STATEMENT OF FINDINGS
SENIOR RELATED
HOUSING
ISSUES
Prepared for
PLANNING FOR AN AGING
CALIFORNIA: AN
INVITATIONAL FORUM
April 1-2, 2003
Sponsored by
California Commission on Aging
Prepared by
Jon Pynoos, Ph.D.
Marvin Schachter
Christy Nishita, Research Assistant, USC
Andrus Gerontology Center
Carla Hett Smith, Program Analyst
Commission Housing Committee
Commissioner Jon Pynoos, Chair
Commissioner Shirley Bierly
Commissioner Marvin Schachter
Commissioner Leah Wyman
California Commission on Aging
April, 2003
Table of Contents
Prologue
I.
Introduction and Purpose
II.
Statement of Findings
III. Research and Statistics
IV. Discussion of Issues
Sources
Statement of Findings on Housing
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3
3
7
12
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California Commission on Aging
April, 2003
Prologue
The California Commission on Aging (CCoA), under the Older Californians Act, is to act
as "the principal advocate in the state on behalf of older individuals, including, but not
limited to, advisory participation in the consideration of all legislation and regulations
made by state and federal departments and agencies relating to programs and services
that affect older individuals." As such, it is the principal advisory body to the Governor,
State Legislature, and State, Federal and local departments and agencies on issues that
ensure a quality of life for older Californians so they may live with dignity in their
chosen environment.
SB 910 (Vasconcellos) requires, among other things, that the California Health and
Human Services Agency (HHSA) prepare a long range strategic plan on aging by July of
2003, and consult or seek the advice of CCoA on this strategic plan. Preparing the
Commission to provide such advice, a series of field meetings called "public discussions"
were convened around the state. In April, 2002, a public discussion in Eureka focused
on rural aging issues; a June discussion in Ontario focused on senior health issues; a
September discussion in Fresno focused on senior transportation issues; a December
discussion in Los Angeles focused on senior housing, and a February, 2003 discussion in
Marin County highlighted planning/systems design for home and community based
services for seniors and adults with disabilities.
Input in the public discussions came from a variety of sources including: State
legislative staff, local government representatives, area agency on aging directors, area
agency advisory council members, physicians, university researchers, local and state
aging and disability advocates, issue specific state advocates (housing and
transportation), seniors and disabled adult consumers, and aging and disabled services
providers.
This paper was developed as a result of those public discussions and research into the
particular issues of senior health, transportation, housing, and planning/systems design.
This Statement of Findings will serve as the basis for discussions with state leadership
during the Commission's April 1-2, 2003, Statewide Invitational Forum.
Following the Forum, the Commission will produce a Statement of Recommendations
that captures the dialogue that occurred on April 1-2. These recommendations will be
submitted to Secretary Grantland Johnson, HHSA, as CCoA's formal input into the long
range strategic plan for aging. CCoA will also submit the recommendations to the
Governor and State Legislature.
Statement of Findings on Housing
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California Commission on Aging
I.
April, 2003
Introduction and Purpose
Affordable and suitable housing is of vital importance for California’s seniors and
adults with disabilities. Housing plays a disproportionately important role in the lives of
this population due to its cost, the amount of time elders spend in their home and their
desire to age in place. Moreover, housing is a major determinant of safety, ability to
get out into the community, and the ability to afford other basic necessities of life.
Many older adults express a strong desire for continuity in their living
arrangements, yet often face high housing costs or live in physically unsupportive
environments that are disconnected from services. Instead of facilitating older persons’
ability to grow old safely, independently, and with dignity, many settings have instead
become a source of the problem itself.
Likewise, for older persons who need more services and support than can be
provided in their homes and apartments, there is an inadequate supply of affordable
supportive housing options. Consequently, many older persons are faced with living in
inadequate settings or moving to more institutionalized settings. Subgroups that are
most vulnerable to poor housing conditions are older persons who are poor, frail,
female, minorities, those living alone, and residing in rural areas1.
The California Commission on Aging’s Strategic Plan emphasizes the importance
of housing for older adults. Input from public discussions in Eureka on April 10, 2002,
Ontario on June 5, 2002, and Los Angeles on December 11, 2002, helped focus the
structure and ideas presented in this paper. Additional ideas were identified through
various meetings with state housing leaders and experts and the research of the
Commission’s housing committee.
II. Statement of Findings
The Commission’s findings from the above-mentioned sources identified four
main housing problems that need to be addressed:
Affordability, adequacy,
accessibility, and appropriateness. The Commission’s findings regarding these issues
and suggested measures to address them are summarized here. All of the issues and
suggestions are supported by research in the detailed Discussion of Issues section of
this paper. Following discussion with state leaders and officials on the statement of
findings during the April 1-2 Invitational Forum, these ideas will be reviewed and
expanded to become the Commission’s recommendations for the Statewide Long Range
Strategic Plan on Aging.
A.
Affordability
Housing costs remain a serious problem for older Californians and government
subsidized housing continues to be in short supply. Therefore, the Commission
suggests the following affordability ideas for discussion with state leaders and officials:
Statement of Findings on Housing
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California Commission on Aging
April, 2003
1. Target Low-income Housing Tax Credits.
Older adults should be given a higher priority in the allocation of the low-income
housing tax credits and the program should include more supportive housing,
housing linked to services, and assisted living. For example, Massachusetts has
used a large proportion of their tax credits for the elderly and Oregon has used
them to develop assisted living.
2. Create Direct Financing Programs.
California could take steps to create a state housing trust fund as an ongoing
and dedicated source of funding for affordable housing that includes earmarked
funds to help finance a range of supportive housing options for the elderly.
