The need for senior housing grows as baby boomers age

 

Affordable Housing, Finance - September, 2002 | Donna Kimura

The graying of America is placing new pressure on public housing authorities (PHAs) to meet the needs of seniors. PHAs across the nation provide approximately 700,000 elderly residents, 62 years and older, with affordable rental housing. In just a one-year period, from 1997 to 1998, the elderly in public housing increased by an estimated 30,000, nearly a 6% jump. It's a sign of what lies ahead.

The older population in America will increase dramatically as baby boomers hit retirement age. By 2030, one out of every five Americans will be a senior. That's about 70 million elderly persons, more than twice what it was in 2000.

Barely half of the public housing's senior-headed households live in buildings designed for their use, said Nancy Bednar, project director at the nonprofit Housing Research Foundation. About 47% of the elderly households are scattered throughout conventional family developments, according to the foundation's recent report "Public Housing for Seniors: Past, Present and Future."

The study reports that about two-thirds of elderly public housing residents live in buildings constructed at least 30 years ago. As a result, the existing backlog of modernization costs is estimated by the Department of Housing and Urban Development (HUD) at a whopping $4.8 billion, or $11,603 per unit. In addition, it estimates an accrual of modernization costs in public housing for seniors of $1,076 per unit each year.

The estimates regarding accrued modernization needs are largely regarded as inadequate and underestimate the actual costs involved in modernizing public housing for seniors. HUD's estimates do not take into account the obsolescence of the housing as well as the need to bring seniors housing, such as Sec. 202 units, said the study. As a result, the actual costs of accrued modernization needs may approach $2,000 per unit each year.

The need goes beyond accommodating a growing number of elderly citizens.

Seniors in public housing are more likely than other seniors to be disabled or frail, according to the foundation. They may need prepared meals as well as assistance with bathing, medication and other tasks of daily living.

"I see all public housing authorities, in five to 10 years, having at least a component of assisted living within their public housing facilities," said Conchy Bretos, chief executive officer of Mia Senior Living Solutions. Her firm is currently working with 30 housing authorities across the nation in creating assisted-living facilities (ALFs).

ALFs, which provide residents with a combination of housing and personalized support services, allow residents to age in place. In many cases, the resident is not ready to move from a house or apartment into a nursing home, which often costs four times as much as an ALF.

The Miami-Dade Housing Authority (MDHA), one of the nation's leaders in providing public housing for seniors, has two ALFs with 200 units under development. They are coming on the heels of the agency's groundbreaking 104-unit Helen Sawyer Plaza project, a public housing development that lined low-income housing subsidies with Medicaid waiver funding.

The state's large concentration of retirees makes senior housing a critical need. Florida has the highest percentage, 17.6% of residents 65 years and older, of all the states, according to Census 2000 data. "We're ahead of the curve," said MDHA Deputy Director Al Brewster, referring to a surge in the elderly population that will hit the rest of the nation in the next 20 years.

With the elderly population already cresting in Florida, the Miami-Dade agency will be looked at for leadership in the creation of ALFs.

The nation's sixth largest public housing authority, MDHA is building a 100-unit assisted-living facility that will include an Alzheimer's unit and an extended congregate care program. Ward Towers will be the agency's first newly constructed ALF.

The agency has pooled several funding sources to build the $15 million project, including about $4 million in HOPE VI funds, $8 million in tax-exempt bond revenues, $3 million in low-income housing tax credits and local resources.

The project is in the early construction stages and is scheduled to be completed in 2003, according to Rudy Perez, director of public housing operations.

At the same time, MDHA is planning the 100-unit Smathers Plaza assisted living facility at an existing seniors housing project in Miami's Little Havana district. The project is estimated to cost $10 million to $12 million. Florida Housing Finance Corp. is providing a $3 million loan, said MDHA officials.

Both projects follow the success of Helen Sawyer Plaza. The project is considered one of MDHA's greatest achievements.

Originally built to house the frail elderly and disabled, the development opened in 1976 under the name Highland Park. In case after case, MDHA leaders began seeing residents grow more frail, Brewster said. The project had to evolve to meet their changing needs. After a conversation and remodel, the project became an ALF in 1998 and was officially inaugurated in 2000.

Three funding streams – HUD subsides, optional state supplementary funds and Medicaid waivers – are combined to support the 104-unit facility, according to housing agency leaders.

The housing authority and Mia Senior Living Solutions, which implemented the conversion and continues to manage Helen Sawyer Plaza, lobbied for a bill to create a project-based Medicaid waiver demonstration project, Bretos said.

A pilot project was then created in 1999 by Florida lawmakers with the original funding covering personal care and management costs for Helen Sawyer residents. A subsequent bill in 2000 provided "priority funding" for all Florida housing authorities to receive Medicaid waiver funding. Six housing authorities in the state are operating ALFs or in the process of building one, Bretos said.

Medicaid waivers reimburse local housing agencies for services provided to elderly residents. The waiver reimbursements vary by state. In Florida, the waiver reimbursements provide $28 a day per resident and $100 per resident per month for case management. Currently, 36 states have Medicaid waiver programs that cover assisted-living facilities, Bretos said. A leading authority in the field, she serves as Florida's secretary for aging and adult services.

A typical Helen Sawyer resident is a woman in her 80s who stays an average of 35 months. About 60 of the current residents are former nursing home residents or were about to be institutionalized.

The Housing Research Foundation's report, "Public Housing for Seniors: Past, Present and Future," can be found at www.housingreserach.org.

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