it happens. we're most grateful for the administration's support, too. peggy, you have done a good job. you realize constructively where we need to go. sylvia burwell today confirmed the administration's support for this. we're reaching out to the senate. dr. collins has been a super star not only in this room but traveling to different parts of the country as well. of course, michael, your work, again, we stole a lot from you over the last couple years. just outstanding work that you have done and committed in the foundation and the organization that you have has truly helped us. great entrepreneurs, last two -- two weeks ago in colorado but now we're very grateful for that assistance. we are going to turn the green light on in this green room.

thank you. [ applause ] secretary of state john kerry will chair a debate of the u.n. security council on the situation in iraq this afternoon. c-span will have life coverage from u.n. headquarters. it begins this afternoon at 2:00 eastern.

four years ago, 114,000 iowans were out of work, unemployment was the highest under 25 years. our state's budget was $900 million in debt. then terry branstad came back and so did iowa. today we have a budget surplus, 140,000 new jobs, unemployment reduced nearly 30%. governor branstad is just getting started. terry's back. iowa's back. terry branstad is building iowa's future. >> he is honest, compassionate. he is a visionary. he is always looking forward, where we can go next to grow the economy. we're seeing that. the jobs are there. our unemployment is low. seventh lowest in the nation. we are seeing young people moving back. more iowans working today than any other time in our history.

i'm optimistic about the future. he has a passion for this state. it's really fun working with him. i'm blessed. >> after 20 years, iowans are tired of governor branstad, scandals, bad deals and political favors. $110 million bad teal. given to a billionaire. isu economists call it the du dumbest decision made in iowa. branstad tried to abolish preschool money. aren't you tired of terry? it's time for a fresh start. jack hatch for governor. >> there are two men running for iowa governor. terry branstad who supports tax breaks for undeserving corporations. the governor gave away $200 million in taxpayer money to a wealthy company, hatch was rebuilding neighborhoods and putting iowans to work.

there's one thing they have in common, for jack that's one thing too many. >> i'm jack hatch. like you, i'm ready for a fresh start. >> a recent poll shows governor branstad with a wide lead over his challenger, state senator hatch. watch live campaign 2014 coverage from iowa as their debate gets under way saturday night at 8:00 eastern on c-span. the 2015 c-span student cam video competition is under way. open to all middle and high school students to create a five to seven-minute documentary on the theme, the three branchs and you. showing how a policy, law or action by the executive, legislative or judicial branch has affected you or your community. for the list of rules and how to get started, go to

studentcam.org. aarp recently joined with the harvard joint center for housing studying and a look at the public and private sector roles for meeting housing needs for the seen yenior population. speakers include kathy greenlee. it coincided with a report examining the housing needs. this is about an hour. [ applause ] good afternoon. am i on here? i'm ann norton. i have -- as lisa said -- the most amazing panel here of women housing leaders. i'm thrilled to be a part of it. we have -- starting on my right -- this is in your schedule. terry ludwig with enterprise.

kathy greenlee the assistant secretary of aging and administrator for the administrator for community living. did i get that right? then we have lindsay goldman from new york city who is going to talk to us today about the age friendly community effort going on in new york. i understand some other communities across the country. i'm struggling here not to feel gloom and doom. i know the report is -- has outlined so many of the challenges that are facing us going forward. we are going to change all that with this panel. we're here to tell you that all is not gloom and doom, that there are some -- many of us, including the wonderful women here with me today and the organizations they are associated with are aware of these challenges, are working very pro actively within their organization and across the

country to find tried and true ways to address these challenges as well as coming up with some more innovative solutions. so our goal here today for the rest of the panel is to try to make you feel all warm -- more optimistic about the future of aging in our country going forward, particularly on the housing and long-term services arena. i just wanted to begin -- in doing some research for the panel besides getting to know my colleagues here, i also rediscovered the founder of aarp. i'm going to give a plug for aarp here because he was concerned about housing and housing for seniors and creating livable communities. this was back in the '50s. i don't know -- i didn't know and many of you might not know that she actually started one of the first independent living facilities for seniors in california called the gray

gables. their principal was that seniors should have environments that allow them to continue to contribute to the communities so that we're not all problems. we also are vibrant contributors to our neighborhoods and our communities. she also started a skilled nursing facility in california. this is in the late '50s. she developed a design for the freedom houses or house of freedom. she did a ribbon cutting with president eisenhower in 1961 showcasing the house of freedom which actually incorporated a lot of visibility features that we have heard talked about today. some of the solutions have been with us for a long time. it's not too late. we do need some innovation because of our current economic climate, our current political climate. but there are solutions. it's never too late to begin.

with that, we're going to begin -- to give you a bit of an idea about our format. i'm going to ask the panelists questions about their work and what they have identified as best practices and also what some of the gaps are and a couple of other questions about what's happening now that's positive and st. louolution-bas. then we will take questions from the floor. i will begin with assistant secretary greenlee. this morning we have heard about the current and impending housing needs and challenging for the 50-plus population in our community. this includes the need for affo affordability, accessibility and housing and long-term care. what in your work with the administration and as the assistant secretary of aging, can you tell us that you have identified at the federal, state and/or local level some of the best practices and policies for addressing some of these challenges? >> i wanted to start by

acknowledging secretary cisne s cisneros, your overview that was so impressive. of all of the issues, the innovations around the country -- you did such a wonderful job in your overview. i would like to start in left field and just announce it's left field before i do this. why do people move to a nursing home? services. what do we pay for when we move to a nursing home? we pay for room and board and we pay for services. the concept talking about housing and services, it's a collision of housing and service but it's not. we've always known this that at some point when someone needs support, we will pay.

for the medicaid program, this is very expensive. the medicaid -- it seems like people have a place to live. even that sets up -- the medicaid program is not our goal that people need assistance. innovation is taking place which teases out across. how do we integrate housing and services and talk about them sooner in a more focused way? i think this conversation actually is very positive. think about the older americans

programs that we administer through the agency. what do older americans have is the comprehensive -- it's a secret of the doorman that at some point you need someone who sees the whole person and all of their needs. the secretary mentioned retirement. we need to support community innovation. what does it take to look

comprehensively? one person in a high-rise in new york or one person in the community to really help some e someone. i was thinking about this. i was in my 40s when i asked myself the question that all of us have asked. what do old people do all day? >> i'm going to ask panelists to turn on your mikes. >> with a do old people do all day? this is a fundamental question. how do we create societies? mine is on. >> no, it's not.

>> i didn't turn it off. >> i asked the question about what old people do all day. it comes back to individual conversations, even though policy policies -- how do we get back to fundamentals of talking to one person at a time? what are your goals as you age? what are your plans? who is helping with your care? all of the planning needs to come about in a way that's comprehensive. if we do that, it is positive. the point of which is -- it's to restart.

