Public policy around senior housing - the good, the bad and the gaps
Public policy is so interesting. Having spent time in both local and state government, I can attest to the depth of the policy discussions and the thoughtfulness that goes into each decision. However, as I sit outside of government right now, I puzzle at how any level of government can keep the complete picture—meaning the impact on other levels of government or even “silos” within that level—in focus.
Last week, JCHE was pleased to have the opportunity to comment on the 2011 Qualified Allocation Plan (QAP) for the state’s Department of Housing and Community Development, the road map for the state’s allocation of federal tax credits. I am very familiar with the QAP process, as I served as an Associate Director for Public Housing and Rental Assistance at DHCD directly before starting at JCHE. But as I read it this year, I quickly realized that I was evaluating it through a very different lens.
The state allocates federal tax credits, which are needed these days to build and preserve affordable housing. The state weights the selection criteria to favor family housing over senior housing. Given the state’s responsibility to shelter families who find themselves homeless, this is a natural, fiscally-responsible response. Senior supportive housing, however, goes a long way towards enabling folks to avoid nursing homes—and when the population that lives in affordable senior housing goes to a nursing home, the federal government picks up the tab at roughly ten times the cost of supporting that same person in housing. Yet the state only sees a fraction of the savings—and as the allocating agency, they focus on the state budget impacts first and foremost.
Furthermore, HUD has announced its intention to reform the Section 202 program—which heretofore provides capital and operating support for senior housing—to rely more on tax credits and other sources of funds. Their plan depends on states deciding to allocate tax credits to senior housing, yet the incentives remain there for family housing.
Every day in my new role, I witness the extensiveness of the need for affordable, supportive senior housing and the enormous success that JCHE has in transforming lives. A few points to consider:
- The aging of the population will hit us like a demographic tsunami. Between the years 2000 and 2025, the number of seniors over 85 is expected to double. We can count on the fact that this will be a frail population. We are not ready. The first of the baby boomers turned 65 this year—the wave is upon us!
- The senior population struggles to pay medical bills, food costs and housing. The U.S. Census Bureau calculates that at 16%, the proportion of seniors living in poverty is higher than the proportion of all Americans.
- Seniors carry a heavy rent burden. The DHCD-commissioned study by the UMASS Donahue Institute showed that 53.5% of people over 75 experienced a housing cost burden—more than half—and the HIGHEST percentage for any age group!
- According to the Massachusetts Secretary of the Executive Office of Elder Affairs, nearly all of the expected population growth in the coming decade in our state will be senior citizens.
- Senior supportive housing is an efficient use of government dollars, compared to nursing home costs. At JCHE, fewer than 3% of our 1,300 residents move to nursing homes annually, despite the fact that our average age is in the 80’s and that the average tenure is 10 years. For our residents who are Medicaid-eligible, we conservatively estimate that the combined cost of the supportive services plus the cost of housing at JCHE is $26 million less annually than nursing home care.
- There are few alternative choices. Seniors in their 80’s can’t simply get another job to earn a few more dollars and many can’t continue to live in non-accessible housing. The private 55+ communities are not addressing the needs of this population. We must provide good options.
But all the numbers and statistics aside, there is a very human element to be considered. There are compelling reasons for seniors to live in housing like JCHE provides, and we need to make it available to a broader number of people. Most significantly, seniors in our housing feel safe. Our residents also do not feel isolated, a key challenge as increased physical frailty limits mobility. The Commonwealth has been encouraging seniors to stop driving and without well-located and staffed housing, that is less likely. For our residents, there is always a neighbor around and “going out” can mean going downstairs for one of our many activities. We also provide transportation to shopping and to sites where our seniors volunteer. And we have skilled staff to help navigate systems like social security and health insurance that can cause frustration for many of our residents, and even terror for those who are not English-speakers.
Very importantly, our residents are not burdened by fears that their rents will soar beyond affordability. This is an enormous relief. Their children don’t need to fear that their parent is alone and without support while they are at work or caring for children of their own.
Historically, there has been a preference for directing state funds to the needs of families. But the demographic realities we are now facing in the Commonwealth cause us to take note. From where I now sit, I fully recognize the urgency with which we need to re-think our priorities.