BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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                                    THIRD READING


          Bill No:  SJR 11
          Author:   DeSaulnier (D)
          Amended:  As introduced
          Vote:     21

           
           SUBJECT  :    Housing with services

           SOURCE  :     Leading Age California


           DIGEST  :    This resolution urges the President and Congress of  
          the United States to support housing with services models to  
          achieve federal goals of using subsidized housing as a platform  
          for service and encourages the President and Congress of the  
          U.S. to expand Sections 1115 and 1915(c) federal Medicare  
          waivers to test and integrate services into affordable housing  
          settings.

           ANALYSIS  :    This resolution makes the following legislative  
          findings:

          1. "Housing with services" is unlicensed, subsidized, congregate  
             properties for low-income seniors that provide access to a  
             range of health-related and supportive services available to  
             residents on a voluntary basis.  Services are provided by  
             appropriately credentialed providers and can enable residents  
             to age in place, reduce hospital and emergency room usage,  
             and postpone the need for costly institutional care.

          2. According to the Department of Aging, the population over 60  
             years of age is expected to grow more than twice as fast as  
             the total population.  Older adults will have an overall  
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             increase of 112% during the period from 1990 to 2020.   
             California's oldest old-age group, those over 85 years of  
             age, will increase at an even faster rate than older adults,  
             having an overall increase of 143% during the period from  
             1990 to 2020. 


          3. 10% of Californians over 65 years of age live in poverty, and  
             21% live below 150% of the poverty line, according to the  
             American Community Survey.  The Section 202 Supportive  
             Housing for the Elderly program is the only United States  
             Department of Housing and Urban Development (HUD) program  
             that currently provides housing exclusively for elderly  
             households, with approximately 263,000 units.  In 2006, HUD  
             reported that 38% of all Section 202 properties reported  
             having a service coordinator on staff.

          4. The nexus between affordable senior housing and long-term  
             services and supports is natural.  The cost of  
             institutionalization exceeds the cost of housing with  
             services models.  In 2004, the cost of a stay in a nursing  
             home funded by Medi-Cal was approximately $49,000 on average,  
             while the cost of Section 202 housing plus the most  
             frequently provided services, such as food, transportation,  
             and housekeeping, is estimated to cost only $13,000.  If a  
             fuller set of personal services is provided for very frail  
             elders, the cost of housing plus services is estimated at  
             approximately $25,000, about one-half of the cost of skilled  
             nursing care.

          5. Many state programs have sought to rebalance spending of  
             health care dollars toward home and community-based services  
             (HCBS) and away from institutional settings, such as nursing  
             homes.  California is one of seven states that invested more  
             Medicaid long-term care funding for HCBS than for long-term  
             institutional care based on data from the 2008 and 2009.   
             Subsidized housing communities can support additional  
             rebalancing efforts by offering economies of scale that can  
             increase service delivery efficiencies.  These efficiencies  
             can result in a more regular support presence and more  
             affordable care.

          This resolution:


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          1. Applauds methods that promote greater collaboration between  
             affordable housing providers and HCBS that divert seniors  
             from institutionalization and encourage aging in place.  

          2. Urges the President and Congress of the U.S. to support  
             housing with services models to achieve federal goals of  
             using subsidized housing as a platform for service delivery.




          3. Encourages the President and Congress of the U.S. to expand  
             Sections 1115 and 1915(c) federal Medicare waivers to test  
             and integrate services into affordable housing settings.

           FISCAL EFFECT  :    Fiscal Com.:  No

           SUPPORT :   (Verified  5/7/13)

          Leading Age California (source)



          JA:k  5/7/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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