As most Americans are aware, our country is fighting an opioid epidemic that claims thousands of people’s lives a year. What may surprise you is that sometimes, grandma and grandpa are the ones selling drugs in your neighborhood. I imagine some readers are saying, it’s not possible that “grandparents” are the drug dealers on the streets of America! Unfortunately, due to a variety of unfortunate circumstances relating to economics and vulnerability, some seniors, have resorted to selling drugs.
Maybe more than any other population group, seniors have relatively easy access to prescription drugs. Obviously, older Americans more so than younger people, because of their physical condition, are more regular candidates for potent prescription medication. For example, according to the American College of Preventive Medicine, elderly people make up 13 percent of the American population but receive one-third of all prescribed medications. Considering how accessible prescriptions drugs are for seniors, older persons are in a unique position to turn around and sell their medication. However, according to Sharon Walsh, director of the University of Kentucky Center for Drug and Alcohol Research, seniors are not dealing drugs in the traditional sense, but rather selling these pills to a network of family and friends.
So, what’s going on with seniors that make them more likely to sell their drugs? First countless seniors live on a fixed-income in addition to being riddled by poverty. Keep in mind this money has to be stretched every month for basic expenses like housing, health care, nutrition and transportation. Imagine only having $1,000 a month to live on. Unfortunately this helps to explain why seniors supplement their income through illegal streams. Luzerne County, Pennsylvania, County Drug and Alcohol Director Steve Ross issued a report stating, “Our seniors are in a very volatile state right now because what we’re learning is that there are a number of seniors out there who are selling the prescription painkiller to pay for their other medications and/or for food.”
Furthermore, seniors have fallen prey to younger, more sophisticated drug dealers who purposefully target the elderly. Because of their easy access to prescriptions, drug dealers promise seniors money in exchange for their medication, which the drug dealers will later sell for large profits. According to a report by the Ohio Substance Abuse Monitoring Network, “Reportedly, dealers stand outside of drugstores and approach seniors about selling their prescriptions, or dealers will convince a senior to go to the doctor and fake pain to get a prescription.” The report goes on to state, “If the senior agrees, the dealer will drive the senior to the doctor and to the pharmacy to fill the prescription and will then pay them.” “That's the only way they (seniors) can make ends meet.”
With seniors turning to selling drugs to pay for their basic necessities, are grandma and grandpa going to jail? While, elderly Americans are being arrested for their unfortunate role in the opioid crisis, prosecutions are uncommon, and when prosecuted sentencing is light. Captain Jeff Orr, president of the Ohio Task Force Commanders Association said in reference to older drug dealers, “If we get information about sellers, we are following up on it. Are they going to prison for it? No. They are being diverted to probation at that age.”
While it’s comforting to learn that our grandparents aren’t doing hard time, the mere thought of them being arrested and thrown in the back of a police car should make people pause.
So what is being done to combat the opioid epidemic in our country? While the White House and Congress have taken steps to combat the opioid crisis, I think our elected leaders in Washington, D.C. would be better served if they more thoroughly investigated the root causes of why people sell drugs. Specifically, as it relates to this issue, why seniors need to sell drugs to earn enough money for their basic necessities. Clearly many older Americans are financially strapped. Consequently, the policies which the administration and some members of Congress have endorsed, such as cutting financial resources for health care and affordable housing programs that benefit seniors, could make elderly people more impoverished and more susceptible to selling medications.
Common sense dictates if we want to get seniors to stop selling their medications then we should enact laws that provide them with the financial security they need, so they are not tempted to sell drugs to pay for their rent, health care or food.
Evan Carmen, Esq. is the Assistant Director for Aging Policy at the B’nai B’rith International Center for Senior Services. He holds a B.A. from American University in political science and a J.D. from New York Law School. Prior to joining B’nai B’rith International he worked in the Office of Presidential Correspondence for the Obama White House, practiced as an attorney at Covington and Burling, LLP, worked as an aide for New York City Council Member Tony Avella and interned for Congressman Gary Ackerman’s office. Click here to read more from Evan Carmen.
It has been a busy 2017 at the Center for Senior Services (CSS), and we are pleased to report on our advocacy efforts. Throughout the year we have been advocating on a wide range of senior issues relating to health care (Medicare and Medicaid), Social Security and affordable housing. Our work included meetings on Capitol Hill, organizing tours of B’nai B’rith sponsored buildings and co-sponsoring rallies on affordable housing. During the year we were excited that our work was noted by the Jewish Telegraph Agency (JTA), The Times of Israel and the New York Jewish Week.
