MINORITY REPORT

Introduction

We, the undersigned six Commissioners, have worked with our fellow Commissioners throughout the year to achieve a consensus report. Regretfully, this has proved impossible. While there are many recommendations within the majority report that we, as individual Members, helped to develop and continue to support, we came to the conclusion that the majority report does not sufficiently address and resolve a principal objective of the Seniors Commission mandate: to make recommendations that when implemented will ensure that the most needy of the nation's seniors have access to affordable housing and health and supportive services to enable them to live in dignity and safety, now and into the 21st century. We believe we were asked to look ahead to 2020, and to think about how things might be done differently.

There is a crisis in housing and services for low income seniors now. Attempts to meet a crisis anticipated for 2020 must begin to fill the huge gaps that exist today. There is now a critical shortage of decent, safe, sanitary housing for seniors that is affordable to them and in which they can receive the services and health care that are essential to making possible a decent and healthy old age. We believe that we can only meet the needs of this population in 2020 if we begin by acknowledging today's shortfall, and move aggressively to increase our housing and service resources for the present and the future.

These are seniors who live on the lowest of low-incomes and are the very old. They often live with a host of risk factors which exacerbate their health and safety, such as living alone, having chronic illness, not owning a home or other assets, having less education, and having no accessible informal support system. They are the neediest of the needy.

Seniors who identify themselves as racial and ethnic minorities also confront cultural and language barriers when seeking needed supportive services. Today, over 15 percent of elderly households identify themselves as minority: African American (9 percent), Hispanic (5 percent) and Asian American (1 percent). But between the years 2000 and 2020, the Black elderly population will grow at twice the rate of the white elderly population, and the Hispanic elderly population will grow four times the rate of the white elderly population. By the year 2020, minority elders will make up 23 percent of senior households.

Already today, many of the least advantaged seniors cannot find essential shelter and services within their severely limited resources. Within the next ten and twenty years, the problem will become increasingly critical unless current policies are changed and today's inadequate federal outlays are increased substantially. The Commissioners whose names appear below believe that the recommendations offered herein, when taken together and implemented, will substantially close the gap between the expanding need and the availability of affordable housing and services-today and into the future.

First, the minority calls for a major increase in the production of federally assisted housing for seniors. While the absolute number of seniors needing affordable housing is increasing dramatically, the supply of affordable housing is declining. Thousands of subsidized units have been lost to privatization and functional obsolescence. Each year the gap has widened, thus reducing the options for the nation's poorest seniors, members of minority groups and those residing in rural America. Seniors with disabilities often resulting from increased longevity have been most perversely affected, because they have a greater requirement for supportive housing and services in order to meet their everyday needs. These forces-the decline in the supply of affordable units and the increase in the number of functionally declining seniors requiring services-have created a crisis for low-income seniors now and into the future. Efforts to meet a crisis anticipated for 2020 must begin to fill and get ahead of the huge gaps that exist today.

Second, the minority believes that scarce government resources need to go to those seniors in greatest need. We agree that it is not only the very poor who are in great need. Particularly in the area of health and supportive services, those seniors whose incomes are above the ceiling for Medicaid certainly may require government support to access services. But the very-low income seniors are simply in the greatest need and greater public resources must be directed at meeting those needs.

Third, the minority recommends strengthening the links between needed housing and essential services through a number of short and long term actions, including some which are fundamental program changes, in order to reinforce the nation's safety net for seriously disadvantaged seniors. This safety net of affordable supportive housing is created with resources from a number of federal agencies, most importantly HUD and HHS, which must be able to collaborate in this effort in a much more coordinated and efficient way. The integration of HUD and HHS resources is essential to create a community-based support system that will, in fact, not only keep seniors from unnecessary, premature and costly institutional care, but also protect their health, dignity and sense of independence.

Fourth, the minority recommends some major changes in the principal funding mechanisms for health and supportive services-Medicare and Medicaid-including a prescription drug benefit. Seniors should not be forced to choose between food and drugs, nor be unable to purchase decent and safe housing because they have too little money after paying for their health care. Being forced to make desperate choices is not what the seniors of this nation deserve. Our recommendations go to maximizing their choice of where to live and how to access the services they need.

Finally, the minority knows that national resources are finite. But national priorities can be changed. Housing must become an important national priority as it is the absolute fundamental on which all human and social goods rest. A person cannot have good health without having a decent place to live. Children cannot be educated without a stable decent home. A senior who is homeless is almost certain to lose mental as well as physical health. A neighborhood or city with inadequate housing is in trouble, socially and economically. And producing new housing units costs more than low and moderate income people can afford. Meeting the housing and health and supportive services needs of seniors will require a change in the allocation of public resources, and a commitment to doing so has to be the first step toward meeting the needs.

It was not easy for the Commissioners listed below to decide to write and submit a separate Minority Report. As did our colleagues in the majority, we sought to reach consensus. There is indeed consensus in many areas of the majority report. However, we believe we have a responsibility to Congress and to the Members who appointed us to set out separately and distinctly our call for urgent and substantial allocation of resources, our conviction that we must begin now to close the gap between supply and need, and our belief that establishing an adequately funded, comprehensive long term care system that addresses shelter and services is critical.

We have one goal: to ensure that every senior has access to decent, safe and affordable housing and appropriate, quality and timely health and support services, now and in the future.

Respectfully submitted,

Ellen Feingold, Co-Chair
Emanuel Cleaver, II
Rita Poundstone
Steve Protulis
James T. Sykes
Harry Thomas

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