By Grace Li–
It has been an exciting year for Openhouse + On Lok Community Day Services, the first licensed adult day program in the nation created with and for the LGBTQ+ community. Since its launch in 2021, the program has garnered national attention for its innovation and commitment to LGBTQ+ seniors. Today, with strong, mission-driven partners and a dedicated community, we continue to develop a model of care that acknowledges and supports the needs of LGBTQ+ seniors like never before.
Helping LGBTQ+ Seniors Feel Seen and Supported
Openhouse + On Lok Community Day Services (referred to as Club 75) was born from the collaboration of two San Francisco nonprofits dedicated to helping vulnerable seniors age with independence—Openhouse, a leading advocate for LGBTQ+ older adults, and On Lok, which has pioneered aging programs for over five decades.
In the groundbreaking Needs Assessment of LGBTQ+ Senior Health in San Francisco—published by the University of Nevada, Las Vegas, Assistant Professor of Public Health Dr. Jason Flatt when he was an Associate Professor at the UCSF Institute for Health and Aging and released by Openhouse and On Lok—data showed that LGBTQ+ seniors are four times less likely to access aging services than other populations. One in five respondents felt unsafe or unwelcome in care settings; others reported difficulty accessing transportation to services and programs that did not reflect the LGBTQ+ experience.
Openhouse + On Lok Community Day Services was created to provide a trusted space where LGBTQ+ elders and their chosen families can receive care while being embraced as their authentic selves. Participants call it “Club 75” because it is their center—a safe, affirming place for connection and community.
Located at 75 Laguna Street in San Francisco, the center features a spacious activity room, a warming kitchen, a library, and gender-neutral bathrooms with showers. The adjacent courtyard, shared with the Openhouse Community at 55 Laguna, provides a serene outdoor space with mature trees and picnic tables. Here, LGBTQ+ seniors can engage in a variety of activities, receive firsthand assistance with personal care, access transportation to and from the program, and enjoy nutritious meals with peers. The program operates on a sliding scale fee structure, ensuring affordability for all, with scholarships available, including one specifically for HIV survivors.
Expanding Care for LGBTQ+ Seniors With Complex Needs
With the creation of Club 75, we aimed to deepen our commitment to the LGBTQ+ community by expanding care beyond the day center. The program now serves as an alternate care setting for LGBTQ+ seniors enrolled in On Lok PACE (Program of All-Inclusive Care for the Elderly), integrating services at Club 75 into their overall care plans.
On Lok founded PACE in collaboration with seniors, families, and community leaders to help vulnerable older adults avoid premature nursing-home placement. This nationally recognized model of integrated healthcare and social services provides low-income seniors with culturally sensitive medical care, transportation, day center activities, home care, and more.
Club 75 serves a unique and diverse population, with 95% of participants identifying as LGBTQ+. Our clients include long-term HIV survivors (22%), transgender individuals (12%), and those living with Alzheimer’s or related dementia (22%). Additionally, 29% of participants are enrolled in PACE. As we continue to learn from our clients’ needs, we are using these insights to shape PACE as a culturally affirming health model that extends beyond the day center.
Advancing LGBTQ+ Care Through Collaboration and Advocacy
As the program grows, it has gained national recognition and fostered partnerships that drive its future. In 2024, the Openhouse + On Lok Community Day Services team presented at three national conferences, sharing our pioneering work at the American Society on Aging Conference in San Francisco (March); the National Ryan White Conference on HIV Care & Treatment in Washington, D.C. (August); and the National PACE Conference in San Diego (October).
With UCSF, we are conducting an evaluation of Club 75 to measure its impact and effectiveness. As we keep evolving and learning, we are hiring and training caregivers who can provide culturally competent care for LGBTQ+ seniors. Our staff’s deep ties with the community enable us to deliver personalized support that speaks to the experience of our community members, for instance for individuals living with chronic conditions and HIV.
To further strengthen our efforts, we are currently developing a caregiver curriculum focused on long-term HIV survivors. In partnership with UCSF and the On Lok PACE behavioral health services team, we have implemented specialized training to enhance our caregivers’ ability to provide affirming care.
A recent milestone in our growth is a $250,000 grant from Gilead Sciences Inc. to support the On Lok HIV Caregiver Training initiative. Launched in January 2025, this two-year project will equip On Lok PACE and adult day center caregivers with essential skills for serving trans individuals and HIV survivors. UCSF and PACE Nursing are providing development and testing support to ensure the program’s success.
Shaping the Future of LGBTQ+ Senior Care
The healthcare system must provide the same level of support and sensitivity to LGBTQ+ seniors as it does to other diverse communities. We are committed to ensuring that our learnings extend beyond this adult day center, influencing caregivers and future care models for generations to come.
Our ongoing collaborations with Openhouse, UCSF, and other advocacy organizations are helping to set new standards for inclusive aging services. By fostering national conversations, training healthcare providers, and developing sustainable care models, we are shaping a more equitable future for LGBTQ+ seniors.
If you are interested in supporting this initiative, we invite you to contribute your time, resources, or financial support to help us expand and sustain these essential services. Together, we can ensure that LGBTQ+ elders receive the dignity, care, and community they deserve.
For additional information about Openhouse + On Lok Community Day Services, contact us at 415-292-8302 or email communitydayservices@onlok.org
With more than three decades in healthcare and 24 years at On Lok, Grace Li’s experience spans a wide range of healthcare settings. She has led On Lok’s PACE expansion across the Bay Area and launched several new programs, including Club 75 during her tenure. She holds a Master of Health Administration from the University of North Carolina, Chapel Hill, and a Bachelor of Arts in Economics from the University of Florida.
Aging in Community
Published on February 27, 2025
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