A Quiet Crisis in America A report to Congress by the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century

Submitted to the
Committee on Financial Services
Committee on Appropriations
United States House of Representatives

And the
Committee on Banking, Housing and Urban Affairs
Committee on Appropriations
United States Senate

Pursuant to Section 525(f) of Public Law 106-74, as Amended
Washington: June 30, 2002

Commissioners

Ellen Feingold Co-Chair President Jewish Community Housing for the Elderly Boston, MA	Nancy Hooks Co-Chair Regional Vice President American Association of Homes and Services for the Aging Albany, N.Y.
Jane O'Dell Baumgarten Member, Board of Directors AARP North Bend, OR	Reverend Emanuel Cleaver II Senior Pastor St. James United Methodist Church Former Mayor of Kansas City Kansas City, MO
John Erickson Chairman & CEO Erickson Retirement Communities Baltimore, MD	M'Liss Solove Houston President and CEO MSH Consulting, Inc., Springfield, VA
James E. Introne, Chair - Housing and Health Strategies Task Force President - The Loretto System Syracuse, N.Y.	Diana Mclver, Chair - Financing Strategies Task Force President - Diana Mclver & Associates Austin, TX
Rita Poundstone Manager Colorado Housing and Finance Authority, Supportive Services Program Denver, CO	Steve Protulis Executive Director Elderly Housing & Development Corporation Assistant to the President of the AFL-CIO Washington, D.C.
James H. Swanson Senior Vice President Paragon Mortgage Corporation, Phoenix, AZ	James T. Sykes, Chair - Needs Assessment Task Force Senior Advisor for Aging Policy University of Wisconsin Medical School Madison, WI
Harry Thomas Executive Director Seattle Housing Authority Seattle, WA

Commission Staff

Gerard L. Holder Executive Director	Kenneth R. Trepeta Deputy Director
Dina E. Elani Associate Director	Margretta R. Kennedy Director of Administration
Judy Crawford Special Assistant to the Executive Director

PREFACE

The Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century (hereafter, Seniors Commission) was established by Congress on October 20, 1999, under the Mandates of Public Law 106-74. Then Housing and Community Opportunity Subcommittee Chairman Rick Lazio and Ranking Member Barney Frank, of the House Housing and Financial Service Committees, announced creation of the Commission and the appointed Commissioners on January 2, 2001. The Commission held its first organizational meeting on April 29 and 30, 2001.

The Seniors Commission was created to study and report back to the Congress on housing and health facility needs for this and the next generation of seniors in America. It was empowered to offer specific policy and legislative recommendations to increase affordable housing and improve health-related service options for seniors now and as the Baby Boomer generation reaches retirement age. Existing and commissioned research - along with expert and public testimony compiled at field hearings across the United States - have been used to compile this report.

As detailed in the legislative Mandate, as amended, the Commission was required to submit to the Congress by June 30, 2002, a report that:

• "compiles and interprets information regarding the expected increase in the population of persons 62 years of age or older, particularly information regarding distribution of income levels, homeownership and home equity rates, and degree or extent of health and independence of living;



• provides an estimate of the future needs of seniors for affordable housing and assisted living and health care facilities;



• provides a comparison of estimate of such future needs with an estimate of the housing and facilities expected to be provided under existing public programs, and identifies possible actions or initiatives that may assist in providing affordable housing and assisted living and health care facilities to meet such expected needs;



• identifies and analyzes methods of encouraging increased private sector participation, investment, and capital formation in affordable housing and assisted living and health care facilities for seniors through partnerships between public and private entities and other creative strategies;



• analyzes the costs and benefits of comprehensive aging-in-place strategies, taking into consideration physical and mental well-being and the importance of coordination between shelter and supportive services;



• identifies and analyzes methods of promoting a more comprehensive approach to dealing with housing and supportive service issues involved in aging and the multiple governmental agencies involved in such issues, including the Department of Housing and Urban Development and the Department of Health and Human Services; and



• examines how to establish intergenerational learning and care centers and living arrangements, in particular to facilitate appropriate environments for families that consist only of children and a grandparent or grandparents who are the head of the household."

In addressing these matters, Congress directed the Commission to define and frame issues more precisely and to provide potential solutions. The Commission sought to:

• Assess the existing Federal role in senior housing, health, and supportive services;



• Explore means for Federal, State, and local governments to coordinate resources through joint collaboration;



• Encourage public-private partnerships (with proprietary and non-profit groups) to address capital formation issues for seniors' housing with a health care infrastructure;



• Educate the public and private sectors on seniors' capital housing and health care needs;



• Craft or develop new models and approaches to delivering seniors' housing that link housing and services;



• Develop strategies to make better use of single-family housing as a long-term care resource (most seniors reside in their own homes, and accessible features will influence their ability to age in place and affect the costs of caregiving); and



• Explore the financing strategies that can be employed to promote supportive housing and aging in place through home and community-based services.

To inform its work, the Commission held public hearings in:

• Syracuse, New York, on July 30, 2001;



• Columbus, Ohio, on September 24, 2001;



• San Diego, California, on November 7, 2001;



• Miami, Florida, on January 14, 2002; and



• Baltimore, Maryland, on March 11, 2002.

A number of Commissioners also participated in a Public Forum in Boston, Massachusetts, on March 1, 2002.

The Seniors Commission established Task Forces on Financing Strategies, on Needs Assessment, and on Housing and Health Strategies to address specific elements of the Mandate. Each task force was given responsibility for Mandate requirements and individual hearings. The task forces worked with the staff to select witnesses who would provide useful testimony for the essential elements of the Commission Report. Commission Co-Chairs Ellen Feingold and Nancy Hooks served as ex officio members of each task force. The Commission contracted with several leading researchers and firms to conduct original research; the significant findings of their papers are included in the Appendix to this report.

Contemporaneous with the Seniors Commission, Congress also established the Millennial Housing Commission. Congress directed that Commission to identify, analyze, and develop recommendations that highlight the importance of housing, improve the housing delivery system, and provide affordable housing for the American people, including recommending possible legislative and regulatory initiatives. The two Commissions maintained appropriate liaison and they shared information, while respecting their individual Mandates.

The Seniors Commission findings, recommendations, and policy analyses are contained in this final report to the Congress.

All appropriate records of the Commission and its work will be available to the public through the National Archives. Its report is available online at www.seniorscommission.gov.

Ellen Feingold
Nancy Hooks
Co-Chairs

[ Index | Seniors Commission Report ]