Research

Contact Information:
Josie Ramirez
Post Office Box 650085
Miami, FL 33265
(305) 666-1264

How to be An Assisted Living Facility in a Public Housing World

INTRODUCTION
The Aging of America - The Demographics

The statistics are alarming. By the middle of this century there will be more persons who are elderly (65 or over) than young (14 or younger). The population of elderly persons tripled in the 20th century. According to the Census Bureau’s “middle series” projections, the elderly population will be more than double between now and the year 2050 to 80 million. The “oldest old” (those aged 85 and over) are the most rapidly growing elderly age group. The biggest blow will be felt between 2010 and 2030 when the “baby boom” generation reaches age 65.

Now compound this with the fact that minority populations will represent 25.4 percent of the elderly in 2030, most will live alone, and be concentrated in specific states: California, Florida, New York, Pennsylvania, Ohio, Illinois, Michigan, and New Jersey.

In 2002 the median income of older persons was $19,079 for males and $10,943 for females. For all older persons reporting income in 2002, 34 percent reported less than $10,000 a year. Only 25 percent reported incomes of $25,000 or more. It is estimated that in 2002, 3.2 million elders lived below the poverty line. Older women were at the lowest poverty level.

Public housing has the highest concentration of poor, frail elders in the nation. At least 27 percent of the elderly public housing residents have a physical or a mental impairment. Most elderly poor live within public housing and elder households occupy over 44 percent of the units in subsidized United States Department of Housing and Urban Development (USHUD) assisted multifamily housing.

In Florida alone, there are 80,000 elders in USHUD subsidized rental housing. The elderly are a vulnerable group, top heavy with the very old (over 80 years old), women, and minorities.

In 1999, Dr. Stephen Golant, of the University of Florida, released the CASERA Project report documenting the plight of elders living in public housing and called them “the largest numbers and concentrations of elder tenants.” He called attention to this ignored group of residents that are not able to pay the $1,800 per month fees of the private assisted living facilities (ALFs) and who must, instead, be institutionalized in nursing homes.

Nursing homes cost the taxpayers four times more what an ALF would cost. Over 35 percent of housing resident elders go into nursing homes because they are no longer able to live by themselves.

Dr. Golant makes a strong argument to provide the necessary, often few simple services for these elders to be able to remain in their homes. Housing administrators report not having the knowledge or funding to be able to provide these services. On the other hand, state governments are anxious to reduce their Medicaid funding to nursing homes.

Florida’s Medicaid budget will reach $3 billion within the next two years if the state is not able to divert more poor elders towards assisted living facilities. The reduced role of federal housing programs and the increasing demand on aging programs make it imperative to target older persons in need of assistance to live independently.

Dr. Golant alludes to USHUD’s changing philosophy from “one of only a roof to one of assisted housing.” Also, to quote a recent USHUD report, “housing and services can no longer be easily separated and, in fact, might be considered one and the same.”

Public housing administrators want their older tenants to age in place but they claim to not have the money, time, or know-how to translate their desires into action. Not to mention that the elderly want to keep as much independence and dignity as they can. Assisted living facilities can provide affordable and high quality facilities that meet the needs of public housing administrators as well as the elderly.

This manual will serve to show you how…