Our advocacy efforts went into high gear in March when the White House’s proposed 2018 “skinny” budget was released, which called for a 13 percent reduction in the Department of Housing and Urban Development’s budget. A few months later when the administration’s more detailed budget was announced, B’nai B’rith was severely disappointed that Section 202, which is housing that was developed for low-income seniors, was underfunded and the White House proposed a rental increase for residents.
Staying on top of the issue, the CSS team started visiting senator and representative’s offices on Capitol Hill that represent B’nai B’rith sponsored buildings. Specifically, we met with offices that work on the House and Senate Appropriations Subcommittees on Transportation, Housing and Urban Development. These committees are responsible for writing legislation that funds rental subsidies for the Section 202 program. During the course of these meeting we explained to staff members how damaging the White House’s budget would be for low-income Section 202 residents. While the 2018 budget has not been finalized we are hopeful that our advocacy efforts on Capitol Hill will lead to the Section 202 program being funded more.
In addition, we followed up those visits by inviting members of Congress and their staff to tour B’nai B’rith Section 202 buildings throughout the country. We are pleased to report that Reps. Jamie Raskin (D-Md.), Matt Cartwright (D-Pa.), Grace Meng (D-N.Y.) and Charlie Dent (R-Pa.), representing both political parties, toured our sponsored properties. Furthermore, three of the four members who visited B’nai B’rith sponsored buildings work on the Appropriations Committees. These tours were a fantastic opportunity for members of Congress to see the benefits of the Section 202 program, and gave residents a chance to speak with their elected representative. Residents were able to directly tell their member of Congress the vital role Section 202 housing plays in their lives.
B’nai B’rith was also pleased to co-host with LeadingAge the “Save HUD 202” Rally and partner with the National Low Income Housing Coalition for the “National Housing Day of Action” over the summer. These rallies took place on Capitol Hill and featured representatives and senators who spoke about the need for affordable housing. We were certainly delighted members of Congress who represent B’nai B’rith sponsored buildings attended the event.
Our advocacy during the course of the year didn’t just stop with affordable housing. We spoke out against the White House and Congress’ attempts to repeal and replace the Affordable Care Act (ACA). After analyzing various proposed bills, B’nai B’rith was very concerned how these policies could negatively impact seniors. For example, many of the proposed replacement bills would have cut critical funding to Medicaid, allowed older Americans to be charged more for insurance, repealed vital taxes that help fund Medicare and waive important regulations that protect health care consumers. We spoke out on these issues by releasing press releases, blogs and joined with liked minded organizations opposing this legislation in a full page advertisement in Politico.
Recently, B’nai B’rith has been very vocal against the recently passed tax reform legislation. We expressed serious reservations about this bill because of the damaging impact it could have on funding for Medicare and Medicaid attributable to rising deficits that will give cover to members of Congress to slash spending. In addition, the negative consequences repealing the ACA’s individual mandate will have on older Americans. We brought our concerns straight to congressional offices during our regular scheduled Capitol Hill visits regarding Section 202. However, we certainly applaud Congress for not eliminating the Low Income Housing Tax Credit which is critical for affordable housing construction, and the medical expense deduction which is incredibly important to countless seniors with high health care costs.
The CSS team embarks on 2018 looking to continue our success from 2017. We will certainly look to invite more members of Congress and their staff to B’nai B’rith sponsored buildings, and advocate for the Section 202 program and other policies that are vital to seniors.
B’nai B’rith International Senior Services Staff: Mark Olshan, associate executive vice president of B’nai Brith International and director of the B’nai B’rith International Center for Senior Services; Janel Doughten, associate director of the B’nai B’rith International Center for Senior Services; Breana Clark, senior program associate; Evan Carmen, assistant director for Aging Policy.
This piece originally appeared in B'nai B'rith Magazine's Winter 2017 issue. To read this and other stories from the issue, visit our magazine online here.
I’ve always thought of myself as a caring person, considerate of others and always thinking that we have a duty to be part of a society in which we respect and help one another where and when we can. Call me a do-gooder if you will, but please know that I am proud to wear that label.
With Congress back in session, I continue to be baffled by its continued attempt to turn back the clock in the face of such overwhelming evidence of the number of aging Americans who require assistance with finding a safe, secure place to live.
The United States used to have a national housing policy focusing in part on creating affordable housing for older persons of limited means. Section 202 of the Housing Act of 1959 was the only federal program that provided safe, affordable housing exclusively for low-income elderly.
The program was envisioned as a partnership between government and community-based nonprofits like B’nai B’rith to supply housing to these individuals. The government would supply the financial means to build the property, while the nonprofits would oversee the initial development and ongoing operations. Subsidies, such as Section 8 vouchers, would bridge the gap between what the tenant could afford and the cost of that apartment.