to look at an individual in the community and what do they need and how to provide services that provide a connection. this is where innovation is happening right now. >> some people are -- i meant me. lindsay, you are actually engaged or -- the age friendly community started from the point that the secretary is mentioning. the grass-roots level with seniors being involved. can you tell us about what you have learned that's working well with the age-friendly community in new york? >> absolutely. age-friendly new york city was started in around 2007. it's a partnership between the new york academy of medicine, the new york city council and the office of the mayor to look at all aspects of city life to

see where improvements to policies, practices and programs can really make a difference for older people in maximizing their participation in society. so what we have done is we have used the world health organization's framework for active aging, which identifies eight domains of an age-friendly community. one of which is housing. we work across those domains. the first step is always to go straight to the source. older people themselves. we do this through community consultations and focus groups and surveys. we ask older people exactly that question that you just posed, which sh, what do you do all day? what is your day to day life like? what do you like about your community? what do you like about your house s housing? what do you not like? what are the barriers that may prevent you from being as involved as possible? and then we bring all of the

relevant sectors to the table along with the older people to collectively strategize creative solutions to those problems that older people have identified. so i'm talking about the housing sector, the non-profit and faith-based sector, arts and culture, transportation. we operate according to the premise that you can actually slow or reverse the disability trajectory by modifying the environment, the social environment, the economic environment and the physical environment in addition to certain lifestyle changes. so i think that we see older people from a right space rather than a needs basis. we see tenants and homeowners as assets to community. long-term residents among the most civically engaged who have

a real comprehensive understanding of their community's assets and v vulnerabilities. this is a good story for us. i can get into more specifics later. but i think what's been really essential is that we have the right people around the table and that we not relegate the issues of older adults and their housing to one government agency like the department for the aging but rather we see this as everyone's issue. it's an issue for all sectors and government agencies. we bring those people to the table. we do it across the city and more localized ways. we go by community district. this strategy has produced really incredible results to really improve the quality of life for older new yorkers. >> could you give us an example

in the housing arena of house having the right people -- the right stake holders at the table has led to success? >> absolutely. i love that you touched open the doorman issue. so we have partnered with local 32 bj, the building service workers union. they have about 50,000 members. what they have done is really taken this up as their issue. they have created a training that's part of the career ladder for their members so that they -- door men and porters and other building service workers learn about the needs and assets of older people, specifically how to identify signs of elder abuse, signs of cognitive decline. building service workers are often very well positioned to identify subtle changes that

occur in an individual over time. so we have empowered them to provide assistance and to know where they can refer these tenants when they start to notice certain troubling signs. and now we have actually expanded that program to include a module on the needs of older people in disasters. because we found during hurricane sandy that building service workers were essential in meeting the needs of their older tenants. >> thank you. i want to move on to you, terri. i know you work in new york, i think, but also all across the country. maybe you could tell us -- i think that you enter -- enterprise does a lot of work in assisting communities and developers, private and non-profit developers, produce housing, correct. >> absolutely. >> can you tell us, what are some of the best practices and

policies that you have discovered actually help address some of these housing issues that we have discussed so much today? >> absolutely. i would say just as a starting point, enterprise is a national organization that looks at safe and healthy housing as a fundamental platform for delivering opportunity. kind of think of it as the first rung on the ladder of opportunity. we try to look at connecting housing to healthcare, to education, to jobs, to transit. that's very much what we believe. that's our theory of change, if you will. so in our work, what we have found is that those critical intersections between today as we're discussing -- many of those intersections but health and housing is so fundamentally important. so what we try to do is really look at the needs starting with what are the resident needs? what are the needs of that older american that's there?

we are working across a variety of age ranges. we take that and think about the systems change that we're trying to embrace. from that perspective. so we're looking at a whole spectrum of services. just to give you a sense of that, we're starting with a building level look. then we're looking at what does it take to get the building constru constructs, the financing, design, construction, what are the services needed. we're looking at that whole piece. i would say some of the things that we have learned as we have done this work for the last 30 years, one is that all these things have to -- they have to work together. so at the building level, we actually have a design practice that's looking at how do you build the housing that's culturally appropriate? how do you look at the special needs of the tenants? especially in the course of disaster but in the course of the day to day. secondly, we have looked to

say -- as we look -- we know the financing models, fantastic keynote. i think certainly henry suggested the shortage of resources. we all have to learn how to leverage resources better. so one of the things that we're trying to look at as we look at financing streams is how do we mix the financing streams and what we are seeing is developers are becoming more -- they are getting better at mixing housing, financing streams with some of the other financing streams like coming out of medicare, medicaid, a lot happening at the state level. we're seeing that happening. i think that the developers we work with understand the criticalness of that. but at the end of the day, i also think that one of the most important things that we have been able to do is to look at -- there's a lot of fragmentation. there's two big themes in my mind. one is how do you drive the

sector -- cross sector conversations and break down the silos? the second thing is just there's a lot of fragmentation. one of the things we did a number of years ago is to introduce criteria that said there's ways we can look at sustainability. how do we look at energy and water efficiency? we have taken that and start to say, what else should we do to try to help create a common ground so as developers are looking at how they develop housing that we could actually influence that process? in this case, pertinent to this conversation today for older adults, we have taken that green community criteria and expanded it to include siding. where is housing getting built relative to transit? universal design. we have a segment on universal design. that's significant because then you build that set of criteria into the policy mechanisms where

incentives are. for example, in developing affordable housing, we know low-income housing tax credit is the biggest driver. those allocations and tax credits are awarded at the state level through an allocation process, a competitive funding round. we now have our criteria imbedded in 25 states. what that starts to do is to say, if you meet the set of criteria, let's say universal design, you score better on that incentive. so you start to really drive capital flows in new ways. we kind of start with what are the basic needs, what can we agree upon, how do you we innovate and be open sourced about that taking it to the needs of our developers, the needs of of the residents and start to put things that we can agree to and start to drive those capital flows. for us, that's been really meaningful work. what we're finding is we need to adopt that work. we're open sourced about that. we're doing that with our partners, many in the room today, to try to evolve that

work and think about what are the policy mechanisms, the capital flows and what are the local solutions that are needed. >> the universal design criteria in the qaps that you have worked to get those in, i would imagine that that would be a really important education process, too, to stress and to get the local fenders to adopt the state housing agency or the entitlement to adopt criteria that reflect an understanding. >> absolutely. what we're seeing is we have started out with making those optional. but it's a pathway for them to achieve certification. they're more entitled to the incentives. that's a huge education process. but what we're finding is a lot of energy and excitement about this, even though it's optional. people are saying, this is a smart way of building. it makes business sense given the demographics as well. it's a huge education process. we're learning, if you will, as

an organization from our work that we did with many folks on the sustainability side. if we want healthy homes, this is also a way -- the green communities encourage a healthy home. we're dealing with asthma from the onset. we're dealing with some of the critical issues. we learned -- we had some tough love in learning how to take that and really make that practical. we have a lot of those lessons. we had to work with asset managers running the buildings and boilers to figure out -- the residents themselves, how do you take a set of practices and make them work? we're doing the same thing with universal design and thinking about working with many partners to say, how do we smartly innovate around that? >> that's wonderful. vivian, you're with aarp foundation. have you thought about what some of the best practices and policies are that you have seen to enable communities and

individuals to better meet these needs? >> sure. yeah. i think -- aarp to see the breadth of best practices happening across the country. i read the report, i am optimistic there are opportunities. we focus on low income which can be more challenging. i think we're seeing some innovations happen. having been in housing for many years, one of the things i know is there tend to be a lot of silos in community. this connection of conversation is critical. how do we engage the housing community to interact with the healthcare community, transportation and other sectors? enterprise is a great example of how this is happening. one of the emerging best practices that i would like to share with you is something that's coming out of vermont. we work with an organization leading age, a learning collaborative. i invite you to learn about that by visiting our website. wf we have a connection to that. it looks at models across the

country that are working. these are very local -- state and local issues. to have one national best practice is probably not the case. it's a lot of models that work in different communities. in vermont, they have done a fantastic job of working with the state on a blueprint for health where they work in collaboration with the healthcare sector and administrators across the state to look at coordinating care and providing a care coordinator, wellness nurse in addition to the housing. the program is sash, services and supportive housing. it's part of the evaluation that the learni ining collaborative doing. we're working with this learning collaborative to create a guide which will be kind of a dictionary, a 101 for health and housing to come together before you have conversation, are you speaking the same language. that's one of the challenges. i was at a meeting last week.