3. Ensure a Fair Share of Senior Housing in the Administration of the Housing
and Emergency Shelter Trust Fund Act of 2002.
One possible method to insure that the needs of vulnerable elderly are met is to
add "frail elderly", "at risk elderly" and/or "very low income" elderly under the
Special Needs Population category. HUD's definition of "frail" consists of
residents who need help with 3-5 activities of daily living (ADL's), and the "at
risk" resident population who need help with 1-2 ADL's. Without a supportive
housing setting and services, such frail elderly are in serious danger of having to
move to more costly institutional settings such as board and care and nursing
homes.
4. Preserve Section 8 Housing.
A significant proportion of Section 8 voucher holders are seniors. Specific steps
must be taken to prevent the opting out of the program by of building owners:
a. Provide greater incentives for building owners to remain in the program.
b. Where landlords do opt out of the program, provide assistance (short
term subsidized rent) to tenants living in buildings that are converting to
market rent in order to give tenants time to relocate to other affordable
housing.
5. Continue to Support Section 202 Housing Production.
Encourage California’s Congressional Delegation to advocate for continued
funding commitments to the federal Section 202 senior housing program.
6. State Enforcement of the Housing Element in local General Plans.
The state housing element law needs tightening to insure that all local
governments, including those that are non-compliant, submit their plans and
address the issue of the need for senior housing.
B.
Adequacy
Moderate to severe problems with electricity, plumbing, or heating exist in many
dwelling units of older Californians. Inadequate housing threatens older adults’ health,
Statement of Findings on Housing
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California Commission on Aging
April, 2003
safety, and quality of life. With insufficient numbers of new housing units being added
in California to meet the needs of our target population, we must look to making
existing housing units adequate and accessible. Therefore, the Commission suggests
the following ideas for discussion with state leaders and officials to improve the
adequacy of housing for older persons:
1. Identification of the need for additional funding for basic home improvements
to improve health and safety in the state’s Consolidated Housing Plan.
2. Expansion of the current state funding sources for home improvements - the
State Community Development Block Grant Program and the California SelfHelp Housing Program.
3. The creation of a state low-interest loan program for home repair for lowincome residents, similar to Maine’s FIX Me program.
4. Working with private sector on initiatives that support home repair.
C.
Accessibility
The home is the long term care delivery site of the future. Most single-family
homes, apartment complexes, and subsidized housing in which older persons live have
significant accessibility barriers and do not provide supportive environment or service
linkages. As the population ages, the lack of accessible and supportive housing
becomes an even more important issue.
The Commission suggests the following
accessibility ideas for discussion with state leaders and officials:
1. Help low and moderate income older persons access housing and home
modification information, including how to access funding.
a. CDA should preserve the core functions of what was the Senior Housing
Information and Support Center (SHISC) and insure that its materials and
information, including a public service announcement on home safety, are
made available to the public.
b. CDA should assign staff to handle housing issues, coordinate its programs
with other state housing agencies, and be aware of other senior
organizations’ housing efforts.
c. The California Housing Finance Agency could develop accessibility loan
and grant programs modeled after a program sponsored by Minnesota’s
Housing Finance Agency.
2. Link home modification better with community based programs.
In order to insure that the home setting supports aging in place,
comprehensive home assessments in home and community based services
programs (e.g., MSSP and other case management services) should be
conducted to help divert seniors from nursing homes and allow older persons to
age in place. These workers and other community services providers should be
trained in Fair Housing Laws to improve their ability to advocate with landlords
for improvements in housing settings.
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California Commission on Aging
April, 2003
3. Provide Increased Funds for Home Modifications
a. Recognizing that home modification can help reduce accidents such as
falls and save long-term care costs, provide additional resources for the
provision of home modifications through programs such as Medicaid.
b. The California Housing Finance Agency could develop accessibility loan
and grant programs modeled after the Fix Up program sponsored by
Minnesota’s Housing Finance Agency.
4. Encourage Visitability and Universal Design
a. In order to build housing correctly in the first place, California should
endorse the concepts of visitability and universal design, providing
incentives for builders and developers to adopt these practices in housing
funded by the state.
b. Incentivise local government adoption of mandatory universal design
guidelines and ordinances.
D.
Appropriateness
Seniors and adults with disabilities who are cognitively or physically impaired, but
not in need of intensive medical services, can live in a variety of settings (a ‘continuum
of housing’) with supportive physical features and linkages to services to the extent that
they are available and affordable. In order to fill in the gaps that currently exist in the
‘continuum of housing’, the Commission suggests the following appropriateness ideas
for discussion with state leaders and officials:
1. Include housing in strategies to increase integration in home and community
based services, recognizing that home modifications can save long term care
service dollars; supportive housing options can prevent relocation to board
and care; and housing alternatives such as assisted living and special housing
for persons with Alzheimer’s Disease can allow frail older people to live in
residential settings and prevent placement in nursing homes.
2. Cluster Services in Housing Sites and Naturally Occurring Retirement
Communities (NORCs) in order to increase efficiency.
a. Target and cluster services such as health clinics, transportation,
preventive health, congregate meals, and legal assistance in government
assisted housing complexes and use them as platforms to serve older
persons in the wider community.
b. In their competitive ranking of applications for dollars for senior housing,
California Housing Finance Agency and CA Department of Housing and
Community Development (HCD) should encourage the development of
partnerships with organizations such as Health Maintenance Organizations
(HMOs), community based care systems, public health, and second career
employment programs.
c. Encourage volunteer pilot programs leading to more efficient provision of
services in housing settings.