Over time, the funding mechanism for the program changed from a direct loan, with interest payments to the federal government, to a simple advance of funds for construction.
Since 1971, B’nai B’rith has been a partner with the U.S. Department of Housing and Urban Development (HUD) in constructing and overseeing such properties. With 38 properties in 26 communities nationwide, we are the largest national Jewish sponsor of HUD-assisted senior housing. Our network comprises nearly 5,000 apartments available to more than 8,000 seniors.
In the 1960s and 1970s, the eligibility criteria were slightly refined. During the 1980s, “cost-containment” became the focus, and there was a shift to reducing the number of units being built and the overall construction cost. While budget driven, many of these decisions had an opposite effect. Having to replace and maintain systems cost more in the long term.
During the mid 1990s the program began to recognize and incorporate the physical and emotional needs of the residents, and the use of service coordinators become more prevalent.
With the aid of these professionals, residents were better able to obtain the support and services they might need to make aging-in-place more possible. HUD finally understood that providing some level of service support within the property often precluded a premature move to a more institutional setting for a resident, at a tremendous overall cost savings to society in general.
Even the definition of a well “independent” senior had changed. As these properties were basically apartments without medical or basic service supports when the program was initiated, one of the criteria for admittance into a HUD-assisted property was the ability to vacate your apartment in the event of an emergency. Today, residents are able to remain as long as they can direct the service supports around them to assist in vacating their apartment in the case of an emergency. Yet, today, nearly 40 percent of residents are considered frail and require assistance with some of the basic activities of daily living.
But, remaining in their homes with support beats having to move to a skilled-care or institutional facility many years before actually needing that level of medical support.
So, for a period of time, the program evolved and — despite severe budget cuts during the congressional efforts to reduce overall federal domestic spending — survive. Politicians from both sides of the aisle have taken pride in visiting these properties and publicly marvel at what they say is their tremendous value, not just for the individuals but for the whole community.
So, where do we stand now?
We know the country is growing older. The percentage of persons 65 and up is a larger percentage of the total population, growing from 35 million (12.5 percent) in 2000 to 49.5 million in 2016 (15 percent) to an expected 71.5 million (19.4 percent) by 2030. Compounding the issue is the increase in the number of persons 85 and older — 6.2 million in 2016, projected to grow to 6.9 million by 2020 due to our increased longevity.
But, the senior population’s sustained growth has not been matched by a corresponding growth in affordable housing. Currently, data show that there are at least 10 to 12 people on a waiting list for every available subsidized unit. The funding to create more of these properties has dried up. Currently, there are no federal dollars available to create new housing for this most vulnerable, growing population.
Where we housing advocates need to expand our efforts is to combat proposals currently being introduced in Congress that would charge current residents even more of their very low income to simply stay put. Even worse are attempts to cut subsidies completely, which could effectively throw current residents out of their apartments, and potentially into the street.
Remember, older persons must already have very low-incomes to qualify — below half of the area median income. Once deemed “income eligible,” they must pay 30 percent of their adjusted gross income for rent. If they have no income, they pay no rent. And we have a number of those individuals residing in our senior housing network. Bottom line is that these applicants were either homeless, near homeless, or at best, very low-income individuals.
Congress has recently debated amendments to the Transportation, Housing and Urban Development Appropriations Bill that would reduce these subsidies while increasing tenants’ contributions from 30 to 35 percent of their meager incomes and require them to pay a minimum amount of rent, or lose the apartment entirely.
And, taking this even further, 139 House members voted for an amendment to reduce funds for project-based rental assistance by $266 million in the current fiscal year, thus jeopardizing approximately 3,000 apartments which could be affected by this action. Fortunately the amendment failed, but the threat remains.
The numbers are alarming, and the White House is threatening to make a bad situation worse. The administration’s budget proposals include the most dramatic cuts to HUD programs since the 1980s, gutting federal housing assistance and redirecting the savings to “higher priority areas.” What could be of higher priority than making certain that vulnerable older persons of very low income status have access to safe, affordable and adequate housing?
Mark D. Olshan, Ph.D. began his career with B’nai B’rith in 1983 when he was hired as its Director of Senior Housing. He currently serves as Director of the Center for Senior Services and Associate Executive Vice President of B’nai B’rith International. He was awarded the Julius Bisno Professional Excellence Award in 2000. To view some of his additional content, click here.
