1 There s No Place Like Home Housing Boston s Older Adults: Meeting the Needs of a Shifting Demographic This house is for the... gathering of nature and human nature. It is a house of friendships, a haven in trouble... It is a house of freedom, guarding the dignity and worth of every person... This house is a cradle for our dreams. - Excerpted from This House by Kenneth L. Patton
2 "What Does it Take to Keep an Elder at Home?" is the central question for those of us whose lives are affected - on a professional or personal level - by our relationships with older or disabled adults. It is a question that all of us will face. Since aging does not discriminate, it is an equal opportunity fact of life that will eventually impact each one of us. Vision A comprehensive and accessible system of community support for Boston's Older Adults. Mission Promoting a system of quality services for older adults and their care partners that is designed to foster their dignity, independence and choice through improved access, collaboration and education. About the Partnership The Boston Partnership for Older Adults is a coalition of over 200 individuals and organizations from throughout Greater Boston. We are working to ensure that all older adults have the support and resources needed to age with dignity both now and in the future. Through improved education and access to information and services, as well as increased collaboration among Boston's aging service providers and funders, we are striving to build a system for older adults and their care partners that values independence, choice and support. The Boston Partnership for Older Adults is supported by the Robert Wood Johnson Foundation through its Community Partnerships for Older Adults (CPFOA) national initiative. CPFOA seeks to foster community partnerships that are improving long term care and supportive services systems to meet the current and future needs of older adults. Special Thanks The Boston Partnership for Older Adults organized and provided this Housing Summit with the financial support of The Boston Foundation and Boston Senior Home Care. We especially want to thank the writers of the papers which provided the background needed to have an efficient summit: Eileen O'Brien, Director, Elders Living at Home Len Raymond, Executive Director, H.O.M.E. Len Fishman, President and CEO, Hebrew Senior Life Stephen A. Gardner, President, The Centerpoint Foundation The BPOA greatly appreciates and wishes to thank the members of the Housing Summit Planning Committee. Finally, we also would like to thank: Ethel Arsenault and Lois Epps The BPOA Housing Committee Members The Housing Summit Facilitators The Housing Summit Attendees (please see the lists for all of these in the back of the report)
3 Introduction Consider the following: Today, nearly 80,000 older adults (aged 60 and over) call Boston home. Nearly 16,000 (20%) of older adults in Boston live in poverty and over 40,000 (50%) live alone. Currently 1,400 older adults in Boston are homeless. Waiting lists for subsidized housing are full. Only one application for HUD 202 funding to devel op affordable housing for older adults in Boston was submitted in July HUD did not approve it. Massachusetts and the Nation are focusing increasingly on helping older adults to remain in their homes and communities. Over the next 25 years, the number of older adults in the United States will double, representing the largest demographic shift in American history. How will we prepare for the housing and supportive services needs of Boston's older adults? Boston, the Commonwealth of Massachusetts and the United States face a housing crisis of the elderly that has yet to be fully highlighted by the mainstream media. While the development of one type of service-enriched housing is sweeping the nation in the form of assisted living facilities, many older adults, particularly those living on incomes far lower than the cost of these facilities, are left at risk. What is needed is an affordable, supportive housing model that recognizes the limited needs of "younger" older adults, but is poised to provide an increasing range of services as an older adult ages. This type of service, if it is to be within the financial reach of most older adults, will require increased coordination and collaboration between developers, funders, public housing authorities, and service providers. In short, Boston must create a continuum of safe, affordable service-enriched housing that will meet the needs of individual older adults in the short term and continue to meet the changing needs of the older adults as they age in place. As the aging Baby Boomers double the population of older adults over the next 25 years, the need to develop affordable housing with a continuum of supportive services for older adults is paramount. 2.
4 Summit Process Support for the Housing Summit came from the Boston Foundation and Boston Senior Home Care, a not-forprofit aging service access point (ASAP) coordinating inhome services to low income older adults in the city of Boston. With this support, the Boston Partnership for Older Adults (BPOA) has worked to build a strong bridge between the housing providers and the agencies serving older adults in Boston. The first phase of this effort involved a series of meetings to identify the current gaps in housing and services and to identify key barriers. As a result of these meetings, the BPOA developed a list of key stakeholders who would be essential to move forward the vision of a continuum of service-enriched housing for older adults in Boston. These 75 participants were invited to a full-day summit to build a vision for the future and to create action plans for implementation. Boston's Mayor, Thomas M. Menino welcomed and pledged his support to over 75 leaders in Boston's housing, finance, policy and older adult service worlds as they gathered together at the Boston Foundation to review the pre-summit materials and to work together to forge a joint vision and action plans. Summit participants spent the day in small groups, focusing on four target issue areas for older adults: Homelessness prevention and eradication Supportive services in existing subsidized housing Support for homeowners Development of new affordable units Under the guidance of trained facilitators, each group: Examined the materials from the pre-summit meetings Developed its own vision Identified the key barriers to accomplishing their vision and Created an action plan for next steps. This report presents: 1. A summary of the Vision Statements which: articulates fundamental principles and conditions which should exist in order to have a system which prevents and eradicates older adult homelessness offers a continuum of housing options, and facilitates the construction of new housing 2. A compilation of the actions and policy changes which must occur in order to: achieve a community wherein older adults do not have to face homelessness have access to affordable housing options and where developers can easily build new affordable housing. 3.