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California Commission on Aging
April, 2003
3. Fill in the continuum of housing by encouraging the development of housing
options such as small group homes for persons with Alzheimer’s disease and
ECHO housing.
a. Promote zoning codes that allow for such specialized housing types in
neighborhoods.
4. Utilize New Integrative Models of Elderly Housing
a. Increase flexibility in the use of funds at the state and local levels to allow
the adoption of models of housing that incorporate both public (e.g.,
senior centers, day care centers, classrooms) and and commercial spaces
(e.g., restaurants, stores).
b. Provide incentives or priorities for California Housing Finance Agency
(CHFA) senior housing financing applicants that demonstrate innovation
by providing housing linked with services.
Encourage partnership
between developers, service providers, and other community
organizations to bring this about.
c. Develop closer working relations among HCD, California Department of
Transportation, CDA, and California Health and Human Services Agency
(HHSA) in order to foster innovative housing developments.
d. Utilize the state plan on aging and area plans on aging to incorporate and
encourage these integrated housing models.
5. Affordability and Regulation of Assisted Living Facilities (ALF’s)
a. Explore governmental funding sources such as Supplemental Security
Income, HUD Section 8 vouchers and the Medicaid waiver program to pay
for housing and services in ALF’s.
b. Encourage Department of Health Services implementation of the Assisted
Living Waiver Demonstration Program (AB 499).
III. Research and Statistics
A.
Affordability
1.
Home Owners’ and Renters’ Affordability Problems
Older renters are more likely to have lower incomes than older
homeowners. According to the latest census in 1999, 74.5% of Californians aged
65 and older lived in owned units and 25.5% lived in rented units. In
comparison to owners, renters were more likely to have incomes of less than
$10,000. Among Californians 65-74, 35.1% of renters versus 11.1% of owners
were low-income. The situation worsens among persons 75 and older: 46.4% of
renters and 22.4% of owners were low-income.
Due to these lower incomes, high housing cost problems are concentrated
primarily among renters, rather than homeowners. Among Californians aged 6574, one in five homeowners pay 30% or more of their income on housing,
contrasted with 61% of renters.
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California Commission on Aging
April, 2003
Percent
Figure 1. Percent of Older Californians Paying More
than 30% of Income on Housing
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Owners
Renters
65-74 years old
Owners
Renters
75+ years old
Source: AARP (1995). State Housing Profiles. Washington, DC: American Association of Retired Persons.
Even more serious are the problems of persons who spend more than
50% of their income on housing and are considered by the federal Department
of Housing and Urban Development (HUD) to have severe housing cost burdens.
In California, 22% of all older renters pay 50% or more of their household
income for housing, while 16% pay 60% or more2. Nationally, half of all older
homeowners with severe housing costs are still paying off a mortgage 1. The
other half own their homes free and clear, but report problems such as the cost
of utilities, taxes, and insurance. Nevertheless, homeowners tend to have higher
incomes than renters that enable them to address these expenses.
Certain sub-populations of elders are extremely vulnerable to severe
housing costs. Nationwide, women account for two-thirds of senior households
with severe housing cost burdens and two-thirds live alone1. By race and
ethnicity, 25% of white elderly nationally are so burdened, contrasted with 70%
of Black and 53% of Hispanic older households1. In rural areas of the western
United States, 21% of all households pay more than 30% of their monthly
income on housing3.
Housing cost burdens are especially detrimental to the elderly because
they are more likely to live on a fixed income than younger age groups. In three
California counties (Marin, San Francisco, and Santa Clara), Fair Market Rent
(FMR) for a studio apartment exceeds the average monthly SSI/SSP payment, a
primary source of income support for low-income elderly. In 39 of the state’s 58
counties, recipients of SSI/SSP would have to spend over 50% of their income
on rent based on the FMR4.
2.
The Importance of Subsidized Housing
Subsidized housing needs to be preserved because it plays a major role in
providing senior housing. For over 40 years, the federal government has
increased the housing supply for older persons by financing construction of
Statement of Findings on Housing
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California Commission on Aging
April, 2003
elderly units and reducing rents through tenant subsidy programs. Nationwide,
approximately 1.7 million older persons live in federally subsidized housing.
Public housing is the largest federal housing program for low-income older
persons serving approximately 500,000 elderly persons, primarily in special
housing for the elderly. Section 202 of the 1959 Housing Act has provided funds
for non-profit organizations to develop about 325,000 units occupied by 387,000
tenants. Sections 515 and 516 of the Housing Act of 1949 provide housing
assistance to rural residents and farm laborers through tenant subsidies.
In addition, older persons live in a variety of housing developed through
other federal programs (e.g., Low Income Housing Tax Credit (LIHTC), Section
236, Section 8 new construction) that have reduced interest rates on loans for
developers. Such programs have generally produced shallower subsidies than
public housing. In order to make these programs affordable by low-income
persons, many residents receive Section 8 rental certificates vouchers, designed
to reduce housing expenses to 30% of income. Across the nation, the federal
Section 8 program is under-funded and only 1 in 4 eligible households receive
assistance.
In California, there were approximately 1,700 senior housing projects with
225,000 units in 19955. Of these, 800 projects, or 150,000 units received either
construction or rental assistance from HUD. Approximately 125 projects with
22,000 units received housing assistance from the Rural Development
Administration (See Table 1).
Table 1. Senior Housing Facilities and Units in California
Number of Facilities
Number of Units
HUD-Subsidized
800
150,000
Rural Development Administration-Assisted
Low-Income Tax Credits
125
63
22,000
4,410
HCD Rental Housing Construction Program
20
1,100
Unsubsidized Facilities
700
49,000
Type of Housing
Totals
1,708
226,510
Source: California Senate Office of Research, 1995. Beyond Bricks and Mortar: Issues Facing Senior
Housing in California.