By Breana Clark
Achieving greater recognition of the needs of our homeless population has become an undeterred focus of mine. Professionally, I am connected to the residents who call B’nai B’rith sponsored, low-income senior housing home, and through volunteering with a local United Methodist Church, I help address local homelessness in the District of Columbia. Through these organizations, I have witnessed a devastating national trend: the apparent aging of our nation’s homeless population.
On the surface, the current proportion of homeless individuals who are seniors represents a failure of our society to take care of our oldest citizens. Though, it is also an expensive problem to ignore. An older person who has not yet reached “retirement age” (those ages 50-64) represents a group which frequently falls between safety nets that are age based. Programs that are meant to intercept the part of our population that, generally speaking, are cycling off the workforce are generally reserved for those who have reached the magical age of 65 (or 62 for subsidized senior housing). Thus, many folks who have lost jobs, lost income or who do not have enough savings, find themselves stuck between the gap, and enter their “senior years” having expensive untreated conditions and deteriorating health.
It should come at no surprise that navigating the conditions of living on the street or experiencing insecure housing (this includes nighttime shelters, a couch at a friend or relative’s home, or frequent relocation because of unreliable conditions) exacerbates physical and/or mental health conditions, poor nutrition and untreated chronic illness. It’s imperative to point this out, as we see that health care needs by those aged 50-64 who lack housing are awfully similar to housed individuals 65 and older. Premature aging and shortened life expectancies are inevitable when one lacks the basic of human necessities in order to survive.
Simply put, seniors have the steepest housing challenge. This should come at no surprise if we look at increasing poverty amongst retirees as well as the decreasing availability of affordable housing. In fact, more than four million people above the age of 65 live in poverty, according to the U.S. Department of Health and Human Services. Of those individuals, only 1.6 million receive rental subsidies from the United States Department of Housing and Urban Development (HUD).
About 10,000 people turn 65 every day in U.S. Based on demographics alone, Justice in Aging, a national nonprofit legal advocacy organization that fights senior poverty, estimates that this will result in nearly 93,000 homeless seniors, doubling the 44,000 in 2010. This number becomes even more significant when economic factors are taken into consideration. While many may hold a stereotyped version of who is included among our homeless and home insecure, it’s important to remember a myriad of economic occurrences that have proven to be especially burdensome in the last decade: the Great Recession, mortgage debt accumulation following the housing crisis, wage stagnation, skyrocketing underemployment, the rising cost of medication and goods and the increasing lack of affordable housing.
Furthermore, in light of recent natural disasters having required evacuation, hunkering down and taking shelter, we have witnessed how quickly circumstances can change for someone depending on their very meager earnings or assets to survive. The recent tragedy of several seniors dying at a Florida nursing home that found itself in the wake of Hurricane Irma illustrates a true reminder that we need to be able to provide safe, quality care and housing for seniors regardless of whether they can live independently or not.
In my capacity as a volunteer, with a mission to serve our homeless in Washington, D.C., I’ve learned a lot about the unique needs of those in our community who lack housing. What has become obvious is the need to address the significant number of folks who have reached their older years but lack housing, health care and an income that can support their basic needs. We are living in a time where our lack of commitment to seniors’ well being, as they age, is not just appalling; the circumstances are dire. Every day, seniors die from a lack of resources in a country that saw economic, social and political progress as a result of their contributions.
If Congress and the current administration want a society that is great, it has to start simple: we must prioritize health and housing for ourselves and our neighbors as we age. We must strive for a society that does not allow housing insecurity and plummeting health to be inevitable part of aging into poverty. We must commit to taking care of the oldest among us.
By Evan Carmen
Our country’s public housing program was first created in 1937 during the Great Depression with a goal of providing affordable housing to low-income individuals and families. The federal government continued to pass major legislation through the 1970s that increased the number of buildings created expressly for affordable housing. For example, in the 1960s and 1970s the federal government increased the number of buildings available for low-income seniors primarily through the Section 236 and Section 202 programs. Because the Section 202 program was created specifically for seniors, amenities and services came with the building that addressed the specific needs of the elderly. Unfortunately, since the 1980s affordable housing has exhibited a steady decline. Consequently, because of the political environment, the Low Income Housing Tax Credit (LIHTC) which was originally created with bipartisan support under the Tax Reform Act of 1986, has emerged as the best way to create and preserve affordable housing.
The LIHTC is administered by the Internal Review Service (IRS), which awards federal tax credits to the private sector to encourage investments in affordable housing. Ideally the federal government would reinstitute policies like the Section 202 capital advance program for the creation of affordable housing; however the LIHTC has been able to pick up some of the slack by creating additional low-income buildings. To further the point, the LIHTC helps finance about 90 percent of all affordable housing in the United States, and has helped fund the creation of about 3 million apartments since its inception.
