Since I started my job at B’nai B’rith International, I have written several blogs being critical of the Trump Administration and Congress’ proposals to cut funding from affordable housing. Over the past twenty months, there have not been many opportunities to applaud our elected representatives in Washington, D.C. for bi-partisan legislation that looks to tackle the severe shortage of reasonably priced homes in this country. Consequently, the recently introduced bipartisan Senate legislation, called the Task Force on the Impact of the Affordable Housing Crisis Act, should be positively recognized. The purpose of this task force is to study how affordable housing financially impacts other government programs (federal, state and local), different facets of people’s lives (i.e. health, nutrition, education, employment, etc.) and make policy recommendations to Congress on how affordable housing can strengthen additional federal programs.   
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Working at B’nai B’rith offers me the unique opportunity to see how housing is intertwined with other areas of senior’s lives, especially health care. One of the goals of B’nai B’rith is to “age in place” which we accomplish through our sponsored Department of Housing and Urban Development (HUD) Section 202 housing. Older Americans are able to “age in place” because service coordinators connect residents with community based services, which have demonstrated a greater likelihood of retaining residents in their existing buildings and therefore avoiding more pricey institutions like a nursing home.

The benefits of the Section 202 program go to the very heart of what this potential task force is hoping to accomplish, that is, to find ways affordable housing can help other federal programs. For example, the financial cost of three seniors in a Section 202 building with home and community-based services is about the same as one person in a nursing home. Keep in mind that Medicaid is a key subsidizer of nursing homes. According to HUD, 38 percent of Section 202 tenants are frail or near-frail, and consequently need help with daily activities, making them potential candidates for long-term institutional care. Therefore, the more Section 202 buildings that can be developed for frail or near-frail seniors, the less financial resources Medicaid will require for nursing homes.
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In addition, bi-partisan policy solutions generally have a better chance of becoming law, especially in the Senate. This legislation was introduced by U.S. Sens. Todd Young (R-Ind.), Maria Cantwell (D-Wash.) and Angus King (I-Maine), along with cosponsors from both political parties. Furthermore, the people who serve on the Task Force will be appointed by both Democrats and Republicans. These Senators should be commended for taking an important “first step” toward discovering how integral affordable housing is to other federal programs. 
 
Obviously, the introduction of this legislation is a far cry away from being sent to the president’s desk for his signature, and even further away from any policy recommendations from the task force to Congress. However, you have to walk before you can run. Hopefully, this legislation becomes a reality, and the policy proposals are Congress’ full sprint towards creating additional affordable housing in the country. 

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.
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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.

We are delighted to report that Rep. Cheri Bustos (D-Ill.) recently visited B’nai B’rith Covenant Apartments in Peoria, Illinois. This visit was a great opportunity for the Congresswoman to learn about the Section 202 program and see firsthand how seniors benefit from affordable housing. B’nai B’rith’s long history with Section 202 housing started in 1971 when we formed a partnership with Department of Housing and Urban Development (HUD) to sponsor housing for low-income seniors. The B’nai B’rith Senior Housing Network in the United States comprises 38 buildings and serves more than 8,000 people. B’nai B’rith International is the largest national Jewish sponsor of low-income housing for seniors in the country.

B’nai B’rith Covenant Apartments, like many of our sponsored buildings, are more than just apartment units. It is a residential community where seniors can age in place. The Congresswoman learned about the wonderful amenities the building offers such as low cost meals, salon, gift shop, grocery store, community rooms and libraries.

After taking a tour of the property, the Congresswoman gave remarks, took questions from residents and shared her positions on important topics that touch their everyday lives, such as Social Security, Medicare, rental subsidies and nutrition assistance. In addition, Bustos offered to help the residents with getting federal benefits from agencies like the Social Security Administration and the Department of Veterans Affairs.

