Carbonell, Josefina G.: 1950—: Head of U.S. Administration on Aging

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Josefina G. Carbonell: 1950—: Head of U.S. Administration on Aging

The top U.S. official serving the elderly, Josefina G. Carbonell has become a national leader in innovative community services. When she accepted this position in 2001, she became the highest-ranking Hispanic-American appointee to the Department of Health and Human Services. Carbonell has earned respect from Republicans while working as CEO of the Little Havana Activities and Nutrition Centers (LHANC) of Dade County, Florida, and as a national technical assistance team member of the Office of Refugee Resettlement, which fostered health clinics and employment and housing programs for immigrants and refugees in Houston, Miami, and New Orleans. A federal appointment in 2001 made her the first local service provider to head the nation's Administration on Aging (AoA).

A native of Cuba, Carbonell emigrated from Havana to Miami, Florida in 1961. She attended Miami Dade Community College and studied public administration at Florida International University. With a Kellogg Fellowship in Health Management, she graduated from an executive program at Harvard's John F. Kennedy School of Government. Carbonell gained firsthand knowledge of the multi-generational families she served from her parents and son, Alfredo Carbonell, a physician. She has personally experienced the challenges of caring for aging parents and two maternal aunts, one homebound with Alzheimer's disease. Carbonell commented on the difficulties of round-the-clock care in Today's Caregiver: "Until it strikes you personally, you really don't realize the tremendous impact and the challenges that lie ahead."

Founded LHANC

An advocate for thirty years, Carbonell worked to improve the quality of life for refugees and the dignity and well-being of elderly and handicapped Miamians. In 1972 she founded the Little Havana Activities and Nutrition Centers (LHANC), a multi-service agency that began with a single meal center for seniors. In 1984, two years after becoming the agency's president, she organized Rainbow, a child-care program staffed by Little Havana's elderly, she organized a Cuban Independence Day celebration and dance in Jose Marti Park, and aided Mariel Cubans in registering as aliens. Rapidly outgrowing its original headquarters in Hialeah, Florida, LHANC burgeoned into the country's largest health and human services organization aiding elderly Hispanics.

At a Glance . . .

Born Josefina G. Carbonell in 1950, in Cuba; emigrated from Havana to Miami, Florida, 1961; children: Dr. Alfredo Carbonell. Education: Miami Dade Community College, A. S.; Florida International University, public administration degree; state and local executive, John F. Kennedy School of Government, Harvard. Politics: Republican.

Career: Little Havana Activities and Nutrition Centers (LHANC) of Dade County, Florida, founder, 1972, president 1982; Office of Refugee Resettlement, national technical assistance team member; lobbyist for welfare and immigration reform, 1999; head of the U.
S. Administration on Aging, 2001–.

Awards: Kellogg Fellowship in Health Management; Miami Citizen of Year Award, 1992; Miami Herald Charles Whited Spirit of Excellence Award, 1993; City of Miami's Women Worth Knowing Award, 1994; National Alliance for Hispanic Health Community Service Award, 1995; Social Security Administration Commissioner's Team Award, 1997; United Way Monsignor Bryan Walsh Outstanding Human Service Award, 1997; named one of Hispanic Business's 100 Most Influential Hispanics, 2001; Claude Pepper Community Service Award, 2001.

Addresses: Office— 330 Independence Ave. SW, Room 4760, Washington, DC 20201 (202) 401-4541. Email— Josefina.Carbonell@aoa.gov. Website— http://www.aoa.gov.

Carbonell launched Dade County health and social initiatives, supported elder care, and founded a volunteer citizenship program and meal delivery to home-bound patients suffering with HIV/AIDS. She opened the Pro-Salud Clinic, Florida's pilot program offering health screening, primary care, wellness management, and medication control to older adults and their families. She also implemented Florida's Volunteer Health Professionals Program, which assists during national emergencies. In addition to volunteer resources, she secured a five-year grant of $186,000 from Proyecto HEAL, which assured basic, affordable medical care to the agency's 41,000 clients. In early October of 2000, Carbonell helped deliver meals and water to elders isolated by flooding during Hurricane Irene.

Carbonell was interested in politics throughout her career as a social services advocate. In June of 1999, she organized support for a bill to restore Medicaid, Children Health Insurance Program, Supplemental Security Income, and food stamps to legal immigrants, focusing on children, the elderly, and the disabled. Because the bill affected the lives of 8,000 Miamians, Carbonell fought for vulnerable people who were disenfranchised by restrictions on the 1996 immigration and welfare reform laws. Under the slogan "Fix 96," she championed civil rights organizations, religious institutions, and immigrants from Cuba, Guatemala, Nicaragua, and El Salvador. A year later, Carbonell lobbied Congress to reauthorize the Older Americans Act.

