Presentation to
The Commission on Affordable Housing and Health Facility
Needs for Seniors in the 21st Century

January 14th, 2002
Miami, FL

by
Keith Campbell
Board Chairman, AARP

MR. KEITH CAMPBELL: Good morning.

(Applause.)

MR. KEITH CAMPBELL: Chairwoman Feingold and Hooks, members of this Commission and thank you for the invitation to describe AARP's views regarding the broad range of issues before this Commission.

But first, I hope you'll allow me to recognize Jane Baumgarten as a member of this Commission, who has been kept very busy these last few months with her work as an invaluable member of the Board of Directors of AARP, but also as a hardworking member of this Commission.

We at AARP do recognize and appreciate how meaningful and fundamental are the questions that Congress has asked this Commission to address. Access to affordable housing and health care are critical concerns for all Americans, but especially significant for the elderly.

It is because of this awareness that AARP strongly supported the legislation that created this Commission.

In fact, over the last three years, six different Board members have testified more than once on some aspects of affordable housing before Congress or one of the regulatory commissions, recommended Jane to the Congress for service on this Commission and provided for your consideration a wide range of AARP-conducted or sponsored research relevant to the Commission's mandate.

In this latter regard, I'm happy to make available to the Commission the results of two brand new studies released by the Public Policy Institute of AARP just today.

One is a report on a case study of seventeen sponsors of subsidized housing for older persons located in nine different states and shows how assisted living services can be successfully integrated into subsidized housing projects for older persons.

The second report summarizes the response of an AARP survey of nearly 1,600 low income housing tax credit property owners.

The report shows that the program has been successful in producing a substantial number of new rental units for low income persons and that approximately one-quarter of the projects financed were intended solely for the elderly.

Despite this success, the report indicates that the production of housing units under the program has not been able to fulfill the growing shortfall in low income rental housing, and as currently authorized, the program cannot reach the extremely low income renters without additional subsidies.

The report also notes that the program does not require provision of supportive services and therefore, projects very widely in whether and how they have chosen to meet the service needs of the residents.

It goes without saying that housing is a critical factor in determining our quality of life. During the 1990s, Americans, on average, improved the quality of their housing. But despite the progress of the `90s, many low income and moderate income older Americans continued to experience housing problems, very serious housing problems, and their numbers are growing.

At the top of the list of the problems are substandard conditions; a lack of affordability; and housing that simply just is not appropriate for the changing needs of older people.

The bottom line is: In America today, there is a deficit of affordable and appropriate housing for growing numbers of our older citizens.

The housing and health care services shortfall today will turn into the housing and health care crisis of tomorrow. Our policymakers, if they fail to anticipate and act on this arrival of the Baby Boomers who are of modest means, this will be a tremendous crisis.

The Association's views regarding housing policy reflect the public commitment made over half a century ago by the Housing Act of 1949, and I quote, that sets the goals of:

"a decent home and a suitable environment for every family in America."

We are woefully short of that goal, ladies and gentlemen.

AARP's policy recommendations are framed by our concern for number one: The affordability, accessibility and appropriateness of housing for older persons.

Number two: How the supply and demand for elderly housing and supportive services affect and are affected by the lifespan needs of renters and homeowners, as well as the design and maintenance of their homes.

And number three: The impact that existing and projected housing stocks and available supportive services have on the quality of life for our older and frail citizens.

First, a clarification. In the AARP's view, housing affordability and availability focus on two different, but clearly related, aspects of the housing question.

We view housing affordability as referring to the financial ability to gain access to housing, as well as the financial ability to remain a resident of that housing, whether in a rental or owned.

We see housing availability, on the other hand, as referring not only to occupancy rates, but also how appropriate the housing is to the needs of older people.

As you are now well aware, AARP research consistently documents that Americans pass through mid-life, regardless of whether they own or rent their housing, they by and large, prefer to remain in their own homes.

But the adaptability of housing in the process of aging in place presents difficult challenges for the housing facilities that have not often been designed with these life changes in mind.

AARP further believes that preserving affordable housing for low and moderate income elder persons must mean than more maintaining, rehabilitating and modernizing existing subsidized housing, although I must emphasize that it remains a critical aspect for these needs to be addressed.

What we need in addition is an increase in the rate of production of appropriate housing and a national commitment to treat an older person's residence, whether rented or owned, as a legitimate venue for the delivery of supported services.

This is critical because many of our older persons, particularly those who live alone, eventually will need some assistance to remain independent in their homes.

The recent credit cap increase in low income housing tax credit program is important, but not sufficient. And as a programmatic requirement, it does not address the need for supportive services.

If we fail to meet these challenges, the likely result will be a crisis in both affordability and availability in housing, creating the possibility that we see America with a significant increase in under-housed or under-served older American citizens.

And as a result of this, it could be a substantial increase in costly and premature admissions of older people to institutions.

Already, what we are calling our "old-old" population -- those aged 85 and older -- represent the fastest growing segment among the older persons in this country.

This group is disproportionately failed and among the most vulnerable to excessive housing cost burdens. To be more specific, there were about 4 million Americans aged 85 and older in 1998. That number is projected to increase by more than 60 percent to approximately 6.5 million in 2020.

