Statement of Findings: Senior Related Housing Issues

1. Statement of Findings:Senior Related Housing Issues Prepared by: Jon Pynoos, Ph.D. Marvin Schachter Christy Nishita Carla Hett Smith

2. Why is Housing Important for California’s Seniors?

3. Housing Plays a Disproportionately Important Role Because: • Cost • The Amount of Time Elders Spend in their Home • Their Desire to Age In Place • Need for Supportive, Accessible Environment Linked with Services

4. Percent of Older Adults Who Prefer to Stay in their Own Home and Never Move Source: AARP (1996)- Understanding Senior Housing Into the Next Century. Percent of Respondents Who Agreed With the Statement “ I’d Like to Stay in My Home and Never Move”.

5. Critical Issues in Housing for Older Persons: The 4 A’s • Affordability- Costs • Adequacy- Condition • Accessibility- Supportiveness of Physical Environment • Appropriateness- Lives with Services

6. Affordability

7. Percent of Older Californians Living in Owned and Rented Units Source: 2000 Census- Californians Aged 65 and Over

8. Percent of Older Californians With High Housing Costs (30% or More of Income) Source: AARP (1995)- Californians Aged 65 and Older Who Pay 30% or More of Income on Housing

9. Severe Housing Cost Burdens Among Older Californian Renters Source: AARP (1995) State Housing Profiles- Californians Age 65 and Older

10. Sub-populations Vulnerable to High Housing Costs • Low-income persons • Women • Those Living Alone • Ethnic Minorities • Those Living in Rural Areas

11. Findings/ Preliminary Recommendations: • Increase Supply of Housing • Housing for Older Adults Should be Given a Higher Priority In Targeting Low-income Housing Tax Credits • Create Direct Financing Programs Through a State Housing Trust Fund

12. Preserve Section 8 Housing • Greater incentives for building owners to remain in program • Ensure a Fair Share of Senior Housing • Bond issue is very promising • Senior organizations signed on and now there is great concern • Consider adding a “frail elderly” or “at risk elderly” Special Needs Category

13. Need for a Special Category for Frail or At Risk Elderly Source: Census 2000

14. Need for a Special Category for Frail or At Risk Elderly Source: U.S. Department of Health Services, Agency for Health Care Policy Research, National Medical Expenditure Survey, Functional Status of Noninstitutionalized Elderly: Estimates of ADL and IADL Difficulties, 1987.

15. Adequacy

16. The Need for Adequate Housing • Older Adults Tend to Live in Older Homes • Dilapidated Housing In Need of Repair (e.g., Plumbing and Heating)

17. Number of California Elderly Homeowners and Renters with Inadequate Housing Extrapolation of American Housing Survey Data. Numbers represent 3.6% of homeowners and 5.7% of renters

18. Findings/ Preliminary Recommendations • Expand current state funding sources for home improvements • State CDBG program and the California Self-Help Housing Program

19. Create a State Low-interest Loan Program for Home Repair to Benefit Low-income Persons • Maine’s award-winning FIX ME program is a low-interest rehabilitation loan program funded by the state and specifically targeted to low-income homeowners.

20. Accessibility Home Modifications Visitability Universal Design

21. The Need for Accessible Housing • The home is the long-term care delivery site of the future • The overwhelming proportion of older adults prefer to age in place • Yet, increasing frailty and environmental barriers pose problems

22. Definition of Home Modifications • Home Modification (HM) Refers To Converting Or Adapting The Environment To Make Performing Tasks Easier, Reduce Accidents, And Support Independent Living.

