3. Stephen M. Golant, Ph.D., “The Housing Problems of the Future Elderly Population,” a Report Prepared for the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century, January 2002. Table 18.
6. Leonard Huemann, Winter-Nelson, and James R. Anderson, “The 1999 National Survey of Section 202 Elderly Housing,” Washington, DC: Public Policy Institute of the American Association of Retired Persons, 2001.
7. Michael Bodaken, "Preserving and Improving Subsidized Rental Housing Stock Serving Older Persons: Recommendations to the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century," National Housing Trust (2002), 8.
11. "The Lewin Group Projections from the 1996 Survey of Income and Program Participation, Wave 5," prepared for the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century, 2002.
14. A Profile of Older Americans 2001 AOA
16. Dr. Stephen Golant of the University of Florida at Gainesville compiled much of the data presented here for the Commission. Dr. Golant's report can be found in Appendix G-1 of this report. In addition to data compilation, Dr. Golant did original analysis of the 1999 American Housing Survey.
23. Michael Bodaken, "Preserving and Improving Subsidized Rental Housing Stock Serving Older Persons: Recommendations to the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century," Washington, DC: National Housing Trust (2002), 8.
27. "The Lewin Group Projections from the 1996 Survey of Income and Program Participation, Wave 5," prepared for the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century, 2002.
29. Golant, Table 17. The Commission finds a requirement of 730,000 new units to be added to either the 1.2 million number found in the American Housing Survey or the 1.7 million found in subsequent studies, including: Andrew Kochera "A Summary of Federal Rental Housing Programs, Fact Sheet #85" AARP, (2001), 4. The basis for the difference in the two studies results from the age used in each study (i.e. 65+ in the Golant study and 62+ in AARP Fact Sheet study).
38. A 1999 HUD report estimated that the average waiting list for affordable rental housing was 33 months. Although this data is not senior specific, it is a broad indicator of the length of time that eligible persons go unserved. See:" U.S. Department of Housing and Urban Development, "Waiting in Vain: An Update on America's Rental Housing Crisis Washington, DC: U.S. Department of Housing and Urban Development (1999).
44. Housing costs for renters include contract rent, utilities, property insurance, and mobile home park fees. Housing costs for owners include payments for mortgages or installment loans or contracts, real estate taxes, property insurance, homeowner association fees, cooperative or condominium fees, and utilities. Dwelling costs do not, however, include costs for maintenance and repairs.
46. Households with negative or zero income are not considered as housing cost burdened. Housing costs are compared with the household’s income from the previous year. Households that reported their monthly costs as 100% or more of their past year’s income were included in the “serious cost burden” category.
52. American Senior Housing Association, "Senior Housing: Solving America's Long-Term Care Crisis" (1999), 2. According to the report, 82 % of senior homeowners own their homes outright. If this trend continues, many senior homeowners will have a valuable asset to leverage to meet their needs.
53. For a discussion of the challenges of remaining in one's own home, see: Kathryn Lawler, "Coordinating Housing and Health Care Provision for America's Growing Elderly Population," Cambridge, MA: Joint Center for Housing Studies, Harvard University, (2001).
54. Timothy Waidmann, Kenneth G. Manton, "International Evidence on Disability Trends among the Elderly." Washington, DC: Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Office of Disability, Aging, and Long-Term Care Policy (1998). Many studies such as the one cited indicate that while the total population of seniors is increasing, the percent of disabled seniors among them is decreasing. The aggregate number of disabled seniors is increasing at a rate slower than the overall population of disabled seniors.
56. The model has two major components: 1) the Pension and Retirement Income Simulation Model (PRISM), which projects work and family history, retirement income, disability, and nursing home use; and 2) the Long-Term Care Financing Model, which projects home care use, long-term care financing and policy simulations.
61. National Investment Conference. 2001. The Case for Investing in Seniors Housing and Long-term Care Properties. Annapolis, Maryland: National Investment Conference for the Senior Housing & Care Industries.
62. Evidence does not exist that the assisted living alternative will become less expensive over the next two decades (National Center for Assisted Living. 2001. Facts and Trends: The Assisted Living Sourcebook 2001. Washington, DC: National Center for Assisted Living, American Health Care Association.)
63. In the third quarter of 2001, the mean assisted living occupancy rate was 85.5% (Robert Kramer, in an address to the national conference of the National Investment Center in Washington), December 13, 2001. In 1999, the mean occupancy rate was 89.4%.
65. U.S. Census Bureau, Population Projections Program. 2000. (NP-D1-A) Projections of the Resident Population by Age, Sex, Race, and Hispanic Origin, 1999 to 2100. Washington, DC: U.S. Census Bureau, Department of Commerce.
66. Consistent with earlier tabulations, this report is primarily interested in the demand for assisted living units rather than the existing or future supply of assisted living units. For any given year or period, the supply of assisted living units must be reduced by its occupancy rate and the percentage of units occupied by seniors as opposed to non-seniors.
