another product of interagency cooperation under Mr. Lynch's guidance; it later merged with Over-60.
By 1995, with a staff of nearly 40 people, the Over-60 Center was bursting at the seams. Desks cluttered the hallways and social workers were relegated to another building down the street. Over-60 was serving 3,500 elderly clients with an average age of 78, 95% of whom lived at or below the federal poverty level. A satellite center had opened in East Oakland, and another was planned. Mr. Lynch now began to envision a new building, encompassing both Over-60 and the Center for Elders' Independence, along with low-income senior housing—all under one roof.
It was at this point that Marty Lynch was nominated for and received the Robert Wood Johnson Community Health Leadership Award in 1995. He used $95,000 of the $100,000 he received to jump-start the capital campaign for the new building. As a result of the award, and later, the ground-breaking for the new center, Mr. Lynch's efforts at Over-60 began to receive local media attention. This, along with RWJF's "seal of approval," brought added funds to the capital campaign. Technical assistance provided by Community Health Leadership Program staff also helped Mr. Lynch learn how to use the Internet, which at that time was a new tool for nonprofits. Networking with other Community Health Leaders at the initial ceremonies, at subsequent annual retreats, and using e-mail, re-energized Mr. Lynch's commitment and provided him with several specific ideas on running community-based programs and nonprofits.
The new center opened in May 2000. It houses the Over-60 Health Center (now merged with Lifelong Medical Care, a community health center that serves a high percentage of uninsured patients, within which Over-60 serves as the geriatric component). The building also contains the Center for Elders Independence (now known as the Program of All-inclusive Care for the Elderly, or PACE), in addition to 40 Housing and Urban Development-funded, low-income senior housing units focused on the disabled elderly. By the summer of 2000, some 4,000 patients per year were receiving preventive, educational, medical, and psychosocial services under one roof, with dental services nearby. It is anticipated that the patient load will soon reach its capacity of 8,000. Over-60 has long been independent of the Gray Panthers, but still works on that organization's principles, encouraging all people to take an active voice in their own health care.
In addition to serving seniors at its three Over-60 Health Centers (one in Berkeley and two in East Oakland), Lifelong Medical Care's two family practices in Berkeley enable it to care for the children and grandchildren whom elders often end up raising. Lifelong offers a holistic range of affordable care to the entire community, from young mothers and their infants to substance abusers to HIV/AIDS patients to the disabled elderly.
In addition to his efforts at Over-60, Mr. Lynch has also served on the boards of numerous other organizations dedicated to improving health care, bringing to the task, in particular, his energy and focus on providing for affordable comprehensive care for elders. These organizations included: The Center for Elders Independence of East Bay, the Alameda Health Consortium, the East Bay Elder Abuse Prevention Consortium, and the California Primary Care Association.
Looking toward the future, Marty Lynch will continue to work on the two issues that have motivated his work so far: achieving universal health care from the grassroots on up, and finding models that adequately tie together the various pieces of health for the elderly in comprehensive, accessible, affordable packages, so they can stay in their communities rather than in nursing homes.
To Mr. Lynch, change needs to begin locally, with such model development, expand through coalitions and constituencies, and end with policy change at the state and national levels. This last requirement of change brings out the importance of advocacy, an area where Mr. Lynch has become progressively more active. He works with national organizations such as the National Association of Community Health Centers, and the public policy committee of the American Society on Aging. At the state level, he works with the California Public Interest Center on Long-Term Care, a combination of consumer- and community-based advocates working on long-term care reform in the state. Locally, he is part of the Mayor's Task Force on the Uninsured, which ties into state and national policy efforts, and he chairs the elderly task force at NAC, a community health association.
Patience and persistence mark Mr. Lynch's leadership style. It takes great patience and open-mindedness to build coalitions, and great persistence and political acumen to cobble together constituencies for change. As he puts it, "Getting to universal health coverage for people is obviously a long and difficult road in this country."
The way Mr. Lynch looks at it, anyone can be a leader—with mentoring, training, and the right opportunity (the chance to make a living doing it). He acknowledges that it helps to have some writing skills and people skills, and the ability to effectively organize people to do the work. But to him, the most important part of leadership is heart. In his view, if you care enough to connect with people, the rest can all be learned in time.
For Marty Lynch, it's been a caring journey of more than 20 years. As one of the people whose lives he has touched puts it: "Marty listens to older people, and he makes sure that other people—such as city council members, assembly members, supervisors—listen also."