they were talking about heal healthca healthcare. they were using acronyms. they were saying, do you mind to translate? you are talking about cdbg. they don't understand. i think as we look at connecting the systems, we have to start with the fundamentals and basics. that's one of the things the learning collaborative is doing. there's great models with cathedral square in vermont. vermont is unique and independent. how are you going to translate that across the country? look at the pieces. you taylor that through the community. it's going back to listening to residents, listening to what their needs are and how do we correct the services to their housing. >> you all mentioned some great things that are working well, some of the factors that need to be in place. what do you see as some of the major gaps? what are we missing?

what do we need to work better at? what do we need more of to not only address the issues of services and connectivity but also affordability? we have heard about the needs of low-income renters, the housing shortage, the lack of sufficient subsidies to keep the housing affordable. what would you say are a few of those gaps? is it just money? is it -- whether we talk about new housing, is it community awareness? is it political will? all of the above? you want to start? >> i will start. i will put a plug in for rental housing. the data speaks to this is an emerging trend. when we talk about diverse markets, we know that they tend to have higher rental incidents than homeowners which tend to be white. looking at the need, the tax credit has been a successful program to build housing. how do we have more like that?

there's a huge shortage. the need is very extensive. how we insent communities to have more affordable rental housing is a big gap. >> i couldn't agree. maybe i would build on that. the importance of also bringing in the private sector i think could not be overestimated. because we all know there's incredible shortage. one of the things about the low-income housing tax credit has worked is it's a public private partnership. we have worked like that at enterpri enterprise. there's a lot of -- maybe the half empty view would be that there's not enough resources. the half full view might be that now more than ever we're seeing a lot of interest in private sector players to come in and say, how can we help? they also see housing as a critical intervention. i like to quote one of my board members who runs children's health watch who says housing is

a vaccine. i know that as a doctor, i have got to have a safe and affordable healthy home for a child to go back to. it's the same with older adults. it's a vaccine. so we're starting to see people in the healthcare sector actually invest in low-income housing tax credits. united healthcare has been an investor with us and are helping us with pilots in texas with some of our developers down there to say, hey, i have a state -- texas state health plan. i could help deliver services in a community-based way. they're not only investors from their financial books, on the treasury side but getting interested in the issue and starting to bring practice alongside the investments. i think that is huge. that's one example. >> that leads us into the issue of health. >> yes. was there a question or just --

>> we're there. we have been there all day. the gaps that you think we have that we need to fill to make better progress on these issues, whether they're policy gaps or practice gaps. is it just money? is it more cross silo cooperation. from the federal level, what would you say? >> it's possible that will be my glass half empty part of my answer. i think as a nation, we need to do a better job of talking about the continuum. between clinical care and community-based care. part of the struggle when we deal with health is it's isolated when we talk about older adults to acute episodes where they are in the hospital. those crisis episodes and not sufficient conversation about the fact that long-term supports and services are a part of healthcare. so are community-based

organizations. there are innovations taking place at each stage but they're not necessarily viewed comprehensively as what are the right investments we need to make all along the way? we tend to focus as a country on the escalating healthcare costs which is clearly an issue we need to address. for older adults, life happens between these crisis incidents. that is not addressed comprehensively enough. part of what we have been able to do -- this started in the early 2000s through the administration on aging is invest more evidence-based programs. they maintain diabetes, deal with depression, stay upright and not fall. how do we integrate that into our healthcare system? i talked to a colleague recently who works elsewhere within hhs. we were venting our mutual frustration that if you found a pill that did that, there's a pathway for adoption.

if you found a device that did that, there's a pathway for adoption. but to find a self-efficacy intervention that has evidence, there's not a pathway for adoption. there needs to be. we have good practices, good science and not an opportunity to make sure we integrate across the healthcare system, the front end of this delivery system. >> would you say the same about integrating the housing issue with the healthcare? >> clearly. this is where the real housing experts in the group can talk about the critical nature of housing having housing support health or impede health. it's interesting to talk about the new housing stock, new opportunities, much of where i end up thinking just for the nature of my work is the existing housing stock. what do we do with what we have now? how do we do person-centered assessments? just because -- listen to what older people want. how do we provide support?

we have to be sensitive to the need to be innovative to support health. since i have the mike, i want to mention one more thing. i don't want us to get way from this without mentioning the advances of technology that i think can help connect housing and health. the fact that we need to pay attention to aesthetics. i'm into audience participation. have you been to the big box stores? there's really ugly ones that look like hospitals. then there's ones that look okay that i like. i think as we talk about supporting people in health and housing, we also have to make sure that we're building things that don't further stigmatize or stereotype what it looks like to be old. i will give you this ugly looking walker, this ramp, these things that we have to look at universal design, adapt things to make it clear that these are supportive supports. that they are visually appealing and we -- we receive resistance

from older people at the time we're try to provide solution. if we bring them ugly stuff to put in their house, to stay home, they will resist. >> that pertains to the issue that chris brought up which is the denial of my generation that we're going to get old and need support. the more attractive they are, the more willing we might be to embrace them. how about you, lindsay? what can we do better there terms of policies or practices to help make the age-friendly community initiative more successful? >> i think that policymakers need to incorporate the voices of older people into decision making and that policies need to support older people in remaining connected to their formal and informal support systems whenever possible. so that in new york, we have

larger contingent of renters who are old er, about 80% of them rely on rent subsidies. i think that there's a real affordable housing shortage, which our mayor is trying to address through a very comprehensive plan. so there's competition for units. so, for example, when you have an older person living alone in a three-bedroom unit, there's a huge waiting list of families who need that space. so there becomes this pressure to move that person somewhere. when we think about doing that, we need to consider, what are the health ramifications of separating a person from his or her support system? because we know very clearly that displacement can have really negative consequences for older people. we saw that during hurricane

sandy. so that's something we also need to consider in relocating people after disasters. as we change or build new housing, we need to think about how is that housing integrated within the larger community? both from a physical perspective, to a social perspective. i think that large numbers of older people sort of living alone in large high-rise buildings, which is what we have in the city in the absence of any sort of connection to the broader community is problematic for everyone. >> great point. along those lines, i know enterprise is doing some amazing innovative work in my hometown of denver in terms of where buildings are sited and enabling

seniors to maintain the connectivity as well as affordability. could you tell us about that? >> when we think about creating opportunities for families, that connection to transit and accessibility is so important. a number of years ago, we set out to look at what's the connection between housing and the transit systems and other community-based facilities? really with a focus on housing to think about how we encourage that -- i will do the shorter version given the time. a transit-oriented development fund. working with our partners out there, we have a number of partners, the city of denver, the urban land conservancy, private funders, public sector funders in the room today. hello, ford foundation. it has been a fabulous opportunity to say, how could we

create communities, make sure we're building housing and preserving housing near transit? whether it's light rail, bus system, as the systems come into denver. we had incredible public sector support. done a lot of local intervention in creating the coalitions that are needed to come together to have the political influence and then to have the practical ability to get something done on the ground. one of the things we found that was missing was the financing. so we created the first really innovative fund around a structured fund for transit-oriented development. it's about a $15 million fund. that's all been disbursed today. the goal is to make sure that we're having housing near transit and that a good proportion of that is going for seniors and for older adults. it's all 100% intended to have universal design and a very significant chunk of that will be for seniors.