Bustos said, “I had a great discussion with the seniors of B'nai B'rith Covenant Apartments today about all of the issues affecting them and their families. Our seniors worked hard all of their lives and they deserve to retire with dignity, and that includes providing them with affordable housing options through the Section 202 program. I believe that all seniors should be able to retire with peace of mind which is why I'm fighting hard to protect the Social Security, Medicaid and Medicare benefits they've earned.”

We thank Bustos for all her hard work to protect critical programs for seniors that enable them to retire with dignity. Too often Congress and the White House are debating policies that will inevitably cut important funding from federal programs that impact the lives of ordinary older Americans. Congressional visits like this allow B’nai B’rith residents the opportunity to be their own best advocate by speaking directly with the representative and making them aware of the human faces and stories behind federal programs that benefit seniors.
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It was great that Bustos’ visit kicked off our 2018 congressional outreach efforts. We are thankful we were able to show off B’nai B’rith Covenant Apartments and most importantly all the great residents who call the building home. 

​​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.
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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. 

The House of Representatives in Congress recently introduced legislation called the “Tax Cut and Jobs Act,” which makes drastic changes to our country’s tax code. Unfortunately, some of the proposed changes might have a negative impact on the Low Income Housing Tax Credit (LIHTC). The LIHTC is an affordable housing program administered by the Internal Revenue Service that awards tax credits to the private sector to spur construction that benefits low-income individuals. The LIHTC is responsible for around 90 percent of all current affordable housing construction in the United States, and has help create around 3 million apartments since it was established. 

In particular, the LIHTC has benefited seniors in the B’nai B’rith Housing Network in St. Louis at Convent Place Apartments, and in Massachusetts at the Coolidge at Sudbury Apartments. The U.S. has an affordable housing shortage, particularly amongst seniors. It is predicted that by 2025, 12.2 million seniors will spend more than half of their incomes on housing.

While the tax reform legislation has no direct changes to the existing LIHTC, the other proposed changes could have unfortunate indirect consequences for affordable housing. First, the legislation lowers the corporate tax rate from 35 percent to 20 percent which means that corporations will have less incentive to purchase the tax credits. After the 2016 presidential election, the mere threat of tax reform caused the value of the LIHTC to go down.  Tax reform that brings the corporate tax rate down to 20 percent without other modifications could be problematic for the tax credit.
 
Secondly, the tax reform proposal could threaten affordable housing by eliminating the use of private activity bonds that utilize the four percent credits from the LIHTC. Private activity bonds help finance around half of all LIHTC construction, therefore eliminating these bonds will have very serious consequences on the creation of new affordable housing, and the rehabilitation of existing stock.  

Tax reform legislation should be viewed as a golden opportunity to strengthen the LIHTC, and it’s a shame that the current proposal does not accomplish that goal. For instance, the House’s bill could include parts of LIHTC legislation in the House and Senate that would fortify this affordable housing program. In addition, both these affordable housing bills have broad bi-partisan support in the House and Senate, which only increases their likelihood of passage if included as part of the greater tax reform effort.  

The LIHTC is critically important to making sure that older Americans have a place to call home, and the tax reform legislation should not include proposals that could potentially make affordable housing for seniors more difficult to come by.   
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Medicare is our national health insurance program for individuals 65 and older and permanently disabled people under the age of 65. Created in 1965, Medicare has made health care for seniors significantly more affordable and given elderly people peace of mind regarding their medical expenses. Medicare can be broken up into Medicare Part A (hospital insurance, skilled nursing, home health services and hospice care) Part B (doctor’s visits, lab tests, surgeries, wheelchairs and walkers), Part C (private health insurance plans) and Part D (prescription drug coverage). Given how vital Medicare is for seniors, it’s important to analyze how legislative proposals in Congress can impact the health care program’s long-term financial viability.

