SENIORS COMMISSION REPORT

We, the Commission on Affordable Housing and Health Facility Needs for Seniors in the 21st Century, are pleased to transmit our Report - A Quiet Crisis in America. This report is presented by the Majority of the Commissioners and contains recommendations for Federal policy that we believe will allow this Nation to appropriately plan for and meet the needs of seniors in the 21st Century.

Our Congressional Mandate was broad and encompassing. The Congress asked not only that we identify existing and future needs, but that we recommend creative, yet realistic approaches to address these needs. As expected, the growth in the numbers of seniors is staggering - today, one in twelve persons is 65 years of age or older. In the year 2020, it will be one in six. Some of this growth - from 35 million seniors today to 53 million in 2020 - is attributable to the aging of the Baby Boomers, but some of it is due to advances in medicine and improvements in our health care systems - resulting in longer life spans. Regardless, this "aging of America" will challenge our Nation's resources.

The Commission is a diverse group, encompassing providers, developers, researchers, advocates, clergy and lenders - each Commissioner brought a different perspective and a different experience base to our mission. As we worked through the past eighteen months to fulfill our Mandate, we experienced a common bond in our caring, compassion, and concern for the Nation's seniors. Ideology and partisanship aside, we shared a common vision that government at all levels should promote policies that allow for choice.

Our commonalities far exceeded our differences, but even though we had consensus on many of our ideas, we could not reach consensus in the interpretation of our Mandate. Thus, the Seniors Commission Report is submitted by seven of the thirteen Commissioners, bipartisan in our views, even though most of the recommendations were developed, with consensus, by the entire Commission. Some Commissioners have elected to sign a Minority Report, which follows the Seniors Commission Report in this document.

As a Majority, we believe that:

• Congress sought our ideas for addressing future needs, not our counsel on funding sources - for broad-brushed, proactive ideas, not prescriptive solutions.



• Congress asked us to address the impending needs of all seniors, regardless of income. We believe that the needs of poor elderly are indeed the most urgent, but we also believe that difficulties associated with the process of aging itself affects all seniors, regardless of their income strata. We heard the pleas of the "forgotten elderly" - incomes too high to qualify for low-income housing and Medicaid, but too low to afford private housing and health care.



• Additional resources are needed to meet the pressing needs of seniors, both today and in the future. We stop short, however, of setting production goals or advising the Congress on the commitment of Federal resources to specific programs. We believe, demographic facts in hand, evolving market demand, and weighing national priorities, that Congress must decide the appropriate allocation of resources.



• Seeing the trend of high homeownership rates among seniors, our Nation must be creative in assisting seniors in preserving this valued asset and using their equity wisely.

The Majority also struggled with the reliability of data available to us to develop our recommendations. Absent other resource data, we relied on data interpolated from the 1999 Annual Housing Survey. Such data is self-reported and must be used with caution. Further, no data can accurately predict unknowns - the economy, homeownership equity, technological advances or consumer preference. To predict with accuracy the economic and demographic profiles of the next generation of seniors is simply not possible.

Anticipating the diversity of needs and demands by 53 million individuals, the Majority sought approaches that would create options and maximize choices for seniors. Accordingly, we developed recommendations that create foundations and building blocks - with flexibility to change as the market changes, from today's survivors of the Great Depression to tomorrow's Baby Boomers. We sought to build upon what exists, and we do not propose major program restructuring or radical reform. We propose, insofar as is possible, solutions that support individual choice rather that government prescription. We propose flexibility and simplicity in regulations and avoid categorical programs with rigid guidelines. This challenge does not have a "one size fits all" solution.

Our Recommendations are far-reaching and they are economically sound. We challenge the Government Sponsored Enterprises and HUD to step out of their "silos" and be part of broad-based solutions, not just in urban areas, but in the rural parts of our country as well. This will require changes in Federal policy; it will not require Federal funds.

We challenge the institutional bias of Medicaid and propose its greater use in less costly alternative residential and community environments. We propose effective ways of linking existing housing and health care resources rather than creating new expensive, categorical programs. We call upon the Congress to preserve our existing senior communities - aging buildings as well as their aging residents need attention. All of these measures would conserve, rather than expend, resources.

Addressing the needs of seniors in the 21st Century will be a monumental task. It is a challenge addressed to all Americans - it cannot be borne by the Federal government alone. We appeal to the Federal government to lead, to serve as a catalyst for change, to make it easier for local governments and the private sector to serve. Through sound policy, governments at all levels can provide incentives and tools. Through flexible policy, we can get these tools in the hands of the people most capable of making a difference.

Our Commission is Federal in scope, but many of the measures we propose will need to be implemented in the Nation's diverse neighborhoods and communities. We encourage partnerships among and between proprietary and non-profit providers, faith-based organizations, community lenders, private investors, and all the many parts of our local, state and Federal government. We ask Congress to create a policy framework for an aging America, and to provide the opportunities and means for change.

It is with appreciation for the opportunity to contribute our services that we, the Majority of the Commission Members, submit this Report.

Respectfully Submitted,

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