Policy makers should find ways to support housing-based services models in addition to supporting more affordable housing.
The fact that this country is experiencing an affordable housing crisis isn’t “news” to anyone.
In 2015, there were 4.7 million older adult renter households earning less than 50% of the area median income. According to the U.S. Department of Housing and Urban Development (HUD), 40% of these households paid more than half their incomes for rent and/or lived in severely dilapidated housing. These 4.7 million households are known as having “worst-case housing needs.” Only 1 in 3 of them receives any type of rental assistance.
While we’re seeing two-thirds of potentially eligible older adults living without any rental assistance, we also find ourselves in danger of losing existing affordable units as publicly-subsidized properties reach the end of their affordability restriction periods. According to the National Housing Preservation Database, more than 1 in 20 publicly supported rental homes faces an expiring affordability restriction in the next 5 years. In the next 10 years, that number more than doubles.
Keeping every affordable option is crucial for those thousands of older adults who wait for a more reasonable option. A 2006 survey by AARP found that there were 10 people on the waiting list for every unit that became available in Section 202 communities, a HUD program designated for older adults. While this data is old, anecdotal evidence implies the trend hasn’t changed. For example, LeadingAge members report extended waits to move into their communities:
- A 168-unit community in Jacksonville Beach, FL, has a waiting list of about 320 people and a 5-year wait.
- A community in Philadelphia, PA, has 100 units and about 150 people on the waitlist. The wait is about 3 to 4 years.
- A 154-unit community in Santa Clara, CA, has approximately 350 people on the waiting lists. The wait time is 3 to 5 years.
- A community in Toledo, OH, with 71 units has 169 applicants on the waiting list and a wait of 2-3 years.
SUPPORTING AFFORDABLE HOUSING LOCALLY
While the affordable housing crisis isn’t news, it seems that public actions to address it have been slow in coming. But some states and localities are moving.
Minneapolis, MN, and Seattle, WA, for example, recently passed zoning changes intended to better support the development of affordable housing. The City of Atlanta just announced $60 million in new funding that is intended to create and preserve 2,000 affordable housing units.
LeadingAge member Selfhelp Community Services and its partners are working with the Neighborhood Pillars Program, launched last year by New York City to preserve affordability in existing housing communities across the city. A $15.1 million loan will help preserve affordability in 3 apartment buildings with 72 apartments in Queens, NY.
In addition to helping protect these low-cost units from being lost to speculators seeking to convert the buildings to high-end apartments, Selfhelp will be able to also offer older adult residents housing-based services like the ones it provides through the Selfhelp Active Services for Aging Model (SHASAM).
SHASAM supports the ability of residents to maintain their health and age in their community by helping those residents connect with needed resources. The program appears to be working. A recent evaluation found that residents living in affordable housing communities offering SHASAM experienced 33% fewer hospitalizations than a comparison group not receiving the supports.
The significance of these investments in affordable housing opportunities can’t be ignored. But much more is needed. As mentioned above, there are millions of older Americans with very low incomes paying an excessive amount for their rent, often forcing tradeoffs with other important necessities like medicine and food.
SUPPORTING AFFORDABLE HOUSING AND SERVICES NATIONALLY
In FY17 and FY18, HUD’s Section 202 program received a combined $110 million for new construction, the first new construction resources since FY11.
That’s a small step in the right direction. But we need a giant leap. That’s why on May 8, LeadingAge hosted a Senior Housing NOW rally at the U.S. Capitol to raise the voices of older adults and demand adequate investment in safe and decent housing.
We certainly need investments in the bricks-and-mortar housing infrastructure. But we also need investments in housing-based supportive services that affordable housing communities can use to help vulnerable older adults manage their health and social needs, and stay out of the hospital, while minimizing costs to the Medicare program.
The Selfhelp evaluation clearly showed how effective housing-based services can be. But we still need sustainable mechanisms for financing these onsite supportive services in every community across the country.
A recent study by the LeadingAge LTSS Center @UMass Boston addressed this financing gap by exploring opportunities to leverage the investment already made by HUD in onsite service coordination. We identified several strategies for scaling valuable housing plus services programs so they could eventually be available to older adults across the country.
The LTSS Center continues working hard to raise awareness about the important role that affordable senior housing communities can play in Medicare payment and delivery system reforms. We believe that older adults, and the country as a whole, would be well served if policy makers devoted their energies to identifying ways to support housing-based services models in addition to supporting more affordable housing.
In my view, focusing on affordable housing and housing-based services offers us a solid path to provide affordable shelter to vulnerable elders, improve their health care, support their ability to age in community, and create savings for the Medicare program.
Alisha Sanders is director of housing and services policy research in the Washington, DC office of the LeadingAge LTSS Center @UMass Boston. Her work focuses on identifying, evaluating, and advancing strategies and policies that link affordable housing settings with health and supportive services.