The B’nai B’rith Housing Network is beginning to greatly benefit from the LIHTC by using this government program to benefit low-income senior residents. In St. Louis, Covenant Place Apartments used the LIHTC as a financing mechanism behind the rehabilitation of the property. Initial projections had the project costing about $84 million, with the LIHTC funding about $29 million or 35 percent of the initial cost estimate. When the project is completed it will offer 355 affordable apartments and a host of amenities. Joan Denison, executive director of Covenant Place said, “The LIHTC program made it possible for Covenant Place to embark on the redevelopment of its three aging and functionally obsolete buildings. Without the LIHTC funds, the cost of development would have been out of reach. Today, we have the new Covenant Place I, Harry & Jeanette Weinberg Building, providing 101 energy efficient, accessible one bedroom apartments, in which the residents say they feel healthier and happier. With a rapidly growing senior population that continues to live longer, there is a critical need for affordable, supportive and accessible housing. The LIHTC program is essential to the future of affordable housing.”
In Massachusetts, The Coolidge at Sudbury Apartments used the LIHTC to finance the construction of 64 units. Like Covenant Place in St. Louis, Sudbury Apartments used the LIHTC as a major financial driver to fund the cost of the project. For example, the total development cost of the project was about $16 million and the LIHTC contributed about $10 million of the financing.
Given the importance of the LIHTC in the affordable housing community, what is the outlook for the continued success of the program? Recently, the Trump administration released its initial tax reform policy. While the initial proposal does not address the LIHTC, the mere threat of tax reform has caused these tax credits to lose their value because they are tied to the corporate tax rate. Under President Trump’s proposal, the corporate tax rate would be reduced from 35 percent to 15 percent, causing potential LIHTC investors to have less tax liability. A decrease in investor’s tax liability lessens their desire to purchase the LIHTC. According to Todd Crow of The Affordable Housing Tax Credit Coalition (TAHTCC), the value of the tax credit has dropped from $1.00 per credit to as low as $0.85 per credit. While the fate of Trump’s tax reform proposal remains unclear, anxiety about the future of tax policy has caused the private sector to re-evaluate future construction projects.
Fortunately, all is not lost for the LIHTC! The good news is that The Affordable Housing Credit Improvement Act has been introduced in both houses of Congress to strengthen the LIHTC, and has received bi-partisan support. While both versions of legislation are similar, the biggest difference between the two bills is that only the Senate’s version expands the housing credit. The Senate’s legislation expands the housing credit by 50 percent, for the purpose of creating or preserving about 1.3 million affordable homes. However, both bills have provisions to make recapitalization of properties easier and establish a 4 percent minimum Housing Credit rate for finance acquisitions and Housing Bond-financed developments. If this legislation becomes law, it would inject a much needed jolt in the arm of the affordable housing community, which needed assistance even before the prospects of Trump’s tax reform proposals. The United States has a housing crises and the LIHTC is one tool to improve the issue.
Sen. Maria Cantwell (D-WA) said, “The affordable housing crisis is exploding all across the country. We are facing pressures from all sides: demand for rental housing has increased by 21 percent, but we are building units at the lower rate since the 1970s. If we do not act to increase the Low-Income Housing Tax Credit—our best way to build affordable homes—by 2025 over 15 million Americans could be spending half their income on rent. This is unacceptable.”
Based on the current environment, the United States federal government is still best suited to offer solutions to our country’s housing crises. According to Harvard University’s Joint Center for Housing Studies, without the LIHTC, “construction costs would have to be reduced by 72 percent of the current construction cost average” to see the development of new housing. Without the LIHTC, how is the private sector supposed to absorb the additional construction costs, and still provide affordable low-income housing?
Sen. Orrin Hatch (R-Utah), Ron Wyden (D-Ore.), Chuck Schumer (D-N.Y.), Brian Schatz (D-Hawaii), Patrick Leahy (D-Vt.), Dean Heller (R-Nev.), Jeff Merkley (D-Ore.), Cory Booker (D-N.J.), Lisa Murkowski (R-Alaska), Todd Young (R-Ind.), Susan Collins (R-Maine) Michael Bennet (D-Colo.), and Cantwell deserve credit for being original cosponsors of the Senate’s version of the legislation, and more members of Congress should come out in support of a policy that looks to increase affordable housing. Members of Congress need to act now, because according to The Affordable Housing Tax Credit Coalition 5.1 million senior households now use more than half their income on housing, and in 2030 the number of seniors is predicted to double.
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