Statement of Findings:Senior Related Housing

Issues

Prepared by:Jon Pynoos, Ph.D.Marvin SchachterChristy NishitaCarla Hett Smith

Why is Housing Important for California’s Seniors?

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

Percent of Older Adults Who Prefer to Stay in their Own Home

and Never Move

77%89% 89% 96%

0%

20%

40%

60%

80%

100%

120%

50-64 65-74 75-84 85+

Age

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”.

Critical Issues in Housing for Older Persons: The 4 A’s

Affordability- Costs

Adequacy- Condition

Accessibility- Supportiveness of Physical Environment

Appropriateness- Lives with Services

Affordability

Percent of Older Californians Living in Owned and Rented

Units

75%

25%Lived in OwnedUnits

Lived in RentedUnits

Source: 2000 Census- Californians Aged 65 and Over

Percent of Older Californians With High Housing Costs (30% or More of Income)

20%

61%

0%

10%

20%

30%

40%

50%

60%

70%

Homeowners Renters

Source: AARP (1995)- Californians Aged 65 and Older Who Pay 30% or More of Income on Housing

Severe Housing Cost Burdens Among Older Californian

Renters

22%

16%

0%

5%

10%

15%

20%

25%

Pay 50% or More Pay 60% or More

Source: AARP (1995) State Housing Profiles- Californians Age 65 and Older

Sub-populations Vulnerable to High Housing Costs

Low-income persons Women Those Living Alone Ethnic Minorities Those Living in Rural Areas

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

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

Need for a Special Category for Frail or At Risk Elderly

Prevalence of Disability Among Older Californians

17%

33%

14% 12%

0%

5%

10%

15%

20%

25%

30%

35%

SensoryDisability

PhysicalDisability

Mental Disability Self-CareDisability

Source: Census 2000

Need for a Special Category for Frail or At

Risk Elderly

Percent of Elderly Needing Assistance with ADLs

11.40%

6.20%

0.00%2.00%4.00%6.00%8.00%10.00%12.00%

Need Assistancewith 1 or more

ADLs

Need Assistancewith 2 or more

ADLs

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.

Adequacy

The Need for Adequate Housing Older Adults Tend to Live in

Older Homes

Dilapidated Housing In Need of Repair (e.g., Plumbing and Heating)

Number of California Elderly Homeowners and Renters with

Inadequate Housing

96435

52262

0

20000

40000

60000

80000

100000

120000

Homeowners Renters

Extrapolation of American Housing Survey Data. Numbers represent 3.6% of homeowners and 5.7% of renters

Findings/ Preliminary Recommendations

Expand current state funding sources for home improvements

State CDBG program and the California Self-Help Housing Program

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.

Accessibility

Home ModificationsVisitability

Universal Design

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

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.

Examples Of Home Modification

Ramps And Stair Glides Hand-held Showers Grab Bars Roll-in Showers Better Lighting Chair Lifts Widen Hallways

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

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

Visitability A set of key features that

facilitates basic access into and within the home for older adults and persons with disabilities

Visitability Movement Growing

As of March 2003: Mandated Legislation:

• 5 States: Texas, Georgia, Vermont, Minnesota, Kansas

•10 cities and counties

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

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

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

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

Findings/ Preliminary Recommendations: Home

Modification

California Department on Aging should Preserve Core Functions of Senior Housing Information and Support Center

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

Link HM Better with Community Based Programs More Comprehensive Home

Assessments in Home and Community Based Programs

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

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

Appropriateness

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

The Continuum of Housing

Housing Options for the Elderly Independent Semi-Independent DependentCommunity-based Single Family Housing X XCommunity-Based Apartment Dwelling X XGranny Flat/Echo Housing/ Accessory Unit X XShared Housing X XRetirement Community (Age 55+) X XAge Specific Apartment Dwelling X XContinuing Care Retirement Community (CCRC) X X XCongregate Housing X XBoard and Care Home XAssisted Living Facility X XFoster Care X

The Focus:

State Must Work to Fill in Gaps in the Continuum of Housing

However, focus today on: Age-specific apartments Assisted Living

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

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.

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

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

Conclusions

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

Affordable and Suitable Housing Should be a Right of All Elderly in California

The Question is How to Make it a Reality