B.
Adequacy
Older adults tend to live in older homes, usually built prior to 1960. Nearly 1.5
million older households across the nation live in dilapidated housing in severe need of
repairs related to such housing systems as plumbing and heating; over 1 million are
homeowners and 400,000 are renters1.
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California Commission on Aging
April, 2003
Among Californians 65 and older, over 12,000 renters and 11,000 homeowners
live in housing with incomplete plumbing, one of several indicators of inadequate
housing.6 Some homeowners may be in a better position to afford repairs, have the
authority to make them, and tap into reverse mortgages to make such repairs.
However, many older homeowners do not have the resources or enough equity in their
homes to afford such changes. Nationally, inadequate housing conditions are especially
concentrated among older households who are poor, minorities (e.g., African Americans
and Hispanics), widows, very old (85 years or older), and frail1.
Elderly households in rural areas, and to a somewhat lesser extent in central
cities of metropolitan areas, are also more at risk of occupying housing in poor
condition. Nationally, 1.6 million non-metropolitan households are living in housing
classified as substandard7.
C.
Accessibility and Appropriateness
Nationally, 95% of older adults live in non-institutional community settings. The
overwhelming proportion of these older persons prefer to remain there 8. For such
residents, their current housing often represents a sense of security, proximity to
friends and familiar services, and memories of where they raised their families.
In spite of the strong preference of older persons to age in place, increasing
frailty may prevent them from achieving this goal. Among older adults residing in
affordable senior housing communities in California, 17% have 2 or more activities of
daily living (ADL’s – basic life functions such as bathing, dressing, and toileting)
deficiencies9. As a whole, the latest 2000 census indicates the levels of disabilities
among Californians aged 65 and older (See Figure 2) is considerable and rises rapidly
with advanced age.
Figure 2. Prevalence of Disability Among Older
Californians
35%
30%
25%
20%
15%
10%
5%
0%
33%
17%
14%
Sensory Disability Physical Disability Mental Disability
12%
Self-Care
Disability
Source: California Association of Homes and Services for the Aging (2000). 1999-2000 Affordable Senior Housing Survey.
California Association of Homes and Services for the Aging.
At the same time, residents of senior housing are older and more frail than other
seniors in California (See Table 2).
Approximately 1.14 million older persons nationwide with health and mobility
problems have unmet needs for additional supportive features in their dwelling units1.
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California Commission on Aging
April, 2003
According to the 2000 census, over half a million older Californians have functional
limitations. Extrapolating from national data on older adults to older Californians, almost
half or 219,000 older persons express a need for home modifications while only
117,000 older persons have the home modifications they need. The reality of these
unmet needs suggest that these persons can benefit from physically supportive housing
settings linked with services. One approach to addressing these needs is a continuum
of housing options, ranging from least supportive to most supportive for seniors and
adults with disabilities.
Table 2. –Characteristics of Senior Housing Residents Versus Other
Seniors in California
Characteristic
Age
% over 85
% 75-84
% 65-74
Degree of Frailty
% Needing assistance with
1 or more ADLs
% Needing assistance with
2 or more ADLs
% Needing assistance with
housework
% Needing assistance with
shopping
% Needing assistance with
meal preparation
% With some degree of
cognitive impairment
Senior Housing Residents
Other Seniors
15.0%
39.0%
39.0%
9.4%
31.3%
59.3%
12.0%
11.4%
8.0%
6.2%
29.0%
10.1%
24.0%
11.0%
19.0%
7.5%
15.0%
5.0%
Other Characteristics
% Living alone
86.0%
26.1%
% Living below poverty 50.0%
8.0%
level
% Minorities
30.0%
22.0%
Source: California Senate Office of Research, 1995. Beyond Bricks and Mortar: Issues Facing Senior
Housing in California.
IV. Discussion of Issues
A.
Affordability: Barriers to Providing Affordable Senior Housing
The most prevalent housing problem of the elderly is the burden of housing
costs. Older adults may become impoverished as too great a proportion of their
household income is dedicated to housing, leaving inadequate resources for other
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California Commission on Aging
April, 2003
necessities, such as food and health care. Housing costs are more serious for older
adults, because they are often on a fixed income with little capacity to raise their
incomes.
The following are a list of barriers to affordable senior housing:
1.
Government Subsidized Housing is in Short Supply
Many older Californians experience serious housing cost problems. Yet,
the availability of subsidized housing units for low-income persons is limited.
Long waiting lists and low vacancy rates for federal, state, and locally subsidized
housing was emphasized at the field meeting/public discussion in Los Angeles.
Waits of up to three years or more for entry into Section 202 housing are
common10. In Section 8 and public housing, there is a large gap between the
number of wait-listed applicants and the number of housing units available. In
California, there are 371,740 families and elderly on Section 8 waiting lists for
104,133 units of housing that are currently occupied. Another 93,632 families
and elderly are waiting for 25,268 units of public housing11. Across California, in
one sample of 146 senior housing properties, there were a total of 18,000
seniors on waiting lists9.
Some applicants cope by cutting expenses, moving in with others, or
asking relatives and friends for assistance, but most have already reduced their
expenses to the extent possible12. It is important to recognize that the lack of
affordable housing not only affects older adults, but low-income individuals and
families of all ages. However, because of disabilities associated with aging and
fixed incomes with little potential for increases, the elderly are uniquely burdened
by the lack of affordable housing.