69. National Investment Conference. 2001. The Case for Investing in Seniors Housing and Long-term Care Properties. Annapolis, Maryland: National Investment Conference for the Senior Housing & Care Industries.
82. In 2001, waiver programs in 49 States and the District of Columbia served more than 560,000 individuals. Arizona is the only State that does not use the 1915(c) waiver because it provides comparable services under another demonstration waiver authority.
93. Michael Bodaken , “Preserving and Improving Subsidized Rental Housing Stock Serving Older Persons: Recommendations to the Commission on Affordable Housing and Health Facility Needs for the 21st Century.” March 1, 2002, p. 2. (Appendix G-3 in this report.
97. Prior to 1990, Section 202 financing was available to developers of housing for both elderly and disabled, low-income households. This report focuses only on those properties that are for seniors, and therefore, the total number of units will be less than the number of units for the Section 202 program as a whole.
98. Other Section 8 is defined as any Section 8-assisted property that is not insured under the Section 202, Section 236 or Section 221(d)(3) BMIR programs. Some of these properties may not have a HUD-insured mortgage.
106. Many types of structures are built in the factory and designed for
long-term residential use. In the case of manufactured and modular homes, units
are built in a factory, transported to the site, and installed. In panelized and
pre-cut homes, essentially flat subassemblies (factory-built panels or
factory-cut building materials) are transported to the site and assembled. The
different types of factory-built housing can be summarized as follows:
108. NCSHA, conversation with Jim Thatcher. According to a survey of the State housing agencies in 2000, 22 percent of the total production level of 60,000 units was developed as “seniors only” housing.
110. HUD, “Evaluation of the Service Coordinator Program: August 1966”; Report to Congress: “Evaluation of the Hope for Elderly Dependence Demonstration Program and the New Congregate Services Program,” June 2000.
117. Federally subsidized housing includes the following housing programs: Sections 202, 236, 221(d)(3) Below-Market Interest Rate, Section 8 New Construction and Moderate/Substantial Rehabilitation, and 515; conventional public housing, housing choice vouchers, and Low-Income Housing Tax Credits.
118. Some housing projects have the financial capability to use their operating budgets to pay for service coordinator positions. The Commission believes that service coordinators should be included in the operating budgets of all assisted elderly housing developments.
126. The Coordinating Council on Access and Mobility was established in 1986 by the U.S. Department of Health and Human Services and the U.S. Department of Transportation. The Council promotes quality transportation services by encouraging the coordination of the program efforts of government and nonprofit human service agencies with public transit and paratransit providers. The Council brings together Federal agencies that fund or purchase transportation services to improve the availability and quality of community transportation services.
129. A forward commitment is a financing tool for multi-unit, service-enriched housing that can make the difference in whether a project is built. Generally, a forward commitment provides the borrower with a locked-in rate for the permanent loan in advance of the property being made available to tenants, and allows developers to know what their debt service will be in advance of construction. Fannie Mae's forward commitment has financed market rate as well as affordable multifamily projects. Freddie Mac has started a forward commitment program on a pilot basis. Freddie Mac's program offers financing to build or substantially rehabilitate garden or mid-rise apartments with either tax-exempt bond financing or low-income housing tax credits.
131. This refers to the Home Owners Equity Protection Act (HOEPA), and it is one title under the Truth-in-Lending Act. The purpose of HOEPA is to trigger specific discloses by the lender to the borrower on a home equity loan when the interest rate and other closing costs cross a threshold where the ACT deems the loan to be of “high costs”. It also prohibits or limits certain types of equity lending practices typically used by predatory lenders to drive up the cost of the loan to a borrower.
132. HUD Notice PIH 2000-41, Use of Housing Choice Vouchers in Assisted Living Facilities, defines assisted living facilities as those that are designed for residents who have the physical ability to live independently, but need assistance with some activities of daily living. These can include residential care facilities, adult care facilities, congregate care facilities, or group homes.
133. L. Earl Armiger, for the National Association of Home Builders, President, Orchard Development Corporation and Elderly Housing Coalition Recommendations to the Commission, Baltimore Field Hearing, March 15, 2002.
135. Enid Kassner and Lee Shirey, “Medicaid Financial Eligibility for Older People: State Variations in Access to Home- and Community-Based Waiver and Nursing Home Services,” AARP Publication No. 2000-06, April 2000.
136. The AARP report that provides this information does not list all nine States that allow a shelter deduction. It does, however, mention the use of this deduction in Idaho, Nebraska, Tennessee, and Utah.
139. D.U. Himmelstein, J.P. Lewontin, and S. Woolhandler, “Medical Care Employment in the United States, 1968 to 1993: The Importance of Health Sector Jobs for African Americans and Women.” American Journal of Public Health, Vol. 86, No. 4, April 1996.
142. 1994 NLTCS, cited in Robyn I. Stone, “Long-Term Care for the Elderly with Disabilities: Current Policy, Emerging Trends, and Implications for the Twenty-First Century,” Milbank Memorial Fund, 2000.
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