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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