Those on waiting lists for housing have few alternatives because vacancy
rates in California are at an all-time low. For example, in areas such as San
Francisco and Berkeley, it is virtually impossible to find affordable housing of any
kind11. Thus, elderly Californians have few alternatives but to cope with the high
cost of their current residence or make a life disrupting move. Even when they
obtain a Section 8 voucher, they often have difficulty finding both units that
meet cost and quality requirements, and landlords willing to accept the vouchers.
2.
Loss of Subsidized Housing
The problems of low-income persons are exacerbated by a loss of existing
subsidized housing stock. As of April 2001, nearly 20,000 subsidized low-income
housing units have been converted to market rents in California4. Under HUD’s
Section 8 programs, landlords received low-interest loans, subsidies, and other
incentives to house low-income families, disabled, and the elderly. Some
developers are paying their loans off early and converting to market rents or
opting not to renew their Section 8 contracts.
3.
Loss of Affordable Housing Through Gentrification
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California Commission on Aging
April, 2003
Gentrification and redevelopment also lead to the displacement of lowincome persons of all ages. For example, gentrification in and near San
Francisco’s Chinatown is forcing low-income residents out of their community
and keeping others from moving in, thereby preventing them from taking
advantage of the On Lok program that exists there. On Lok, which became a
model for programs across the country called “Programs of All Inclusive Care for
the Elderly (PACE),” enables frail elderly to remain at home by providing access
to an interdisciplinary team of health care providers. Displacement of residents
involved in these types of innovative programs threatens the health of clients,
who are still in need of services.
4.
Overall Lack of Housing Production in California
Between 1990 and 2000, approximately 400,000 single family and multifamily housing units were built in southern California. This stands in sharp
contrast to the previous decade (1980-1990), when approximately 1 million
housing units were produced. The most significant drop was in multi-family
housing unit production, where only 120,000 units were built in the 1990’s in
comparison to 470,000 in the previous decade. According to Southern California
Association of Governments13, 58,400 new housing units are needed to keep
pace with population growth in southern California. However, the region has
had a yearly annual shortfall in single- and multi-unit family home production of
16,400 units since 1991. The lack of housing production to meet population
growth decreases the available housing supply and increases housing prices.
5.
Difficulties with Federal Low-Income Housing Programs: Section 8, Section
202, and Rural Housing Issues
a. Inefficiency of Section 8 Vouchers
As previously noted, the Section 8 program is severely
underfunded. Yet even among those who receive a voucher, less than
half are able to use them. Section 8 vouchers are inefficient because they
rely on the private marketplace which is not open and often hostile to
those using the Section 8 program to find housing. There is no
requirement in California that landlords accept vouchers, and there are
requirements placed on landlords who accept the vouchers that may seem
burdensome. Especially in a tight rental markets, landlords can easily
choose other tenants. The problem is compounded in that HUD lags
behind in updating its ‘fair market rate’ (FMR), the rate that determines
the amount paid to a landlord under Section 8. At any given time, HUD’s
FMR reflects market rates from several years prior, making it difficult for
Section 8 rates to compete in today’s markets. Thus, some landlords
already participating in the Section 8 program have a financial incentive to
evict these in order to rent the units at a higher price or not to renew
contracts. Also, since voucher holders are screened by landlords, previous
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California Commission on Aging
April, 2003
eviction and bad credit prevents some voucher holders from finding a
residence.
Some local governments have attempted to mediate the
detrimental effects of Section 8 implementation. For example, in Santa
Monica, city policy dictates that if the owner opts out of Section 8, the city
will pay the higher rent charged by the landlord for a certain period of
time. This policy gives tenants time to find affordable housing. The City
of Los Angeles passed an ordinance to prevent the eviction without cause
of Section 8 tenants.
Various states and local jurisdictions have attempted through Fair
Housing Law to prohibit discrimination against Section 8 voucher holders
by landlords. California Fair Housing Law prohibits discrimination against
source of income, but advocates argue that this is not enough to prevent
landlord discrimination against Section 8 tenants. Stronger laws exist in
New Jersey, Connecticut, Massachusetts, Chicago, and San Francisco.
These laws and ordinances further broaden the definition of source of
income. Some of these creative definitions include: 1) Any lawful rent
payment, 2) All lawful sources of income or rental assistance from federal,
State, local, or nonprofit-administered benefit program, and 3) Income
derived from social security, housing assistance, child support, or public or
general assistance.
b. Developers’ Difficulties in Utilizing Federal Section 202 Program
Several difficulties in the Section 202 Program were raised by
developers in the Commission’s Los Angeles meeting. Because of local
planning processes and funding constraints, developers often cannot meet
the 2-year time frame of utilizing the Section 202 grant. Additionally,
because grantees under Section 202 are non-profits, they often have
difficulty coming up with their 10% match requirement. As previously
mentioned, multiple funding sources are leveraged to make affordable
housing work. Many Section 202 projects utilize Section 8 vouchers. This
is done through federal contracts that in the past were of 20-year-long
duration. The contract renewals are now ranging from 1 to 5 years.
Sustainability of affordable housing projects is compromised by this policy.
Also, testimony heard by the Commission described a local
disincentive for providing Section 202 housing. Local jurisdictions cannot
give preferences to housing applicants from their jurisdiction, thus, even
though they created the housing with the intention of meeting local
needs, there are no guarantees that local needy residents will actually be
able to live in the housing.
6.
Scarce Supply of State Resources for Affordable Senior Housing:
Proposition 46, Housing Trust Fund, Low Income Housing Tax Credit
(LIHTC)
Statement of Findings on Housing
Page 14
California Commission on Aging
April, 2003
a. Need for a State Housing Trust Fund
A rapidly growing method of financing housing developments across
the nation has been the creation of state and local housing trust funds.