5 The following guiding principles emerged from each group: Homeless older adults must be treated with dignity and respect and have access to safe, affordable hous- ing with the medical and social services needed to live comfortably and independently. Older adults at risk of homelessness will receive the specialized medical and social supports which have demonstrated success in preventing homelessness. All older adults living in subsidized housing shall have access to a range of supportive services which have demonstrated success in improving health and quality of life and which help older adults to remain safe and independent in the community. Older adults are empowered to take the lead in mak- ing decisions about their housing and supportive services. All older adult homeowners will have access to a coordinated and integrated system of benefits and supports which will enable them to remain safely in their homes and communities for as long as possible. Access to suitable housing with the appropriate services is an entitlement of every older adult. 4.
6 Recommendations These guiding principles and conditions are the indicators of a housing system which: prevents and eradicates homelessness, supports older adult homeowners facilitates the development of new affordable housing and ensures that supportive services are available in existing housing for older adults. Research Anecdotally it is known that providing supportive services to an older adult enhances his/her ability to remain in the community and decreases his/her use of dollars for more long-term intensive care. Yet in order to ensure that supportive services are funded and on going, empirical data must be gathered to clearly demonstrate this well-known reality. The overarching goal of the Summit was to identify actionable steps. The working groups used the guiding principles and conditions listed above to articulate specific actions and policy changes that they felt would ensure that the housing system and the community are reoriented to meet the needs of all current and future older adults living in the city of Boston. The recommendations were summarized and categorized into the following five areas: Research Leadership Policy Housing Development Education Action Steps 1. Analyze the return on investment of current spending on housing with supportive services for older 1. adults. 2. Conduct a review of sources and use of new moneys for the development of housing with supportive services. 3. Convene a meeting of housing developers and older adult services professionals to create a blueprint for 3. the redeployment of resources to develop additional housing options for older adults. 5.
7 "Boston has the opportunity to set the standards for models of care and housing that are financially viable, community based, and hold preserving dignity in aging as a human right" - Mayor Thomas M. Menino: 6.
8 Leadership In order to address the needs of Boston's older adults, it will be necessary for Boston's public and private sector leaders to take a more active role in the current and long-term development of housing for older adults. For the last few years, Boston has experienced a rapidly growing housing market. An examination of this market reveals that much of the housing which is being built is high end and unaffordable for many of Boston's older adults. Additionally, Boston tends to build housing in response to neighborhood needs. City-wide leadership is necessary in order to develop a comprehensive housing plan that will address the needs of all older adults in the city, not just those in particular neighborhoods. Action Steps 1. Create a comprehensive Strategic Plan for the short and long-term housing of Boston's older adults, which is based on the input and participation of public and private sector leaders, and older adults in the city. 2. Establish a public and private sector leadership team which advocates for federal and state policies that promote housing as a right, and ensures that housing incorporates services that enhance the lives of older adults as they age. "BPOA has played an instrumental role in helping to organize the Coalition for Senior Housing, a new statewide alliance that will be advocating for low and moderate income housing and support services so seniors can remain in the community." - Aaron Gornstein, - Executive Director, CHAPA: 7.
9 Policy Older adults are a growing segment of the population. To meet the goal of a system which encourages older adults to remain in their communities, a thorough review of all policies and regulations affecting the development of new housing is required. Developers who attended the summit shared their frustration with the myriad of regulations and financing streams, which must be navigated in order to build affordable housing with supportive services for older adults. Additionally, older adults need access to information about housing options. Action Steps 1. Review current city and state regulations for financing elder housing development and identify areas of overlap and duplication in order to determine opportunities for streamlining the process. 2. Reallocate existing resources to support one-stop informational, neighborhood based centers for older adults to maximize self-determination and choice. "Boston is recognized nationally as a leader in the development of affordable housing. Building on that success, we must continue to develop housing models and community-based services that meet the needs of older adults." - Eliza Greenberg, - Commissioner - Commission on Affairs - of the Elderly 8.