based on that about how to really drive the presidenter va -- the preservation of housing near transit, we have expanded that into eight cities across the country. we're working on expanded initiatives where we look at critical intersections. it drives health outcomes so dramatically and other outcomes. we're doing that work today. we have -- we're in a small r and d place. we piloted in denver. we are in scale mode with a number of terrific partners across the country. for us, affordable housing, if you are giving back, but 77 cents or so is given back in transportation. social isolation, accessibility are fundamental. we have to look at that. what we're finding is that this is where tables are being set across the country.

as transportation dollars come in -- there's not a lot of dollars for housing in a place like los angeles, for example, measure r, people have taxed themselves to build out transportation systems. if we -- we're focused on low income, the most vulnerable among us, that we have to be able to focus on those dollars coming in and thinking about, what are the outcomes for low-income families as the dollars come in in terms of their housing, economic opportunity, healthcare, he had kal -- the education outcome. they talk about terminology, but it's how do we break down the silos, work on a local or regional scale and then try to share those learnings across the country. >> great model. i see that -- we could have this go on for hours. we do want to take questions from the floor. if you have a question, there

are mikes set up. i see one here. is there just one? there's just one low and moderate income households. i wanted to build on -- the comment about technology. there's so much opportunities there in terms of leveraging technology for housing, especially to support affordable housing. i was wondering if -- what

enterprise is doing to perhaps even make smart homes as common language among the rest of the country as you made greenhou housing. i'm thinking 3-did printers, building homes. that could be a way of lowering the cost of affordable housing. i was wondering if you knew ho wide or what might be some best practices on that. >> sure. i'm going to say that i wish i had a better answer than i do. we have had fabulous partners, aarp, safe, leading age, with our seniors collaborative trying to learn technology is one of those angles we have been trying to learn with. i think that we're touching the tip of the iceberg there. i do think it's a really important area for us to move. we have a lot of fabulous partners across the country that are certainly using technology to allow aging in place, whether

it's being able to prevent falls, looking at medication and dosage, looking at all sorts of pieces of how technology might be part of the season. in california, we are working with a number of folks who are looking to bring broadband in as a -- with the broadband, having to limit social isolation. also to -- education front, for a lot of reasons, broadband is really important. we have looked at technology. certainly, along the sustatai sustainability front, we have made partnerships to make sure on the green side, there's a lot of technology that allows to you do a lot more and be more productive along that. we have done some of that. i think it's a challenge for us all. i think to really engage the technology -- not just the technology companies but it's a great opportunity -- i have a board retreat next week in silly -- in san francisco.

we're doing an innovation segment with technology companies. i'm very interested in this question of, how could we amplify this? what are the critical investments that would need to be made? what role do technology companies play? what role do -- there's a number of players that could be involved here. >> thank you. >> hi. i'm pleased that the discussion today has also included the importance of social components and connectiveness. one of the things as a former housing developer who has been in aging, which is kind of a fun little space to be in, one of the things that always created the silo for me was the policy mismatch of eligibility criteria between being eligible for housing subsidies and being eligible for medicaid and oaa and all of the other things.

if there's one thing that could start to bridge some of these gaps, i was wondering if there's discussion about how to align those eligibility criteria so that people aren't falling through the gaps and that they can leverage the systems to work together. i was wondering if that's a conversation that's being had. >> we're going to look at me and i don't know the answer. i don't. if someone here does, we should let the audience help inform when i don't. obviously, half of the equation is the half of the equation you just described in terms of medicaid and older americans act but not the opportunity to bridge with the hud world in terms of 202 or 811 or any of the other services. does anyone know? >> or section 8. >> or section 8. [ inaudible ] >> since i can barely hear you -- >> if you wouldn't mind coming to the mike. >> as you are my life line, we

should give you a microphone. >> do you get one? >> i will hand you the mike. it's an excellent point. >> i'm with the department of a with housing and urban development. jennifer ho at hud has been working with hhs primarily to help with aligning policies for hud and hhs so that the conversation wouldn't be so disconnected. moving forward we are working on one accord. >> is the issue of mutual eligibility on the table? >> it's blanketed in terms of the different issues on the table. whether or not it's making sure -- first of all, 202 is for very low income. a lot of medicaid, medicare programs are more for extremely low income. we are finding out what changes need to happen. there are multile pl issues on

the table. jennifer ho is the contact. >> hhs and hud have had a collaborative for years looking at homelessness. hud has encouraged local collaboration that would help people score better when they apply for hud support. i don't know whether or not the eligibility is part of it. thank you. >> great point. >> one of major issues is there isn't enough in terms of housing subsidies for low income renters of all age, but particularly seniors. yes, ma'am? >> donna butts with generations united. it's been a rich discussion, fascinating. so many things to work on. one thing that struck me as lindsay talked about the three bedroom apartment in new york a report generations united released that other people were advisers on. we looked at housing through an intergenerational lens. we think about things

differently. one of the recommendations we had was to think about taking some of the lessons from other countries m. this case it had to do with spain and their home share program. you have older adults who want to age in place. in spain they have married those without incurring debt. >> what the experts say is whether it's moving in like a home share or helping the older person age in place or a young person moving into a neighborhood like teach for america offering kpx amount of services to people ageing in their home. then we could reduce the student loan debt or at least reduce the interest on that.

what i think about with age friendly communities is i love it. i hear they are old age friendly. i wonder if the panel can make recommendatio recommendations, have ideas that when we are thinking about age friendly, we are thinking about all ages. >> great point. >> one thing that's really critical is that we promote and implement smart employment practices. i think this is the strategy that benefits older people but also younger workers. really people of all ages. talking about policies like job sharing and phase retirement and caregiver support programs. health and wellness programming. flexible schedules. those kinds of things. i think that the more younger people are exposed older people

the better society is at large. work has positive associations with physical and mental health and leads to less reliance on social insurance programs. so we really want to do what we can to keep people employed as long as possible. especially if they want to be working. incentives for companies to hire and retain older workers. you know, when working -- to complement working we want to promote civic engagement. there is one city that provides local tax credits for older people who do a certain number of volunteer hours. recognizing that not all older people are terribly frail and in need of a lot of services, but that, you know, it's a real continu continuum. we are talking about a 30-year age range.

i think work is really a key piece of this puzzle. in new york city we have 25% of older people still working. you know, we'd like to keep it that way. >> thanks for bringing up the intergenerational issue. highlights with hispanic and asian families in particular that multi generational households are common. i know in my family we were a three-generation household for years until my fwrand parents passed away. we look at it as part of aging in place or an age friendly that we would live together in a communal environment. we are looking for house that is allow people to live together under one roof. the policy around changes in zoning to allow mother-in-law suites, granny flats to allow

them to retain separation and independence which is an americ american. growing up with older aunts and uncles, you benefit much from them. that was an enriching experience. it's a good policy and a good society thing. we want to make sure we continue the connections with family and also with relationships. friends, bringing younger people and older people together. it's a great solution. again, i have been in a lot of meetings. we talk about my length yells and the challenge with housing. it seems like a good way to help affordable housing for generations. >> is multi generational housing more on the agenda? >> absolutely.