Where they exist, these funds have been very effective at providing
ongoing funding to ease affordable housing shortages. Housing trust
funds are dedicated public sources of revenues, established by legislation,
ordinance or resolution, which can only be spent on housing14. For
example, Florida dedicates a document transfer fee tax of 2% toward
their state’s housing trust fund. In California, there are many local
housing trust funds, but no state housing trust fund. A barrier to this
state source is proposition 13, which requires a 2/3 vote in the legislature
for a tax or fee increase.
b. Proposition 46
The passage of Proposition 46, the Housing and Emergency Shelter
Trust Fund Act of 2002, provides a $2.1 billion dollar housing bond for
affordable senior housing. In contrast to a permanent state housing trust
fund, this bond measure is a temporary source of funding that will run out
in a few short years. The part of the bond that is dedicated to rental
housing is channeled through the state’s Multi-Family Housing Program.
All funds are targeted to lower-income persons and those that are
considered by the state to have the most pressing needs. Unfortunately,
even though many older persons are low-income, and experience physical
and cognitive impairments, frail elderly are prohibited from being a
“special needs” category in the points distribution of funding applications.
This makes it very difficult for housing sponsors to obtain funding to build
housing specifically for seniors.
c. Low Income Housing Tax Credit Prioritizing
The LIHTC is an important federal resource for producing lowincome rental housing. The LIHTC program creates affordable rental
housing by offering investors a credit against federal income taxes based
on the cost of acquiring, rehabilitating, or constructing low-income
housing. Each state is allocated a certain amount of tax credits to
administer. California’s Tax Credit Allocation Committee sets priorities as
to how these credits will be distributed.
In California, 63 or 3.7 % out of 1,708 complexes receiving lowincome tax credits in the early 1990’s were non-licensed senior housing
projects. California has set families as a higher priority than elderly for the
program. Currently, 15% of tax credit awards are set aside for senior
housing, while 60% of awards are set aside for family housing. Additional
set asides include 10% for projects considered to be at risk of being lost
due to landlords marking them up to market rates, 10% for Single
Statement of Findings on Housing
Page 15
California Commission on Aging
April, 2003
Resident Occupancy (SRO), and 5% for special needs. However, even tax
credit assistance sometimes requires additional financing mechanisms
(such as Section 8) to make units in these properties affordable to the
very lowest income elderly when the projects are located in expensive
housing markets such as the Bay Area.
7.
Poor Enforcement of State Housing Element Law
Currently, California State law requires a ‘housing element’ in city and
county General Plans that are supposed to guide development through local land
use plans. Housing elements are required to be submitted to the California
Department of Housing and Community Development for approval every 5 years.
The purpose of the housing element is to ensure that communities plan for the
housing needs of all their residents, although the law does not require that the
local governments provide housing to meet these needs. The housing element is
an ideal place to raise awareness about the housing needs of the elderly and to
identify strategies to address their problems. Unfortunately, over 1/3 of
jurisdictions within the state are out of compliance because they do not produce
a housing element, and there is no state enforcement that they comply.
8.
NIMBYism (Not In My Back Yard) Against Affordable Housing
Developments
Several testimonies heard by the Commission reflected local battles
that are fought over the siting of affordable housing. One advocate
pointed out that affordable housing should be allowed to bypass local
planning commissions and other authorities ‘by right’ because of the great
need. They felt meeting the needs of certain local residents should not be
dependent upon opinions of other residents.
9.
Local Land Use Barriers
Land for development of housing, especially for affordable housing,
is in short supply in California. In the early 1990’s, the state used local
money to backfill state revenue losses, creating financial hardships for
many local governments. This resulted in the local fiscalization of land
use: using land in way that will bring in the maximum revenue to local
governments. An example is the preference to zone and use land for
commercial purposes (e.g., WalMart and Costco Stores) instead of
housing because of the sales tax revenue that will go to the local
government. Some local jurisdictions have passed ordinances that allow
for mixed-use housing (residential and commercial combined use).
Additionally, bonuses and other zoning/permit benefits are offered that
encourage high-density housing. These are examples of creative ways to
open up land for use for affordable housing and to make developing
affordable housing more financially feasible.
Statement of Findings on Housing
Page 16
California Commission on Aging
April, 2003
B.
Adequacy: Barriers to Adequate Housing
Excessive housing costs can prevent persons from maintaining their place
of residence or obtaining decent living accommodations in the rental housing
market. Assistance is needed to help low-income elderly homeowners make
basic improvements so their homes are secure, safe, and livable. The State
Community Development Block Grant Program and the California Self-Help
Housing Program provide grants for housing rehabilitation. In other states,
programs provide loans directly to low-income homeowners. Maine’s FIX ME
program helps very low to low-income homeowners with low-interest loans to
make home repairs. Administered by the Maine State Housing Authority, the
program provides for repairs for roofs, electrical, plumbing, or heating systems,
and accessibility improvements.
C.
Accessibility: Barriers to Providing Accessible Housing
1.
Lack of Basic Accessibility and Supportive Features
As the population ages, the lack of accessible and supportive housing
becomes an important issue. Unfortunately, the overwhelming proportion of
single-family homes, apartment complexes, and subsidized housing in which
older persons live were built for residents who were physically and socially
independent, thus accessibility or provision of supportive services was not
considered. These dwelling units have been referred to as “Peter Pan” housing,
designed for persons who will never grow old. They include stairs that are
difficult for frail older persons to climb, inaccessible entrances for those using a
wheelchair or walker, and unsafe bathrooms. The addition of accessible and
supportive features in these dwelling units can improve their safety, make
caregiving easier, delay premature and costly institutionalization which saves
money that would otherwise be spent on a nursing home, and honor older
adults’ preference to age in place in their own homes and communities15. It is
also important to note that the demand for the current stock of accessible and
supportive housing units is so great that in order for the supply to ever meet the
demand, existing housing supply modification must be a part of the solution.