Clearly, the powerful demographic forces at work by 2020, less than two decades from now, the number of persons aged 65 and older will be up by a projected 55 percent to over 53 million. Must of this growth will be driven by large increases in numbers of persons 75 years older. I hope to be one of those.

It is especially relevant to the work of this Commission as we now know it that as elderly populations increase, the proportion who have difficulty performing two or more basic activities of daily living, i.e., bathing, dressing or eating, will also increase.

Today, the availability and access to supportive services varies widely. An important factor is the residential distribution patterns of older Americans. According to AARP's analysis of the 1999 American Housing Survey data, 72 percent of today's elder Americans live outside central cities. They are dispersed across suburbs, small towns, and rural areas.

Such dispersion presents formidable challenges to the efficient delivery of supportive services such as transportation, in-home health care, home-delivered meals and other necessary services.

We believe that the findings from the AARP-sponsored study of the Section 202 supportive housing program, which has already been distributed to the members of this Commission, illustrate the housing problems faced widely today by low and moderate income elderly.

The study illustrates the issues, challenges and most importantly, the rapidly expanding need for supportive services. It demonstrates clearly the importance of considering housing as an effective point of delivery service.

It is important for the Commission to develop and validate estimates of what the needs of older Americans will be for affordable and appropriate forms of housing and supportive services.

It is important, too, that the Commission identify more comprehensive, yet flexible, approaches for dealing with housing and supportive services issues than exist today, and that is provide an expanded list of options for addressing the physical and mental needs of older people.

We need to create a policy environment that encourages the private sector to develop a wider range of housing options, as well as additional programmatic strategies for making home-based supportive services a viable option for meeting those needs.

We should explore additional tax incentives and other innovative financing tools, such as the low income housing tax credit program and reverse mortgages, to make these housing supportive services feasible.

We should review existing legal and regulatory structures to see if there are unnecessary barriers and business and financing practices that limit the availability and affordability of different forms of housing as in the case, for example, with manufactured housing.

We need to evaluate and where appropriate use emerging technologies to enhance innovative approaches to housing construction and service delivery, as well to improve the effectiveness of existing approaches.

Where new housing stock is being produced, we believe that the concept of "universal design" should be incorporated, which will permit that housing to better meet the different lifespan needs of residents and help older persons remain independent.

We should explore every opportunity to develop public-private partnerships in the effort to meet the housing needs of our elderly citizens.

We must also recognize the important role home ownership plays in meeting the housing needs of older persons. Particularly in the moderate income elderly, we must do everything possible to promote, preserve and protect it.

Among the many positive effects of expanding home ownership has been the opportunity to better target the limited existing stocks of subsidized housing units to those with the greatest need.

We believe that the home modification and repair programs that enable older persons to live independently in their homes longer and more safely should be supported.

In the overall picture, protecting the equity that older homeowners have in their homes against such exploitive practices as predatory lending preserves a valuable financial asset that can be used in a number of ways to maintain the independence of older persons and improve the quality of their lives.

We believe that the efforts to enact stronger statutory protections against these harmful vending practices, like those efforts being made by AARP and other concerned organizations in the states such as Florida, as well as efforts at the federal level, should be supported by the Commission in its final report.

We commend the Commission for carefully examining the affordable housing and supportive service needs of older Americans, not only now, but in the future.

Congress will benefit from this analysis, as well as the options you recommend. But there will be other beneficiaries for your work as well.

For example, today, AARP is engaged in a new initiative that focuses on helping midlife and older Americans address an important set of life choices: the continuum of choices that range from independent living to long term care to end-of-life issues.

Housing and health care will be an important aspect to this initiative. The Commission's report on needs and supplies of affordable housing, assisted living and health care facilities for older persons, and your consideration of inter-governmental and public and private sector partnerships and financing options will help inform our own efforts in this area.

And I'd like to -- before I close -- like to give you a personal vignette.

The last two months, my wife and I have been in Iowa with her 86-year-old mother, who had a major health crisis and was in the hospital for almost a month.

This lady lives in a typical midwestern older house: two stories and a basement. We have finally got everything consolidated to one floor, but we have spent the last two months getting her back on her feet with a walker, oxygen machine and things like that and finding the resources locally to help her remain in her home.

I'll confess that my background in health care and having helped my father do some of this several years ago helped us find the resources that allows a certified medical assistant to come in seven hours a day, the visiting nurse takes care of the medications, the homemaker services to come in and do the necessary housekeeping duties that are entailed once a week.

But over this two months, my mother-in-law decided that there was a new assisted living facility being built seventeen miles away, and inasmuch as one daughter is in Alaska, one is Arizona and one in Texas and one at home, that she would no longer be a burden and a worry to these girls.

So she decided she would go into this assisted living which won't be ready until May or June. But she had three worries, number one, being a burden to the children. Number two, would she run out of money? But number three was could she have her dog? And when they said yes, that was the tipping factor that said that she would make these other two decisions.

But I just want to tell you that this is so timely for me personally to have been through this with the family that is -- every word I spoke here has great, great meaning.

And with that, I would certainly like to thank you for inviting AARP to gives its views and you certainly know that you will be privy to all of our research that we do and we will look forward to seeing your final report in June.

Thank you very much.