Throughout the year, Congress has spent time trying to repeal and replace the Affordable Care Act (ACA) through various health care proposals. One of the proposals, the American Health Care Act (AHCA), would have dissolved the .9 percent  Hospital Insurance trust fund payroll tax. This tax is directly responsible for helping fund the Medicare Part A Trust Fund. Recently, the Medicare Board of Trustees reported that Medicare Part A will be able to pay 100 percent of its obligations until 2029. However, had the ACHA become law, revenue for Part A would have been reduced by $59 billion, and caused the trust fund to be less solvent. 

When members of the House of Representatives voted for the AHCA, I often wonder how they could explain voting for a health care bill which makes Medicare more insolvent. Members of Congress are always talking about Medicare’s fiscal future, well, cutting off the program’s funding is a sure fire why to guarantee insolvency.
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Furthermore, Congress’ attempts to repeal and replace the ACA, whether through the AHCA or the Graham-Cassidy bill, would have been severely damaging for older Americans (55 to 64).  Some older adults could have found their private health insurance to be cost prohibitive. The Congressional Budget Office (CBO) estimated that older Americans would have suffered greatly if the AHCA became law. For example, a 64-year-old making $26,500 a year would have seen an increase in premiums by an astronomical $14,400 in 2026. Furthermore, a 60-year-old earning $40,000 would receive a tax credit under the AHCA of $4,000 compared to $6,750 under the ACA to purchase insurance.  

In addition, the recent proposals in Congress would have eliminated Medicaid expansion (ACA allows states to increase eligibility for people under 65 who were at or below 138 percent of the federal poverty line) which could have left low-income older Americans without viable health care. Evidence demonstrates that Medicare eligible seniors with prior health insurance as older adults require less expensive health care than people who were uninsured before they enrolled in Medicare. Whether it’s the ACHA or Graham-Cassidy, had these bills become law, Medicare spending across the board (Part A, B, C and D), could have seen an unnecessary spike.
 
A study published by the New England Journal of Medicine, entitled “Use of Health Services by Previously Uninsured Medicare Beneficiaries” found that uninsured persons between the ages of 50 to 64, were more likely to experience worsening health and die younger compared to persons of the same age who were otherwise uninsured. Consequently, once the uninsured population became Medicare eligible they required more expensive health care. The study found that the costlier care resulted from 23.4 percent doctor visits and 37 percent hospitalizations. In conclusion, the study stated, “These findings support the hypothesis that previously uninsured adults used health services more intensively and required costlier care as Medicare beneficiaries than they would have if previously insured.”   

To further the point, the United States Government Accountability Office published a similar study that examined the impact of having continuous health insurance prior to joining Medicare entitled, “Continuous Insurance before Enrollment Associated with Better Health and Lower Program Spending.” This report found that people with continuous health insurance coverage for about six years prior to being Medicare eligible were more likely to be healthier for their first six years on Medicare as compared to their insured counterparts. Financially during the first year on Medicare, people with prior continuous coverage had about $2,300, or 35 percent less in predicted spending than the previously uninsured population. 

Overall, Medicare helps 57 million people in America gain access to health care, with half of its recipients having incomes of less than $24,150 a year. Recent health care proposals would have purposefully defunded Medicare and made health care less accessible for the majority of older Americans. 
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While reasonable people can disagree on health care fixes to the ACA, I hope Congress does not champion policies that put Medicare’s long term financial future into question.  

​​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.

We were very pleased to welcome Rep. Charlie Dent (R-Pa.) recently to B’nai B’rith Apartments in Allentown, Pa. Dent has been an influential member of Congress since January 2005, and presently serves on the House Appropriations Subcommittee on Transportation, Housing and Urban Development. This committee is responsible for appropriating money for the Section 202 Department of Housing and Urban Development (HUD) housing program. B’nai B’rith is a proud sponsor of Section 202 HUD housing, was excited to show Dent all the great residents, staff and amenities in the building.

B’nai B’rith’s long history with Section 202 housing started in 1971 when we formed a partnership with HUD to sponsor housing for low-income seniors. The B’nai B’rith Senior Housing Network in the United States comprises 38 buildings and serves more than 8,000 people. B’nai B’rith International is the largest national Jewish sponsor of low-income housing for seniors in the country.