Physically supportive settings that provide accessibility outside and inside
the dwelling unit as well as other adaptations play an important role in assisting
frail older persons remain at home. Such features should be16:
a. Controllable by residents (e.g. individual thermostats at appropriate
heights)
b. Forgiving (e.g., carpeted floor surfaces that may reduce injuries from falls)
c. Easy to use (e.g., places to sit while cooking)
c. Supportive (e.g., grab bars and handrails) and
d. Accessible (ramps, wide hallways and doorways, roll-in showers)
Such settings can make it easier for older persons to carry out daily tasks,
enhance safety, increase socialization, and promote self-efficacy. Although the
Statement of Findings on Housing
Page 17
California Commission on Aging
April, 2003
addition of supportive features in homes has been increasing, most existing
housing stock still lacks features needed for seniors or adults with disabilities.
There is a growing movement to build accessible and supportive housing
in the first place to minimize the need for adaptation and to make all housing
accessible to persons with disabilities. Two important concepts regarding housing
accessibility include visitability and universal design. Visitability is a set of key
accessibility features that facilitate basic access into a home and usually includes:
Zero step entrance to the home, wide interior doors, a wide level route through
the main floor, and at least one accessible bathroom on the main floor.
Universally designed homes and neighborhoods are user-friendly for persons of
all ages and supportive for those with temporary or permanent disabilities. The
universal design of all products and environments should ensure usability by all
persons to the greatest extent possible without the need for adaptation or
specialized design. In terms of housing, universal design suggests such features
as a zero step entrance, accessibility to all rooms in the house, extra wide doors
and hallways, accessible bathrooms on all floors, backing for grab bars in
showers and bathtubs, and lowered switches and outlets.
2.
Statute Addressing Accessibility is Limited
Government response to improving the suitability of conventional housing
has been slow to evolve. The Fair Housing Amendments Act (FHAA) of 1988, the
major piece of federal statute that requires basic accessibility (wide hallways and
accessible bathrooms and kitchens) in housing settings, applies only to buildings
with four or more dwelling units. The law calls for “reasonable accommodations”
in existing multi-unit housing for persons with disabilities and allows tenants to
make adaptations, but is vague on the responsibility of the owner to pay for
changes, even in the common areas. The Act is administered locally and does
not cover single-family homes.
Because California’s population and housing stock continues to grow, it is
an ideal state in which to incorporate the principles of universal design and
visitability. Other states have set the example for an increased housing
accessibility statute in California. State visitability legislation has passed in
Texas, Georgia, Vermont, Minnesota and Kansas which requires visitability in
single-family homes and in some cases, duplexes or triplexes built with state or
federal funds. Currently, no city in California has adopted a visitability city
ordinance. There are voluntary programs in Visalia, Livermore, and San Mateo
County, and the issue is also being discussed in Modesto and Santa Monica.
In 2002, Governor Davis signed AB 2787, which directs the Department of
Housing and Community Development to develop universal design guidelines and
develop at least one model universal design ordinance. This bill represents an
important opportunity to increase not only accessibility but to create user-friendly
housing for individuals of all ages.
Statement of Findings on Housing
Page 18
California Commission on Aging
3.
April, 2003
Loss of Important State Resources for Housing Accessibility
The Senior Housing Information and Support Center (SHISC) in the
Department on Aging (CDA) has been dismantled due to budget problems.
SHISC was responsible for a statewide information clearinghouse on senior
housing options and home modification resources. Its mission was to promote
opportunities for Californians to live safely in their homes, with access to
supportive community resources, throughout their lifetimes. Services included:
a.
Resource Library on home improvement, community services, and senior
housing options.
b.
Information on funding sources for home modification and organizations
that can help.
c.
Education and training on home modifications for seniors and adults with
functional impairments, and their families, as well as professionals in the
field.
d.
Public outreach to California communities on the importance of building
collaborative partnerships that promote independence for seniors and
adults with functional impairments.
4.
Lack of Knowledge of Housing Accessibility Resources by Many Home and
Community Based Services Providers
The state and local agencies operate many fragmented home and
community based services programs that enable very low-income elderly to
remain in their homes as they age. Programs that offer case management and
more comprehensive approaches to serving seniors often are missing linkages
with the community resources on home modification. Multi-Purpose Senior
Services Program (MSSP), an important resource for frail seniors currently does
address this issue. Education on home modification, including Fair Housing Law
and the American’s with Disabilities Act (ADA) would be valuable knowledge for
any such local or state provider to have in order to encourage more accessible
home environments for seniors and adults with disabilities.
5.
Lack of State Resources for Home Modification
California does not have any state sources of funding for home
modification. Other states have successful sources of funding for this. The
Minnesota Housing Finance Agency’s (MHFA) Fix Up Fund uses housing revenue
bonds to assist homeowners in increasing the livability, accessibility, and energy
efficiency of existing homes. The low-interest loans are made to homeowners by
locally participating banks, credit unions, and housing agencies. The MHFA also
has a separate $500,000 deferred payment Accessibility Loan program funded by
state appropriations targeted at households of one or more persons with a longterm physical disability that substantially affects functioning in the home.
Statement of Findings on Housing
Page 19
California Commission on Aging
D.
April, 2003
Appropriateness: Barriers to Providing Appropriate Housing
1.
Gaps in the Continuum of Housing
Seniors and adults with disabilities who are cognitively or physically
impaired, but not in need of intensive medical services, can live in a variety of
settings with supportive physical features and linkages to services, often costing
less than nursing home care. Unfortunately for the individual in need of these
options, choices have been limited due to gaps in the housing continuum and
lack of appropriate geographic distribution (See Table 3.)