we are seeing more mixed income communities, more and more mixed age communities. i think it's interventions everyone has talked about are really important. we look at what the community is made of. a whole range of ages. synagogues, churches, communities. you know, we have looked at some of the models, too. we know a lot of folks we serve need other forms of income. i was intrigued with the question. i think we have looked at accessory dwelling units, other ways like granny flats and other things that might be an income generating model for a family that's low income. a little bit of density into the community. but do it in a responsible way. we have looked at some. there are challenges but

interesting opportunities. >> i think the home sharing model also isn't being used just for younger people moving into older folks' home but single older people moving in together to share resources. >> we once had a brilliant idea of doing a mother-in-law could move into your place where you had excess and you would trade mother-in-laws. you take mine. i'll take yours. that was the sharing. >> i don't know. seemed interesting. there were a few problems inherent in that. >> sounds like a new reality show. >> it does. >> thank you. first just thank you. for those of us plodding away in the field, this report is really meaningful. i'm very, very grateful. thank you. so my question is the magnitude of the problems cited in the report or the opportunities, depending on how you see it and

the solutions we are talking about seem like it's a disconnect. when mr. cisneros was secretary of hud and public housing was a problem, he didn't try to do two little things. he combined everything and did a bold program, the hope 6. in the report there is a mention and people talked about the 202 and it's gone as if it is not a big deal and a complete waste of opportunity. whether it's integrating housing and health care. we are an enterprise partner. i'm proud of it. the last building had 17 sources of financing. the impact of that was a $42 million project and $26 million in construction and design. the rest was lawyers, accountants and costs in contrast to a building we built with 202 funds with a $10 million grant and $9.6 million was for actual construction

costs. there was hardly any transaction cost. we have gone into a situation where you have to spend millions of dollars on consultants and on lawyers to make basic transactions. why are we letting everyone get away with the elimination of the 202 program which is efficient and produced so many more savings than medicaid could pay for ten times what the 202 program was with and still save money. why are we letting them off the hook. >> hear, hear. >> yeah. [ applause ] >> if anybody wants to respond, feel free. >> i would just say that certainly as we have done -- participated in the bipartisan housing commission. you saw a push to expand resources to 202 and other oh other things.

the point is right. it takes building a lot of public will to do it. we have to do that. we just did a big study on the cost of affordable housing. how do we do it differently? the financing streams are very, very challenging. local zoning. all the things we have been talking about. we need to at the same time advocate for resources but do what we have much more efficiently. it's both of the pieces and build the public will to support what we need. >> rely on what we know works. yes, innovation is important. we know things that work well. let's not forget about them. >> right. we have a quick little bit of time for one more question. >> i'm encouraged by today. my name is louis tenenbaum. i have been working on the issue

of ageing in placer for 20-some years. i talk to colleagues, friends and customers. most of whom are ineligible. so we have a huge -- they have a great deal of trouble managing services for their parents, finding services for the parents, deciding about services for the parents and themselves. the largest share of the demographic is not eligible for anything. we need much better services between ccrcs and medicaid. there is a huge population that has a great deal of trouble. i want to encourage us to use the private sector or use encouragement to the private sector to better use private individual funds which is all we have for most people to improve services available to most agencies. really to work at making it possible for people with just some money to age in place easily and well.

i think it will make a difference hopefully in individual lives, neighborhoods, communities and all of our levels of government. please join me in giving a hand to our wonderful colleagues. >> secretary of state john kerry will chair a debate of the u.n. security council on the situation in iraq this afternoon. c-span will have live coverage from u.n. headquarters in new york city. it begins this afternoon at 2:00 eastern. >> two former members of congress are running for governor in arkansas. c-span will have live coverage of a debate between mike ross and asa hutchinson tonight. here is a look at ads voters are

seeing until that debate. >> the democratic gazette said the attacks on mike ross aren't true and are a smear on his family business. there was never a justice department investigation and the house ethics committee approved the sale. why is hutchinson attacking ross? to cover up the fact that he got caught cheating on taxes and that hutchinson was a d.c. lobbyist who put millionaires before arkansas's middle class. sorry, asa, this cover-up won't work. >> for our schools a choice for governor. there is asa hutchinson. >> he voted to cut college loans. >> and prek programs. >> and opposes the plan to expand prek. >> i think this is the wrong direction. >> the prek plan that works for arkansas. >> a focus on career tech training and college opportunities. >> under pike's plan i know my kids will have what it takes to

get ahead. >> that's why teachers doerns mike ross. >> on education, mike has a record i can trust. >> have you seen this smear piece paid for by allies of barack obama? here's what they don't want you to know. asa hutchinson found a mistake in his taxes, reported the mistake himself and paid his bill in full. many of us have made mistakes on taxes. asa was honest enough to admit it. that doesn't stop team obama. they know lies got him re-elected. they hope it works for mike ross as well. fortunately arkansas knows better. >> it's a $16 billion industry and arkansas's largest. with 97% of the farms family owned our next governor must fight on their side. when some criticize free trade it only hurts our farmers. whether it's rice, wheat or poultry, i want to keep arkansas business open to the world. it's the best way to grow our

economy and create jobs. i'm asa hutchinson. as governor we'll hit the ground running and never look back. >> mr. ross served as a u.s. congressman for 12 years in arkansas's fourth district. mr. hutchinson is a former u.s. congressman in arkansas's third district. he's also served as the administrator of the u.s. drug formt administration. the two will debate in little rock arkansas tonight. you can see live coverage on c-span starting at 8:00 p.m. eastern. >> the c-span cities tour takes book tv and american history tv on the road. traveling to u.s. cities to learn about their history and literary life. this weekend we have partnered with comcast for a visit to st. paul, minnesota. >> in the 1930s, i wouldn't call st. paul las vegas but it was a lively city. the gangsters brought their gun molds during prohibition. you had the biggest jazz artists

of the decades here in st. paul. this is a lively place partly because the gangsters were welcome here. virtually every major gangster, kidnapper and bank robber in america lived and worked within a three-block radius of where we were standing today. john dillinger, baby face nelson. this was the epicenter of 1930s crime in the era of john dillinger. the fbi, the federal bureau of investigation with j. edgar hoover, had this building as their headquarters. this is also the building where all of the bootleggers and bank robbers were tried and sent to alcatraz, levinworth and other prisons in america. it's where it began and where it ended. >> we are standing here at fort

snelling looking over the junction of the minnesota and mississippi rivers. st. paul is up the mississippi river from fort snelling. the fort was here before the city was. it's intimately connected in the creation of st. paul. in the 1830s there were groups of settlers living on the military's property. finally the army had enough competing for resources and felt they should be removed officially from the military property. the settlers move across the river to the other side and form what became the nucleus of the city of st. paul. when you think about the story and the history of this region that you think beyond the walls of fort snell iing we try to pu people to think more about what does it mean when all the cultures came together. what perspectives do they have on these events? >> watch our events from st. paul saturday at noon eastern on

c-span 2's book tv and sunday afternoon on american history tv on c-span 3. >> we continue our look at the housing needs of seener yors. chris herbert led a study by the harvard joint center for housing studies on meeting the increasing aging population due to the baby boom surge. this event co-hosted by the aarp foundation is about 45 minutes. >> good morning. it's nice to see so many people here today, the day after labor day weekend. we hieard grumbling. this is a testament to the issue and the fact that people are ready to get back to work after a good summer and good labor day weekend. let me first start by sending my thanks to the hartfords for funding and to the aarp foundation.

thank you. i also want to thank the folks we work with closely at the foundation. vivian and tyler who have been instrumental in helping marshall this through the process and have been certainly not funders but collaborators. they have helped put together a committee to shape the report and review drafts. i will not go through the process of naming them now but they are named on the website. their input was critical in terms of informing us and pointing us many the right direction. i would have to thank the joint center staff. a number of whom are here today. i won't call them out. i think the effort that goes into the report, our state of the nation report and the american housing report is phenomenal. i think we under estimated to

some extent the amount of effort that goes into learning the issues that intersect with senior and older american housing. a special thank you to jennifer molinski, the manager of the project who is passionate about the issue and really put blood sweat and tears into getting the report where it is today. a lot of credit goes to jen. let me turn to the report itself. obviously the motivation for the study begins with the fact that we are at a time of unprecedented growth in the older population. it's growing not just because of longevity which is increasing. because the baby boom generation has been crossing important thresholds.

