Elderly Housing Needs in California

Jon Pynoos, Ph.D. and Christy Nishita from the Center, along with Marvin Schachter and Carla Hett Smith from the California Commission on Aging, produced a policy report on the housing needs of older adults in California. This report will aid in the creation of a long- range strategic plan for older Californians, as required by SB 910 (Vasconcellos).

Input from public discussions held around the state as well as additional research culminated in the production of policy papers on the issues of housing, health, transportation, and planning/systems design. The papers were presented at the California Commission on Aging's (CCOA) Statewide Invitational Forum on April 1-2, 2003. The CCOA is the "principal advocate in the state on behalf of older adults, (providing) 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".

Invitees to this forum included representatives of state agencies and organizations such as the California Department of Aging, California Health and Human Services, the California Housing Finance Agency, the California Association of Homes and Services for the Aging, and Housing California. The paper on housing issues included sections on the adequacy and accessibility of housing. To improve the adequacy of housing by addressing problems with electricity, plumbing, or heating, a few of the recommendations were to:

1. Expand the current state funding sources for home improvements- the State Community Development Block Grant Program and the California Self-Help Housing Program
   
   
2. Create a state low-interest loan program for home repair, similar to Maine's award-winning FIX ME program, which is a low-interest rehabilitation loan program funded by the state and specifically targeted to low-income homeowners.

To address the accessibility of housing, a few of the recommendations were to:

1. Link home modification better with community-based programs: Comprehensive home assessments should be conducted in home and community-based services programs (e.g. MSSP and other case management services) to facilitate aging in place.
   
   
2. Increase funds for home modification by:
   1. Advocating for Medicare and Medi-Cal to pay for home modification assessments by health care professionals and reimburse a greater range of home modifications
   2. Developing accessibility loan and grant programs under the California Housing Finance Agency. Programs could be modeled after the Minnesota Housing Finance Agency's (MHFA) Fix Up Fund, which uses housing revenue bonds to assist homeowners to increase the livability, accessibility, and energy efficiency of homes. The MHFA also has an Accessibility Loan program funded by state appropriations.
      
      
3. Endorse the concepts of visitability and universal design by:
   1. Providing incentives for builders and developers to adopt these practices in housing funded by the state
   2. Encouraging local governments to adopt mandatory universal design guidelines and visitability ordinances

The full report (in Microsoft Word format) can be accessed at: CCOA Housing Forum Paper

Aging Programs Feeling the Budget Crunch Nationwide

According to the National Conference of State Legislatures (NCSL) State Budget Update, a whopping two thirds of the states in the U.S. are facing budget crises for the 2003 fiscal year. For half the states in the union, budget allocations for Medicaid and other health care programs have already been exceeded for 2003. The state of the economy is fueling change for aging services in states such as: Texas, New York, Massachusetts, Minnesota, and Florida.

For the state of Texas, budget dilemmas bring a mixed bag of change. Governor Perry issued his budget proposals while emphasizing that Texans "don't want, don't need and don't deserve new taxes." In order to follow through on this commitment to keep the budget burden off the taxpayer, Governor Perry's proposals include different cuts, consolidations, and realignments of departments to save $1.7 billion. On a positive note, in the Department of Human Services, proposals include the increase of nursing facility reimbursement rates by 3.3 percent. Another positive change for aging services is the reduction of the Community Care Waiting Lists. Proposed funds will allow the transfer of 1,073 adults and 267 children, currently in nursing facilities, into the care of various community based programs. The total allotted funds for this effort is $70,963,031.

In New York, the picture is rather bleak. The terrorist attacks of September 11, 2001 resulted in the loss of approximately 100,000 jobs. Compounded with the recession, the total estimated shortfall for the next two years is $11.5 billion. Governor Pataki, in his budget address of 2003, stressed preserving jobs by not raising taxes. Increased government efficiency and streamlining of programs is a necessity. In New York, where public education is supposed to be a top priority, Governor Pataki lamented the required cuts in funding, as the money just isn't available to keep programs as they are. In terms of aging services, a third of non-profit nursing homes in the state are close to bankruptcy. The Office of Aging is also due for a 9% funding cut. In counties like Nassau, the waiting list to receive home aide is a long 2 ½-3 years. With funding cuts, the wait will be even longer. Naturally Occurring Retirement Communities and Foster Grandparents are two groups in danger of having state funding eliminated. The Retired and Senior Volunteer Program is also facing elimination in an effort to save the state $500,000. The program serves as a telephone-operated neighborhood watch for seniors residing alone in the community.

In his budget proposal, Governor Romney informed the citizens of Massachusetts that projected growth in Medicaid costs and other necessary programs would require program slashing and new taxes. Changes in Medicaid co-payment structures have been proposed to offset the costs of the program. Other changes include the elimination of the Senior Pharmacy Program ($85 million saved) and a $7 million reduction of funds for the Office of Elder Affairs. Home care programs are expected to bear the weight of these cuts. In addition, service coordinator positions for the congregate housing programs are at risk of elimination.

In the state of Minnesota, the Board of Aging is expected to feel the repercussions of a proposed $800 million cut in funding for Human Services. In facing the estimated $4.2 billion shortfall, the state braces for cuts in their Home Modifications budget. The state-funded community services grant program that supports homemods projects is expected to feel the impact of funding cuts. Another concern for seniors is a possible cut in state support for group residential housing.

Unlike most states in the nation, Florida will actually enjoy a $140 million General Revenue fund surplus at the close of the fiscal year 2002-03. Governor Jeb Bush proposes the allocation of $414 million towards community care services and an expansion of the Silver Save program that acts as prescription insurance for the elderly. Statistics project that potentially over 73,000 seniors would be able to enjoy the benefits of this program.

This major conference is co-hosted by the University of Florida Rehabilitation Engineering Research Center on Aging, the American Society on Aging and the European Union Commission, in partnership with several federal agencies, corporate sponsors, and partner organizations. The conference will bring together researchers, practitioners, business leaders and people involved in aging policy issues.

The conference will include sessions related to research and development, practice, products and services, and policy. Commissioned papers will be published following the conference. Conference proceedings (abstracts and full papers) will be posted on the website of the Rehabilitation Engineering Research Center on Technology for Successful Aging (www.rerc.ufl.edu).

To request additional information about the conference, click here or visit www.asaging.org and click on "Events".