2.
A Patchwork System of Programs Linking Housing and Services
Senior housing is too often disconnected from support services.
Historically, federal and state subsidized housing were intended for independent
older persons. Yet as residents of senior housing grow older, their need for
supportive services increases. Older Californians living in senior housing should
not have to move or relocate in order to receive necessary health care and
supportive services. The concentration of such senior housing residents offers
opportunities to take advantage of economies of scale by targeting services.
Consequently, some housing sponsors, along with service providers, have
attempted to link housing and services; often by adding service coordinators,
who assess resident needs and arrange for services Excellent targets for these
service linkages include government-assisted housing developments and
naturally occurring retirement communities (NORCs). NORCs are places that
include high proportions of older people and are often located in older
neighborhoods, private apartment complexes and mobile home parks. However,
only a patchwork of these services exists in most areas.
Table 3. The Continuum of Housing
Housing Options for the Elderly
Semi-
Independent Independent
Community-based Single Family Housing
X
X
X
X
Community-Based Apartment Dwelling
X
X
X
X
Granny Flat/Echo Housing/ Accessory Unit
X
X
X
Shared Housing
X
X
X
Retirement Community (Age 55+)
X
X
X
X
Age Segregated Apartment Dwelling
X
X
X
Continuing Care Retirement Community
(CCRC)
X
X
Congregate Housing (20+ units)
X
X
Board and Care Home
Assisted Living (Personal Care) Complex
Foster Care
Intermediate Nursing Care
Pynoos, J. &Matsuoka, C. (2001). Housing and the Continuum of
Continuum of Care. Albany, NY: Delmar-Thompson Learning.
Statement of Findings on Housing
X
X
X
X
X
X
X
X
X
X
X
Dependent
X
X
X
X
X
X
X
X
X
X
X
Care. In C. Evashwich, The Long-Term
Page 20
California Commission on Aging
April, 2003
Housing should be an integral component of efforts to better integrate
Home and Community Based Services Systems in California but it is often left out
of the discussions. The physical environment along with supportive services are
often key in an older persons’ ability to stay in the community and out of more
costly institutional settings. For example, the lack of local land use planning and
zoning with ‘smart growth’ principles (mixed land use, preserving open space,
strengthening and directing development towards existing communities, creating
a range of housing opportunities and choices, creating walkable neighborhoods,
provide a variety of transportation choices) contributes to the disconnect
between housing and services.
3.
A Lack of Coordination Between Housing Long Term Care and Health
Sectors
There is a policy disconnect between housing, long term care, and health
sectors that results in an inefficient use of resources and a lack of coordination.
The Commission heard testimony that this was a particular problem in rural
areas. Each sector has its own distinct financing systems and regulatory
structures. Additionally, state actions at both the legislative and administrative
level inhibit coordination by creating silos of services and supports for seniors.
4.
A Stalemate on Affordable Assisted Living
Assisted living is a viable alternative to nursing home care. Assisted living
is a professionally managed residential long term care option that can meet the
needs of frail older persons who need supervised care, personal care services,
medication monitoring and services that can respond to their scheduled and
unscheduled needs. Its rapid growth indicates the attractiveness of this option
for older persons. Unfortunately, assisted living in California is an option that is
out of reach for most low-income seniors due to the lack of reimbursement for
this level of care. However, thirty-five states currently reimburse for assisted
living services through Medicaid Home and Community Based Services Waivers
(1915c). The states must assure the Centers for Medicare & Medicaid Services
(CMS) that the reimbursement of assisted living facilities will not cost more than
institutional care. For example, in Oregon, SSI is used to pay the cost of the
housing and Medicaid covers reimbursement for services through a five-tiered
rate scale depending on the type and degree of resident impairments. Another
financing option that now also becoming possible is for Section 8 vouchers to pay
for the shelter costs and Medicaid payments to cover services.
The passage of an Assisted Living Waiver Demonstration Program (AB
499) in California was a step in the right direction. One million dollars was
included in this year’s budget to develop the waiver request to the federal
government. However, the Department of Health Services, charged with
developing and implementing the waiver, is behind in implementing the pilot
project which must address both issues of cost (the legislation says “The
department shall not implement the waiver program if it will result in additional
Statement of Findings on Housing
Page 21
California Commission on Aging
April, 2003
costs to the state”) and quality of care.
DHS has released a request for a
consultant to work with the state on developing the waiver pilot project.
5.
Under-utilization of Echo Housing, Small Group Homes for Persons with
Alzheimer’s Disease and Adult Foster Care Programs
In public discussions, the Commission heard testimony on the benefits of
both echo housing (mother-in-law cottages), small group homes for persons with
Alzheimer’s Disease and adult foster care programs. It was pointed out that
local zoning barriers currently exist in many places that prevent the expansion of
echo housing and special small homes for persons with Alzheimer’s Disease.
While adult foster care model programs exist for seniors, especially in rural
areas, they are not available across the state.
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California. California: California Senate Office of Research.
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Senior Action Network (2000). Two Bits For Housing: A Campaign to Develop More Affordable Senior
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Williams, K.A. (2000). The Long Wait: The Critical Shortage of Housing in California. California:
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Pynoos, J., Reynolds, S., Salend, E., & Rahman, A. (1995). Waiting for Federally Assisted Housing: A
Study of the Needs and Experiences of Older Applicants. Washington D.C.: AARP.
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Menzer, M.B.(2001). Housing Southern California: Smart Growth Strategies, Southern California
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1
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