10 Housing Development Boston's housing prices are the third highest in the nation and rents in Boston are the nation's second highest, making it difficult for many of today's older adults to live in the city without subsidy. Currently, Boston has limited affordable housing options. 1,400 older adults in Boston are homeless and the waiting lists for subsidized housing are full. The Baby Boomer generation which began turning 60 in January 2006 will increase the number of older adults by as much as 46%. These facts coupled with the reality that many Boomers have not adequately funded their retirement needs will significantly increase the number of older adults seeking housing subsidies starting in the year 2006 and continuing through at least Action Steps 1. Expand the current database of public and private housing supply for older adults in Boston, and ensure it is accessible through a single entry point. 2. Build new supportive housing, which includes subsidized units. With the number of older adults in Boston increasing by as much as 46% by the year 2030, development of subsidized, supportive housing is critical. - Anna Bissonnette, - Founder, The Committee - to End Elder Homelessness 3. Preserve, maintain and adapt existing subsidized housing to meet the needs of Boston's older adults. 9.
11 Education Public recognition and understanding of an issue is fundamental to making change. The issue of housing for older adults affects the overall quality of life for everyone in a community. Yet, without an understanding of the issue, the opportunities for the general public to contribute to the solutions will be limited. Throughout the discussion, it became evident that even among housing development and supportive service professionals, there was a desire and a need to become more informed about each other's fields. Through this increased knowledge, opportunities for collaboration, coordination, and creative problem solving are enhanced. 2. Educate Housing Development and Older Adult Services Professionals... Create trainings, seminars and/or conferences, which will bring together housing development and... older adult services professionals to share... information about their respective fields in order to... enhance opportunities for collaboration and... coordination. Action Steps 1. Educate the community... Increase awareness through informational cam-... paigns on the following topics:... Homelessness of the older adult: who is affected... and what are the socio-economic ramifications... for the community... Affordable supportive housing for older adults:... what is it and why should government and the... community promote its existence... Educate to address the "Not in my back yard!"... syndrome: why government and communities... should facilitate development that includes... housing for older adults 10.
12 Conclusion Boston should meet the housing and service needs of every older adult as they age in place. There was significant agreement across groups that Boston, as a city, has a responsibility and a desire to meet the housing and service needs of all of its older adults, regardless of income, age, sexual preference, lifestyle or medical condition. As the aging Baby Boomer generation swells the city's elder population, the issue of housing with services will become even more critical. The number of elders who can afford the stand-alone, assisted-living type of service-enriched elder housing is much smaller than those who must rely on a more community-based service/housing network, particularly in the city of Boston. The range of services needed by elders will change over time. Some elders are relatively independent, living in their own homes and needing limited services such as house cleaning. As individuals grow increasingly frail, more assistance with daily living skills is required. The housing/service network must be able to provide a menu of services that covers the continuum of needs from independent to very frail. Services would range from simple home maintenance tasks, through assistance with tasks such as food purchase, meal preparation, medication management, and personal care, and finally through end-of-life decision making. As one summit participant said, "there is little financial support for the time it takes to plan and coordinate". Representatives from these many service agencies echoed the frustration of this kind of "silo" approach to serving elders. Yet Boston has the ingredients for a more integrated network and the payoffs are numerous. Maximizing the quality and efficiency of existing housing stock, providing incentives and efficient approval and financing processes for the many developers interested in Boston, educating the public and professionals, and coordinating and integrating the variety of existing service programs working with elders will go a long way towards enabling Boston to rise to the opportunity presented by the aging population. At this time, these services are provided by a variety of discrete agencies that have minimal contact with one another and limited coordination. 11.
13 Acknowledgements We wish to thank all of our member organizations for their support in planning and delivering this summit, for developing this action plan, and, most importantly, for their commitment to making its vision a reality: BPOA Housing Committee Members Aaron Gornstein Al Davis Al Scott Anna Bissonnette Ashley C. McCumber Basak Demires Ben Haynes Bill McGonagle Brian Souza Carole Cornelison Clare Wohlgemuth Cynthia Canham Dann Friedman Eileen O'Brien Elizabeth Babcock Eliza Greenberg Elizabeth Doyle Ethel Arsenault Gerry Wyse Jim Greene Joe Chaisson Joe Green Joe McPherson Joyce Williams Katie Cahill Holloway Len Raymond Lois Roach Lydia Agro Marcie Freeman Maria DePina Maureen Flynn Maureen Piraino Meg Kiely Michael Flynn Nancy Sullivan Pam Jones Pat Canavan Philip Beaulieu Rachel Goodman Regina Dennis Robert Ormsby Robert Pulster Roberta Rosenberg Russ Tanner Ruy Costa Sandra Albright Sandra Henriquez Sheila Dillion Stephen Gardiner Sue Stockard Susan DiMatteo Facilitators Lydia Agro Communications Director, The Boston Housing Authority Susan DiMatteo Assistant Deputy Director of Homeowner Services, Department of Neighborhood Development Jeanne Dooley Facilitator Katie Cahill Holloway Senior Project Manager, Residential Development Unit, Department of Neighborhood Development Marian Knapp Consultant Lois Roach Project Manager/Facilitator, Boston Partnership for Older Adults Donna Soodalter-Toman Consultant, D.S. Toman & Associates Consulting Nancy Sullivan Boston Counselor, Homeowner Options for Massachusetts Elders Attended The Honorable Mayor Thomas M. Menino Paul Grogan, President The Boston Foundation Lisa Alberghini Executive Director, Planning Office for Urban Affairs Sandra Albright Executive Director, Kit Clark Senior Services David Aronstein President, Stonewall Properties Don Bianchi Senior Policy Advocate, Massachusetts Association of Community Development Corporations Anna Bissonnette Founder, Committee to End Elder Homelessness (HEARTH) 12.