23. Examples Of Home Modification • Ramps And Stair Glides • Hand-held Showers • Grab Bars • Roll-in Showers • Better Lighting • Chair Lifts • Widen Hallways

24. Importance of Home Modifications • Cost Effective • HMs In Combination With Assessment And Follow-up By An OT Can Reduce Health Care Costs And Delay Institutionalization • Adequate Space Can Facilitate Caregiving For Frail Older Persons By Relatives And The Formal System

25. Need for Home Modifications in CA • Over half a million older Californians have functional limitations. • Almost half or 219,000 older persons express an unmet need for home modifications Source: 2000 Census

26. Visitability • A set of key features that facilitates basic access into and within the home for older adults and persons with disabilities

27. Visitability Movement Growing • As of March 2003: • Mandated Legislation: • 5 States: Texas, Georgia, Vermont, Minnesota, Kansas • 10 cities and counties

28. Case Study: Vermont • Law applies to any “spec” built family or multi-family housing units, including privately funded housing. • A task force, which included the contractors, realtors, disability, and aging groups facilitated passage

29. Most Important Features • Zero Step Entrance into the Home • Accessible Entrance Door • Wide Level Route Through Main Floor • Wide Interior Doors • Accessible 1st Floor Bathroom • Apply to All Newly Constructed Single Family Homes

30. Universal Design • Adaptable Housing and Neighborhoods Designed to be Useable by All Persons to the Greatest Extent Possible • Different from visitability because it applies to entire home

31. Universal Design Features in Housing • Wide and Level Entries • Wide Interior Door Openings • Lever Door Handles • Variable Height Counters • Supportive Bars in Shower and Bathroom • Bathrooms and Kitchens Large Enough to Accommodate Walkers/Wheelchairs

32. Findings/ Preliminary Recommendations: Home Modification • California Department on Aging should Preserve Core Functions of Senior Housing Information and Support Center

33. CHFA should develop accessibility loan and grant programs • Minnesota’s HFA Fix Up Fund uses housing revenue bonds to provide homeowners with low-interest loans to improve accessibility. The MHFA also has a separate $500,000 deferred payment Accessibility Loan program funded by state appropriations

34. Link HM Better with Community Based Programs • More Comprehensive Home Assessments in Home and Community Based Programs

35. Findings/Preliminary Recommendations: Visitability and Universal Design • Endorse the Concepts of Visitability and Universal Design • Provide Incentives for Builders and Developers to Adopt These Practices • Provide Incentives for Local Governments to Adopt Mandatory Universal Design Requirements

36. Encourage Implementation of AB 2787- Senior Housing: Universal Design bill • Authorizes the Housing and Community Development Department to develop Visitability/Universal Design guidelines for the purpose of developing a model ordinance

37. Appropriateness

38. The Need for Appropriate Housing • Senior Housing Disconnected from Support Services • Older Californians Should Not Have to Move to Receive Services • There are Gaps in the Continuum of Housing

39. The Continuum of Housing

40. The Focus: • State Must Work to Fill in Gaps in the Continuum of Housing • However, focus today on: • Age-specific apartments • Assisted Living

41. Findings/ Preliminary Recommendations: • Provide Incentives for the CHFA Senior Housing Financing Applicants to Link Housing with Services • Cluster Services In Senior Housing and Use Housing as Platforms for the Delivery of Services

42. Develop Closer Working Relations Among HCD, CA Dept. of Transportation, CDA and HHSA to Develop Models of Housing That Incorporate Both Public and Commercial Spaces.

43. Findings/ Preliminary Recommendations: Assisted Living • Explore Governmental Funding Sources such as SSI, HUD Section 8 Vouchers, and the Medicaid Waiver Program to Pay for Housing and Services in Assisted Living

44. Encourage Implementation of Assisted Living Waiver Demonstration Program (AB 499) • $1 million dollars was included in this year’s budget to develop the waiver request to the federal government • The Department of Health Services has released a request for a consultant to work on developing the waiver pilot project • Implementation of pilot project has been slow

45. Conclusions

46. Serious Housing Problems Remain for the Elderly • Affordability Problems, Especially Among Older Renters • Housing Lacks Accessibility and Connection to Services • Problems Especially Severe Among Specific Subgroups of Minorities, Frail, and Women

47. Affordable and Suitable Housing Should be a Right of All Elderly in California The Question is How to Make it a Reality