we have seen it growing for years. since 2011. beginning to accelerate and ten years from now, the oldest old population beginning to grow. it is a tremendous need to meet the needs of an aging society. the needs are great. there are challenges we face as we age. challenges to maintain our health and physical security. to remain connected to our communities. and to remain productive members of society. as lisa said in her remarks, i think if you look at it, housing is critical to so many of the elements of maintaining well-being and we use the phrase lynchpin. we have discussion if anyone would know what it is. i'm glad you defined it. housing is a lynchpin of well-being because it intersects with so many key issues. one is the financial security of households. housing is typically the largest item in a household budget. whether your housing is affordable or not will have a lot to say about whether or not

your overall financial picture is in good shape. it's also the principal source of wealth. if you are a homeowner whether you have the nest egg or not is an important asset people can tap potentially as they age. in terms of physical security, whether the home is suitable to your needs as the inevitable challenges arise. does the house provide a safe and secure environment. as we learned more and more the ways if which the house is also related to health issues in terms of both the interior environment of the home and how it connects to communities. in terms of social connections, where you live, what your housing situation is. does it facilitate you interacting with the community. do you have access to transportation options to engage with the community. the housing is central to that. finally in terms of links to long term supports and services, as we age when we needer more supports in the home, those are helping in situations facilitating getting the services so we can age in our communities and avoid the high

costs of institutionalized care. we face significant challenges. in terms of financial security, older households are already facing high housing cost burdens. giving to the situation of those approaching retirement may may worsen. more people are enterering retirement with mortgage debt. in terms of physical security, there is a shortage of housing with accessibility features. there are important trade offs between spending on food and therefore hunger and health care and therefore health. in terms of social connections there are deficiencies in terms of the house ing that's well connected to city centers and town centers and transit. there are deficiencies in pedestrian infrastructure that make it difficult to make those. there are ways in which the housing and health care system don't work well together and

threaten the ability to get services you need. housing play as critical role in making the connections. we certainly are facing a number of challenges today as the list makes clear. we'll face more challenges in the future. this is a problem already but going to become a bigger problem. the issue or the good news is there is still time to prepare. most of the challenges will really accelerate when the population begins to grow. that will happen a decade from now. as lisa said there were a number of promising models and ways we know to address these things. if we are going to build infrastructure in terms of housing and systems to deliver the services we have to start now. the goal is to raise awareness and understanding of the issues. to provide the data that's needed to document it and highlight areas where action is needed and can take place at all levels of government by the private and nonprofit sectors. most importantly at the individual and family level.

there is a need for individuals to take stock of what's going to be the demands on them as they age. and begin to take steps now to prepare for that. also to provide the support needed for the policies and programs that are going to be needed to support an aging society. with that, let me now turn to the details of the report. as we say, these reports are always chock a block full of information. every paragraph is carefully honed. so i will be able to touch upon only a part of it. i encourage you to read the report. let me turn to the highlights. so the first portion of the this shows the population in 50 year increments. we define a preretirement group, 50 to 64. retirement into the first year's

post retirement. then 80 and over. you can see that we have already experienced a huge run-up in the 50-plus population. when the baby boom turned 50 in the # 0s the group started to grouchlt from 1990 to 2010 we saw the population double. the baby boom started to turn 65. we are just beginning to see the population grow rapidly. we'll see the group grow to 43 million. the oldest old are growing in longevity. that beginning at the 2020s and 2030s we'll see the oldest old

population grow. that's the group that has tremendous needs for support. although it's growing now. it will be growing more rapidly a decade from now. this chart illustrates challenges when you age if terms of increased risk of disability, isolation and financial stress. so we show here different categories of disabilities from cognitive issues with memory and decision-making, self-care in terms of bathing and dressing. independent living in terms of running errands and taking care of finances and mobility. as you can see, there is an increase as people from go from their 50s and 60s to their 60s and 70s and a huge increase as they hit 08 pl80 plus. by then one in three have issues with independent living. one in five have issues with self-care.

likewise with people living alone as people become widowers and widows, more than a third are living alone, increasing the risk of isolation. when we look at housing cost burdens we have less of an increase. this is more of a democratic problem with more than a third of people facing housing cost burdens in their 50s, 60s and 70s. it rises in the 80s. as we see people age, issues around disability, isolation, and issues around financial stress grow. in terms of disability, age in many respects is the great equalizer. what the charts show is again looking now at incidents of disability. combining the likelihood of having the issue of hearing, vision, self-care, mobility and the likelihood of having an issue rises sharply with age. these panels show issues by race and ethnicity, income and housing tenure.

>> this is not an issue for some demographic slice. it's an issue for all of us as we age. the financial pressures also converge. this shows the median income again for different demographic groups. if you look at green brars that's people 50 to 64 by race, tenure and family type. you can see at that point there is a wide disparity in median income. much higher for whites and asians, homeowners, married couples. you look at people in their 80s and the differences largely dissipate. most household types regardless

of what the demographic stripe is had median households between $20,000 and $25,000. the longer we live, the fewer income sources there is to rely on, the more the differences come together. more financial stress across the spectrum. turning to housing and financial security. one of the main issues we look at is housing cost burdens. this is the share of households spending at least 30% of income for housing which is a typical measure of affordability. people are spending more than 50% of their income on housing. we always get a question when we do a report. what do you find surprising? this part of the analysis though it is one we may spend the most time on gave me pause. if we look at renter households. among older households the differences aren't that significant from the overall population.

people in their 50s and 60s, half have housing cost burdens which is true of all. they do rise with age. they are already high. by the time you are in your 80s, almost 60% of renters have housing cost burdens. it's not a slice of data we often look at. if you look at it that way you find, in fact, people who have a mortgage later in life are more likely to face housing cost burdens. among those 50 to 64, a third have housing cost burdens but by the time they age into retirement ages it's 45% and then 60. really this issue about managing your mortgage debt while you are still working and trying to get to a situation where you are not facing the costs in retirement is really significant.

as a 53-year-old mortgage holder of a 28-year mortgage this certainly gave me pause thinking about what i may need to do in the next ten years. if you look at homeownererers who own the homer-free and clear it is a dividend in terms of avoiding housing cost burdens. 13 to 14% of homeownerers under 80 have housing cost burdens. it rises after 80 because property taxes and insurance becomes more of a burden. owning your home free and clear is an important dividend homeowners get and one we'll see is one becoming less likely to be realized. another issue we look at is what are the implications of housing cost burdens? the way the joint center looks is to see the consumer [ speaking french ] -- expenditure survey. we compare those who are facing moderate cost burdens between

3050% of their income or severe, spending more than 50%. this is just for households in the bottom expenditure quartile. how do they spend their money. green bars are those able to find moderate housing. the red are severe burdens. the spending categories that take the big hits make up the big portion of a household's fortune. food is one that's a significant one. those facing severe cost burdens spend between 41 and 47% less a month on food showing a link between spending on housing and whether or not you can get adequate nutrition. the next category transportation. a clear trade off between how high your housing costs are and

how much you spend on transportation. here, the differences are between two-thirds and three-quarters lower spending on transportation. the link between high housing costs and isolation. in terms of health care, we see there is a lower spending of about a half to two-thirds for those who face severe cost burdens. among those 80 plus it's 67% less on health care. the other area of spending that cuts back is retirement savings. it will be reflected in your situation when you retire. clear links between whether you can get affordable housing and spending on all other categories. >> back to the mortgage issue, this chart shows the share of households who are homeowners with mortgage debt and the

average amount of debt over time. just looking at the yellow bars for 65 plus going back to 1992, about 19% of people who are 65 and owned a home had a mortgage. it's gone from 28% to 5%. if you think back to the cost burden chart, what does that imply. how people can monitor retirement and what the implications are. how we are managing mortgage debt going forward will be important for the next generation of older households. the other issue for 50 to 64-year-olds is the toll that the housing crash has had on the home ownership rates. this compares rates in 2005 and