14 Jack Boesen Executive Director, Massachusetts Senior Action Council Marcia Burley Executive Director, Howard Benevolent Society Al Calderelli Executive Director, East Boston Community Development Corporation Brent Carney Office of Senator Edward Kennedy Joe Chaisson AAA Advisory Council Elizabeth Clifford Home Care Program Coordinator, Executive Office of Elder Affairs Peter Clenott Interim Director, Housing Department, Action for Boston Community Development Carole Collins Director, Bureau of Housing Management, Department of Housing and Community Development Ellen Connolly Director, Multi-family Housing, Department of Housing and Urban Development Carole Cornelison Deputy Director, Homeowner Services, Department of Neighborhood Development Al Davis Director, Boston Housing Authority Elderly Housing Division Brad Day Supportive Housing Program Manager, Community Economic Development Assistance Corporation Regina Dennis Assistant Director, Elderly Housing, Manny Dikibo Director of Operations, City of Boston Assessing Department Elizabeth Doyle Assistant Director, Housing Development, Department of Neighborhood Development Paul Ferreira Managing Director, Baran Companies Ellen Feingold President, Jewish Community Housing for the Elderly Len Fishman President and CEO, Hebrew SeniorLife Stephen Gardiner President, CenterPoint Foundation Linda George Executive Director, Boston Senior Home Care Wynn Gerhard Managing Attorney, Greater Boston Legal Services Aaron Gornstein Executive Director, Citizen's Housing and Planning Association Eliza Greenberg Commissioner, Commission on Affairs of the Elderly Jim Greene Director, City of Boston, Emergency Shelter Commission Joanne Handy President and CEO, Boston Visiting Nurse Association Sandra Henriquez Administrator/CEO, Boston Housing Authority Dion Irish Deputy Commissioner, Inspectional Services Department Julia Kehoe Director, Metropolitan Boston Housing Partnership Dorothy Kelly Gay Director of Supportive Housing, Center Communities of Brookline Meg Kiely Development Officer, Planning Office for Urban Affairs Joanne Lee Deputy Commissioner, Commission on Affairs of the Elderly Bill McGonagle Deputy Administrator, Boston Housing Authority Emily Meyer Executive Director, MA Assisted Living Facilities Assn. Dale Mitchell Executive Director, ETHOS Ellen Nolan Gard Chief Operating Officer, Committee to End Elder Homelessness (HEARTH) Eileen O'Brien Director, Elders Living at Home Program Adele Pollis Principal, AP Associates Bob Pulster Executive Director, ESAC Len Raymond Executive Director, Homeowner Options for Massachusetts Elders Esther Schlorholtz Vice President and CEO, Boston Private Bank and Trust James Seagle President, Rogerson Communities Candace Sealey Office of Congressman Michael Capuano Marc Slotnick Associate Director, Department of Housing and Community Development Russ Tanner Real Estate Consultant, Rising Tide Development Eleanor White President, Housing Partners Joyce Williams Associate Director, Central Boston Elder Services 13.
15 Board Officers and Staff Ann Hartstein President Clare Wohlgemuth Vice President Ralph Browne Treasurer Geraldine Wyse Secretary Emily Shea Executive Director Maureen Flynn Manager, Public Relations and Education Cheryl Cumings Project Manager Lois Roach Project Manager and Facilitator 99 Chauncy Street, Suite 602 Boston, MA Phone: Fax:
16 99 Chauncy Street, Suite 602 Boston, MA Phone: Fax:
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Dear member of the Illinois Congressional Delegation, As members of the Illinois Business Immigration Coalition (IBIC) Steering Committee and leaders of the Illinois business, civic and education communities,
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