BILL ANALYSIS Ó
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Date of Hearing: August 6, 2013
ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
Mariko Yamada, Chair
SJR 11 (DeSaulnier) - As Amended: August 5, 2013
SENATE VOTE : 34-0
SUBJECT : Housing with services.
SUMMARY : Memorializes Congress and the President of the United
States to support and encourage housing with services models
which incorporate federally subsidized housing programs into a
range of supportive services that enable residents to remain
occupants even though their physical state has deteriorated, and
they are no longer fully independent. Specifically, this
resolution makes the following findings and declarations :
1)That "housing with services" as subsidized residential
properties occupied by low-income seniors that provide access
to a range of long-term supports and services offered by
appropriately credentialed providers.
2)That the state's demographic shift indicates exponential
growth of the 65+ population which is currently roughly
one-in-ten, to roughly one-in-five by 2035.
3)That the incidence of poverty and near poverty amongst
Californians over the age of 65 is significant, and how age
and poverty are correlated.
4)That the United States Department of Housing and Urban
Development's (HUD) Section 202 projects, and the projects
managed through California-based hubs, are poised for housing
with services models.
5)That there is cost benefits of extending supportive services
to HUD 202 programs over the costs of placements in
institutional settings.
6)That HUD is cultivating a growing commitment to develop
housing with services in order to maximize individual
residents' capacity to remain free of institutional settings.
7)That California has made a commitment to maximizing the least
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restrictive, most integrated housing settings as articulated
through the State's Olmstead Plan and the Money Follows the
Person Program.
8)Expresses praise for methods that promote greater
collaboration between subsidized housing and home and
community-based services.
9)Urges the President and Congress to support housing with
services models, innovations, and funding.
10)Urges the President and Congress to direct the Centers of
Medicare and Medicaid Services to expand Section 1115 and
1915(c) waivers to test and integrate supportive services into
affordable housing settings.
EXISTING LAW :
1)The federal HUD Section 202 Supportive Housing for the Elderly
Program provides direct loans or capital advances from the
federal government to enable private, not-for-profit sponsors
to produce secure, barrier-free, and supportive housing
facilities for older persons.
2)The California Department of Housing and Community Development
(HCD), within the Business, Transportation and Housing Agency,
develops housing policy and building codes, regulates
manufactured homes and mobile home parks, and administers
housing finance, economic development and community
development programs.
3)The California Housing Finance Agency (CalHFA), within HCD,
makes low-rate loans through the sale of taxable and tax
exempt bonds. CalHFA provides assistance in below-market
interest rate mortgages and down payment assistance for
first-time homebuyers, insurance for single-family home
purchase mortgages, and loans for the development of
multifamily rental housing.
Two principal policy statements on supporting the needs of aging
people are the California Olmstead Plan, and the State Plan on
Aging.
1)The California Olmstead Plan was issued in 2003. The plan
articulates principles of an ongoing effort to promote
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opportunities for adults with disabilities to live
independently. The plan promotes self-determination, choice,
and community integration. The plan expresses a goal to expand
the availability of housing options for persons with
disabilities, and ensure the availability of housing options
that are augmented by services and supports, and can
facilitate the full inclusion of the resident into the
community.
2)The State Plan on Aging is published every five years.
Federal law requires state units on aging to submit a state
plan. When approved, federal funds become available. The
current state plan, "California State Plan on Aging,
2009-2013" addresses key socio-demographic factors that shape
needs, priorities, and promising practices identified by the
California Department of Aging (CDA) and the 33 area agencies
on aging (AAAs). The plan describes the CDA's work with AAAs
to provide cost-effective, quality services to adults with
disabilities, and their caregivers.
FISCAL EFFECT : None
COMMENTS :
AUTHORS STATEMENT : "The number of persons at risk for
institutionalization in nursing homes is expected to grow
dramatically in the next two decades as our population ages.
Facilitating aging-in-place keeps seniors in their home
environment and is less costly to taxpayers. Housing with
Services models connect long-term supports and services to
affordable housing for seniors, offering an additional
aging-in-place option. Housing with Services models can include
service coordination, wellness and health education, health
monitoring provided by a nurse educator, co-location of health
services, or a community based adult service center. This
resolution encourages the federal government to support Housing
with Services generally and to expand Medicare waivers to
facilitate the integration of services into affordable housing
for seniors and persons with disabilities."
SUPPORT : According to Leading Age, HUD rental subsidies have
resulted in the development of over 6,000 Section 202 facilities
housing approximately 263,000 households of older persons.
Waiting lists for Section 202 facilities are long, applicants
frequently must wait over 2 years. Persons are eligible to
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apply for assistance if their incomes are very low, (which is
generally equal to 50 percent of the area median family income,
adjusted for household size). Residents are predominantly
elderly women, living alone, with incomes between $5,000 and
$15,000.
According to Leading Age, HUD reports that housing made
available under the Section 202 program is considered of good
quality, and performs better during on-site inspections than
other housing programs. Resident satisfaction surveys suggest
that residents are more satisfied with their home than
participants in other programs. In 2006, the median age of
Section 202 residents was 74 years, and 31 percent were age 80
or older. Residents of Section 202 projects in 2006 had a
median tenure of 4 years; 18 percent of all households had lived
in the project for more than ten years.
According to information provided by Leading Age, A critical
aspect of Section 202 housing is that it can accommodate
residents with supportive services as their independence begins
to deteriorate. Furthermore, a majority of Section 202 projects
have the capacity to provide an array of communal services for
their residents. Community space for social and/or recreational
purposes is available in over 90 percent of the projects.
Currently, space for congregate dining and supportive service
providers is used in about half of projects. Examples of formal
services are meals (funded through Administration on Aging, and
other state and local funds), housekeeping (funded through
Medicaid waivers, and other local funds), assistance with
medications (funded through Medicaid waivers and other, local
funds), and bathing (funded through Medicaid waivers, and other
local funds). HUD administers programs through two hubs in
California; San Francisco, and Los Angeles.
A service coordinator is a person trained to work with residents
and their families when supportive services are needed.
According to HUD, in 2006, 38 percent of all Section 202
properties reported having a service coordinator on staff, and
that older facilities tend to be larger than newer projects,
which permit greater economies of scale in staffing than in the
newer, smaller facilities.
REGISTERED SUPPORT / OPPOSITION :
Support
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Leading Age California
Opposition
None on file.
Analysis Prepared by : Robert MacLaughlin / AGING & L.T.C. /
(916) 319-3990