14 for different age segments. homeowner ship races have held up well. a slight decline in 55 to 79-year-olds and 80 plus has gone up a little bit. the 50 to 64-year-old group has seen the homeowner ship rate fall. it's not one that's likely to be made up in the remaining years before retirement. we are going to have that group go into retirement less likely to own their home. if we look at the overall net wealth picture between 2007 and 2010 the 50 to 64-year-old group saw yet wealth grow. the common theme in the report is the group of 50 to 64-year-olds and how much they have been suffering from the recession and other financial issues we have been having, less likely to find benefit pension plans. as much as we look at today's older households, trying to extrapolate from the 50 to 64-year-old group forward it's

not a pretty picture. in terms of health there are a lot of figures in terms of the distribution of wealth by owners and renters. the bottom line is homeownerers have a quarter million dollars of net wealth for the typical to median homeowner compared to $6,000 for renters. we think, too, about the situation for homeowners and renters as they retire. very different situation. it's sizable but not the lion's share.

that will be an important issue going forward. being able to get rental housing assistance is important to manage their finances. what this chart is showing is on the left-hand side using data from hud the number of oltder is 62 plus who are very low income which is a standard determination of eligibility for housing assistance programs. then the green portion is a share of the group that managed to get housing assistance that they are income eligible for. in 2011 there were 3.9 million low income elderly households of which a third were able to get housing assistants. it was about a quarter but two-thirds don't get housing assistance or are eligible for it. of the group, the two-thirds who don't get it, 60% suffer from

what's worst case housing needs. paying more than half the income for housing or living in severely inadequate housing or both. so that absence of housing assistance for the group has important ramifications for how well housed they are and what the financial situation is. what we have done is a simple exercise. perhaps naive. trying to where it is. that age eligible group is going to grow by leaps and bounds. what we project to be the number of oh elderly renters. we do it constantly. if we assume the same share are low income then as they are today, what does that imply about the number of eldererly households for assistance. a lot of switches in there.

i think in some sense you could say homeowner ship or renter ship might be too low. it might be too generous since the group is suffering financially. on the other hand, it could go the other way as well. based on that we project by 2030, 6.4 million, very low income renters, elderly renters eligible for assistance. just to keep the same one-third share that would mean 900,000 more assisted units for the population. we now have 1.4 million. we haven't add thad many in a long time. if we don't keep pace with it we'll have more elderly renter households on their own in the housing market. already we see that results in 60% having worst case housing needs n. the short run this issue about rental housing assistance and how much support

we are providing. turning to accessibility needs and housing stock one of the key issues as we talked about is how well suited housing is to meeting the needs of an aging population in terms of accessibility. as a starting point it's helpful to look at what types of homes older households are in already. this is a distribution os after 2011 in terms of the type of structure that households 50 and over are living in. 71% are living in single family detached housing. most is owner occupied. the good newses is they probably have greater ability to modify the home. single family housing may present more challenges in terms of multi floor living and the like to adapt to meet their needs. if you look at the share living in multi family ten plus to the extent multi family buildings with elevators may have greater accessibility it's a small share

of the eldererly, older population. only 9% of older households are living in large multi family buildings. when you think about adapting housing to meet accessibility needs we are talking about adapting single family housing. we are talking about it because this is a population that doesn't move very frequently. as people age, the likelihood of moving becomes much lowerer. in their 50s, 4% of the population moves every year as you get to the 60s and 70s, down to 3%. we are looking at microsoft older houses now is where they are likely to be living as they age. this chart shows a share of households of different age groups who have been in their home for different period os time. the dark green bars show the share living in their home for 20 years or more. if you look at the right hand panel, those 80 and over, 60%

have been in their homes for at least 20 years. if you look at the 65 to 79-year-olds, 47% have been in it for 20 years. another 23% for ten years or more. basically people are making decisions about the housing they will occupy. we don't like picture ourselves in that situation. he didn't do anything to make his house accessible. he said my parents are 90. they're fine. i said, they're lucky. may you be as lucky as well. no one in the process. not the architect, the builder pointed out to them that this

was an issue we needed to be aware o. all along the supply chain needs to be built in as well. this terms of accessibility features we looked at using the american housing survey characteristics of the stock along the main dimensions used in terms of universal design including hall ways and doors. lever style doors on handles and faucets. no step entry. accessible electrical controls. and single floor living.

if you look at the bundle of the thing it is share of housing stock that has more than one of these things becomes quite limited. . 57% of the housing stock has one of the features and only 21% has at least three. only 1% has all five. we are talking about how accessible the existing stock is. there are significant deficiencies. the northeast tends to have more single family homes that lack single floor living or no step entry. even though the slope is upward on the features is probably not as deep as it needs to be. it will be adding to accessible stock. we have an issue with how well

suited it is in terms of the aging population. this chart compares the likelihood of living in a home with at least three accessibility features versus the likelihood of having a disabled family member. for those households, one in five are likely to have disabilities in the home. by 80 the incident of disabilities goes up to 60% of households and the likelihood of living in a house is only 30%. at that point if you move you will move to the more accessible housing. moves are rare and not enough to off set the rise in disability. so a big mismatch between needs for accessibility and what the stock offers. so what does it take to try to

make the stock more accessible. met life has estimated what the expense would be for the most commonly needed investment miss the home. some are simple, not that expensive. add aing handrails, less than $1,000. each door estimated. for a wheelchair ramp, stair lifts, more expensive. 3,000 to 12,000. then you talk about remodeling a bathroom to make it accessible. adding a bathroom, a bedroom the costs become much more substantial. while some things can be done easily, other things take much more more expense. to give you an example of the scale of this, consider the scale that as of 2011 there were 10.3 million households who

reported having serious difficulty walk iing or climbin stairs. then you say, of the 5.5 million they need to put in a ramp to get into the housement it adds up to 1.3 million for ramps. either way you slice it, that's a big market. 1.3 billion. it's either a big opportunity or a big need for subsidies. when you multiply the millions of households facing this by ho des costs you can add township a big number. how do we pay for this, increase the stock. there are a number of policies and programs out there that are potentially being used or are being used. one of them is visibility

ordinances. there's been a growing adoption of these over the last couple of decades initially focused on housing being built with public funds having mandates to have visibility features, many of the features talked about in the earlier slide. more and more there is an interest in expanding it beyond just the public funded housing to more housing. certainly having mandates or incentives to have new housing have those features would add to the stock over time. there is also examples of tax incentives offered to homeowners or home builders who undertake housing with features to undertake the improvements.