When Dent arrived he was treated to a tour of the building which featured an apartment unit, patio, common area, computer room and arts and crafts room. The tour allowed the representative to see all the building’s wonderful amenities and how Section 202 properties provide a community and family atmosphere for seniors. After the tour Dent spoke with about 90 B’nai B’rith residents regarding Section 202 rental subsidies, social security and health care. This Q-and-A allowed residents to directly tell the congressman how these federal programs affect their daily lives and for the congressman to share his perspective on important issues that impact seniors.   

After the event Dent said, "I truly appreciate the great work B'nai B'rith has been doing here in Allentown, Pa. for decades. B'nai B'rith provides affordable housing options to many seniors they very much like it here so we are blessed to have this organization in the community. And we want to continue to support organizations like B'nai B'rith and other who providing affordable housing in 202 for so many seniors and elders across the country."

In attendance from the B’nai B’rith Housing community were B’nai B’rith International Associate Director of the Center for Senior Services Janel Doughten; B’nai B’rith Assistant Director for Aging Policy Evan Carmen; B’nai B’rith Senior Program Associate Breana Clark; as well as B’nai B’rith Apartments staff including Board President Barbra Butz; Project Administrator Bob Sipos; Property Management Assistant Kathy Andreas Heath; Service Coordinator Jennifer Leffler; Rental Assistant Jessica Yaich and Recertification Specialist Beth Gonzalez.
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During the past few months we are happy to report that Reps. Jamie Raskin (D-Md.), Matt Cartwright (D-Pa.) and Grace Meng (D-N.Y.) have visited B’nai B’rith sponsored buildings in their districts. These congressional visits have given representatives firsthand exposure to the critical importance Section 202 buildings play in the lives of low-income seniors. Hopefully members of Congress leave Section 202 buildings with the understanding that they are not just a pile of bricks sitting on concrete—they are buildings that provide a safe and secure community for seniors, and more importantly a place for older Americans to call home. 

Hundreds turned out when B’nai B’rith International, LeadingAge and other organizations co-hosted the Save HUD 202 Rally on Capitol Hill.

The purpose of the rally was to demonstrate how important existing Section 202 buildings are for low-income seniors and to indicate the need for additional funding for affordable housing, specifically for older Americans. B’nai B’rith launched its senior housing program in 1968, and since 1971, in a cooperative partnership with the Department of Housing and Urban Development (HUD), we have made rental apartments available for senior citizens with limited incomes, primarily through the Section 202 programs.

In May, the Trump Administration released its full Fiscal Year 2018 Budget and for the first time, the residents of Section 202 buildings could see reductions in their rental subsidies.

Unfortunately, the Trump Administration is proposing to give the secretary of HUD the authority to increase rental contributions from 30 percent of adjusted income to 35 percent of gross income, and increase minimum rental payments to $50 a month. Increasing the minimum rental payments to $50 a month would impact people who make less than $2,000 a year.  While the administration’s proposed budget has a hardship exemption, I am curious to hear from the Trump Administration as to which low-income seniors who make less than $2,000 don’t qualify for a hardship exemption.

I think all reasonable people can agree, seniors who make less than $2,000 a year don’t need the federal government increasing their rent!      

With Congress ultimately responsible for writing the federal budget, having hundreds of people at the rally on Capitol Hill was a great way for the housing community to express its concern for low-income seniors.  

Also, B’nai B’rith was extremely pleased to see Senators Bob Casey and Robert Menendez and Rep. Al Green at the rally expressing their support for the Section 202 program. These members of Congress represent residents in B’nai B’rith sponsored buildings across the country, and we certainly appreciate their commitment to seniors and affordable housing.  

During the rally Sen. Menendez said, “I am proud to stand with you today and every day to fight to protect and expand affordable housing for seniors.” We certainly urge other members of Congress to support additional funding for senior affordable housing as the need will only increase.
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