Carbonell was a delegate to the 1995 White House Conference on Aging and to the 1999 White House Conference on Mental Health. She also served on the National Committee to Preserve Social Security and Medicare, the Florida Commission on Long Term Care, the National Alliance for Hispanic Health, and the Theodore Gibson Memorial Fund. She has been honored with numerous awards, including a 1992 Miami Citizen of Year Award, a 1993 Miami Herald Charles Whited Spirit of Excellence Award, a 1994 Miami Beach Women Worth Knowing Award, a 1995 National Alliance for Hispanic Health Community Service Award, a 1997 Social Security Administration Commissioner's Team Award, and a 1997 United Way Monsignor Bryan Walsh Outstanding Human Service Award. In 2001 Carbonell was named one of Hispanic Business's 100 Most Influential Hispanics and was the winner of a Claude Pepper Community Service Award.

Selected to Head the AoA

Nominated to head the Administration on Aging (AoA) on June 7, 2001, Carbonell was unanimously accepted by the Senate Committee on Health, Education, Labor and Pensions and confirmed by the U.S. Senate on August 1, 2001. Sworn in one week later, Carbonell became the first Floridian to serve in the AoA and the third Cuban American to hold a prominent position in the George W. Bush administration. By accepting this new challenge, Carbonell left a functioning geriatric service complex comprised of 500 volunteers staffing 21 sites and serving over 55,000 registered clients. One of her final accomplishments for LHANC was the founding of the first senior center dedicated to the care of Haitians in South Florida. In a United States government press release, Health and Human Services Secretary Tommy G. Thompson lauded her "first-hand knowledge of the real issues faced by a dynamic population of older Americans and their families."

Carbonell brought to the AoA her considerable skill in refugee resettlement and in leading a family-centered agency that was both intergenerational and culturally diverse. She earned respect for publicizing the hardship of long-term caregiving and for recognizing the "graying of America." Upon taking office, Carbonell began developing policy and planning service delivery for the elderly and their caregivers. Similar to the maze of networked and interdependent programs in Dade County, the AoA relied on state and local agencies, volunteers, and tribal organizations to answer the challenges raised by the increasing longevity of the U.S. population.

A recognized expert on health, nutrition, and emotional support, Carbonell missed the personal touch of aiding elderly Miamians, but thrived on the demands of a federal job touching millions of lives. Her office developed plans for upgraded outreach and case management; the AoA handled referrals to existing service agencies, for transportation and personal care, and for daycare and meal preparation and delivery. Carbonell's staff also surveyed methods of preventing elder abuse, declines in health and vigor, and financial and legal problems. For family caregivers, AoA bolstered support, education and demonstration, and research.

In November of 2001, Carbonell observed National Family Caregiver Month with an appearance on the radio station WMKV-FM. She described her own family's needs and expressed hope in a fully implemented federal aid program, National Family Caregiver's Support Program (NFCSP), a $125 million boost to the Older Americans Act. The program, one of her first successes in Washington, is a flexible model based on first-person reports on nurturing the homebound and on current research into caregivers' problems. NFCSP coordinates numerous sources of assistance at the community, local, and state levels. To gain information from frustrated families, Carbonell's staff set up listening sessions to determine needs; they also collected data on inconsistencies in service by identifying communities that lack support and on those unaware of government aid.

Carbonell envisioned the future of NFCSP as providing help for caregivers juggling home duties with jobs. Her concerns included stress from unrelieved stretches of tending the elderly and sick, the increasing costs of prescription drugs and medical treatment, and the fatigue, worry, and frustration that cause caregivers to make workplace errors and miss meetings and work-days. She asserted in Today's Caregiver that "the business community needs to look at long-term care and support services as a benefit. So we will be working together with the private sector in developing ideas and coming up with solutions."

In the long-term, Carbonell proposed adding support for improved planning in the face of demands resulting from aging and debilitation. She advocated using faith-based communities, training sessions, youth assistance at household chores, and respite programs that replace caregivers temporarily with volunteers. In sympathy with hard-pressed families, she commented to Today's Caregiver, "I think we struggle as we try to do everything, and we just have to realize that we're not alone." She urged all citizens to network with other families, to talk honestly about hardships and to share experiences and advice.

Attended World Assembly on Aging

Carbonell led a U. S. delegation to the Second World Assembly on Aging in Madrid, Spain. She and other representatives of United Nations member states established the International Plan of Action on Aging. The plan looked into global needs arising from changes in the environment and from migrations in a population rapidly rising in median age. Carbonell emphasized the urgent need for reasonable policies at the domestic level, which impact some 35 million elderly Americans.

For Older Americans Month in May of 2002, Carbon-ell chose the theme "America: A Community for All Ages." She paid tribute to the family as the nation's strength and noted that 95 percent of personal care comes from the family. She saluted unselfish gifts of comfort, security, and sustenance, and honored the historical perspective that the elderly provide to young people as they seek self-affirmation and prosperity. For fiscal 2003, she requested $1.3 billion to fund the NFCSP as well as Medicare patrols, research and training, home services, and Meals on Wheels.

As head of the AoA, Carbonell has also established goals to lessen language barriers, upgrade literacy and acculturation, and counter isolation and post-traumatic stress disorders among refugees. As a Cuban immigrant, she commiserated with the difficulty of adjusting to a foreign land and customs, and the fear of the elderly that they will die and be buried far from home. To reach people of retirement age often overlooked by community support groups, she proposed agency collaboration to build trust and enhance quality of life.