it's played a big role in providing big grants and loans to homeowners to improve their homes. other options include the potential for medicaid through home, the community based waivers. to be able to fund improvements to the home so people can age in place. there are a variety of ways to tap different grants and low interest loans to help homeowners make the investments. finally volunteer assistance may be an area, a question of whether we can bring toyota scale. an interesting example is rebuilding america which has a model sort of like habitat for humanity. they rely on volunteer assistance, donations of resources to go into homes of the elderly veterans and disabled households to make homes accessible. they do it in 2013 they modified 4200 homes. it's small scale but the kind of

community level grassroots effort that brought to scale might actually go a long way towards helping. social connection and community support. the ability of people to remain connected with their communities is important to take advantage of what the households bring. there are a number of ways in which the current layout of housing will become a challenge to maintain that social connection as household age. if we look at the distribution of where the 50 plus households currently live this is based on the american housing survey. it estimates that about 25% are in central cities, 50% in

suburban areas. another 25% are in nonmetro areas. we have about three-quarters of older households living in areas that are not dense by definition. therefore may be constrained in terms of the transit options available to them. if we look at the distribution of households by their -- this is looking at the share that have no access to cars and do not have transit within a quarter mile of where they live. based on this measure you can see people in their 50s, 60s, 70s by that measure have good access to transit. if they drive or live near transit. by the time you get to your 80s the share of households at that level have some deficiencies in their ability to connect with transportation opportunities. it becomes mucher more limited. particularly in suburban and rural areas. we struggle with how to present this information.

living within the quarter mile of transit isn't a good measure of whether it is useful for you. a quarter mile is a long way if you are walking with a walker. you may have to cross streets that don't have good crossings, good sidewalks. when you get to the transit can you get into the station? does the transit take you where you want to go? there aren't good measures of how much transit serves the needs of people who have issues with mobility. the other issues in terms of having a car, even a question of whether or not you actually have broad use of the car. as people's vision is diminished and reflexes and confidence are diminished very tlr survey that is say i don't f you missed out on activities because it was late, it was raining. there are ways in which the access to cars helps with people's ability to connect with transit. as much as we struggle to capture it, there is no

question as people age, particularly into their 80s they become more ice isolated in suburban and rural communities in particular. to enhance connectivity, certainly one way is through services that can help people being tied to their communities. senior centers provide activities for engaging with the community. agencies on aging are an important resource for a host of services including meal delivery, home care, adult day care. there is a whole service infrastructure that needs to be there. both once people get into the community so they have places to gather and interact with people and also to deliver services to them in their home. part of it is a service system that needs to help plug the gap. beyond that, there is also a need to encourage broader housing options.

people need to have options within the communities close to centers, close to transit. it may mean more multi family housing in places that were averse to that. more dwelling units. allowing for other forms of cohousing, other groups living together that may not be allowed by zoning. we have to think about the communities that may not have had diverse options that there bye-bye a growing need for them. obviously improving transportation options. as i mentioned there are ways in which the mass transit system can have it accessible to people. there is a range of taxi discounts and other options for making more transportation options that will take people from point to point they need on an affordable basis. certainly need to think about

making street crossings safer. all of these things that are helpful to make sure even if the destinations are within reach they can be safely traversed. put these things together. we are talking about making an age friendly community. that means it's not just for older households. it could work as well for young families and young people as for older people. having a better transportation. they are needed for healthier communities overall. finally in terms of linking housing and long-term supports and services, as i point out at the beginning, the incidence of disability rises sharply with age. many people will be wrestling with the need to have long term

services and supports to maintain residents in their homes and communities. that's important because folks clearly express a preference for that. because of the importance of the social networks and connections. it's also important because maintaining residence in your home saves society a lot of money from delaying institutionalization before it is needed. we do look. this chart shows the living arrangements of households or a population with disabilities by age. the slice that's pulled out is a share living in group quarters which is an institutional setting not in the community. you can see that share is low. it's 5% of those under age of 80. it rises to 13% of those 80 and over. still the majority of people with disabilities are living in the community. this is a trend that's been increasing over time. the nursing home population has been declining. there's been more options like assisted living. more ways of providing support in the home.

it's all been for the good. one way in which people are able to get -- probably the most important way people are able to get support in the home is from family members. either spouses or children. two-thirds of people getting long term care in the home are getting it from family members. that's an important means of keeping people in their homes. only 9% get care from nonfamily sources solely. one of the issues we are facing as a society are demographic shifts. they will make that source of support more challenging. baby boomers got married later, had fewer kids. smaller families. if you look at the share of people by age who have -- who do not have children, people in their 50s, 16% do not have children compared to 6% of those in their early 70s. for those that generation is now approaching the older age, there will be fewer family caregivers to rely on. i think aarp has an estimate

that as of today there is a ratio of seven family potential caregivers for every person 80 and over. by 2030 that will be 4-1. by 2050 down to 3 oh to it would put more pressure on other sources of care. this estimates the cost of providing weekly assistance of different types. from adult daycare to a homemaker service, home health aid and both are assumed at 30 hours a week for a month. the monthly cost is $1400 to

$2500. assisted living is $3500 and nursing home care is about $6500. across that gradation, the costs go quite high. going back to the homeowner issue, in terms of home owners, we look at their wealth. how long can they support themselves drawing down the health in each of the situations some it can go on for years. given the wealth of about $6,000. they can last about four months, but with the other issues, they don't have the resources to more than a month or two. while we have these growing options, the cost is high and while some people have the wherewithal to support it, many don't. they spent time thinking about how we support them.

briefly to expand affordable housing, there processes to revamp that and make it more productive and switching to long-term rental assistance and looking to the development cost. there is some hope that might help and it's partly passing the buck to other development funding. the source of that which itself has been mentioned for cut backs and also relied on for hosting a range of rental housing. we really need to think about given the faaccount that we haven't had a lot of that. >> there were a lot of models taking assistance and we do have

to take advantage with the developments of older households and help to support the models. final leeways to look to enhance the reinterview back into the community. if you were institutionalized and coming back out and whether it's accessible or not. whether you were able to secure that unit and it's successful, and money follows the person that may be used for this person. how do i facilitate private housing as well. that's kind of a run of the issues. the joint centers often go for

the centers for gloom and doom. it was about how awful the situation is and makes you want to send me this. it does report to a number ofless proing approaches. the other issue that i think we had to take comfort in is that while we are wrestling with serious issues today growing more profound overtime. we do have time to prepare and build more of a housing infrastructure and build more of an infrastructure for the serfs needed. we have models that we can use. we have to start now. with the introduction, it will require efforts at all levels of government and expand funding

for this. they bring together different funding streams. in terms of the advocacy role. that's a tremendous opportunity here. i think one of the issues breaking through the consumer. when they market the products for the accessibility they find a more willing clientele. it will come back to the individual. taking steps to recognize the important of what the communities have to do to be supportive of those steps. the rubber meets the road at the community level where the housing options have to be expanded and where the service has to be expanded and see better transportation. there is a lot of pressure on

the emotion as well. this is not an isolated problem, but a problem that faces most communities across the country. you look at the power point. this is a map showing counties and a share of the population in 1990. the red areas are difficulties and places in florida or places in arizona and places in the midwest. population over 50 is less than 25%. if we fast forward over 20 years, the red areas are growing and certainly florida still has the areas, but they are all across the north and in appalachia and the northeast.

communities across the countries have to face. we hope we raised awareness and pointed to solutions and can help the process to get ready for what has happened over the country over the next ten years. thank you very much. >> what do you think of that? the conversation is under way, here are a couple of comments and rights. they came back from the august-september break. it's time to put them on status and wages and benefits. royce responds, the military works like this. we stay on the task at hand. no leave and stop gap when the mission requires it.

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children. he fought for $5 billion in cuts to education made by his insider buddies. ob on the is proposing getting tests to 4-year-olds. heard enough? wendy davis will reduce the number of tests our kids take across the board and cut waist and davis will use education to build an economy for all hardworking texans. you decide who will be best for texas. >> this is the first time in 14 years that texas will elect a new governor. texas gubernatorial candidates, senator wendy davis and republican attorney general greg abbott face off in a debate tonight. you can see it at 10:00 eastern on c-span. >> the student video cam competition is under way open to middle to high school s