By 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.
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.
By Rachel Knopp
On the 13th anniversary of B’nai B’rith’s Resident Leadership Retreat, 28 seniors joined together at Perlman Camp in Lake Como, Pa. with the intent to bring a greater sense of community back to their homes. These representatives came from the 38 low-income senior housing facilities from across the country that B’nai B’rith proudly supports.
As the largest national Jewish sponsor of federally subsidized housing for the elderly in the United States, B’nai B’rith has become a key advocate for low-income seniors on Capitol Hill. However, experiences like the Resident Leadership Retreat remind us that our residents are their own best advocates for their communities.
Janel Doughten, associate director of the B’nai B’rith International Center for Senior Services, reminds us of the importance of our resident leaders. “Unlike staff and the board of directors who go home at the end of the day, our residents call these facilities home at the beginning and end of each day. The goal is to help create a sense of community among the residents.”
The safety, security, and peace of mind that B’nai B’rith buildings have brought to residents lives were frequent topics of discussion between attendees. One resident from the B’nai B’rith building in Tucson, Ariz. said that finding his current building brought him out of homelessness. Many others shared in the sentiment including Bobbie Rudolph, from B’nai B’rith Apartments in Allentown, Pa., “I no longer have to worry about being evicted, due to not being able to pay my rent. The B’nai B’rith and U.S. Department of Housing and Urban Development (HUD) Supporting Housing for the Elderly Program allows seniors to retire and live with dignity.
With this in mind, it becomes clear why the resident leaders are so invested in strengthening their communities. Some representatives are long-standing officers of their building’s Resident Council, while others are self-proclaimed activists who demonstrated leadership by starting a recycling bin, like Liam Flanagan who lives in Covenant House, which is located in Brighton, Mass. Despite the range of displays in leadership, each representative arrived to Camp Perlman with an open mind to learn from one another.
Diane Daria, also from Covenant House, regards her building as providing a “built-in community.” Many of the seniors in B’nai B’rith housing facilities have lived alone for many years, like Daria. Before moving into her building, she lived by herself in a little bungalow located in the suburbs of Massachusetts. Now, Daria has the opportunity to connect with the over 250 residents that also call Covenant House home.
Still, Daria recognizes her responsibility to foster community. In addition to taking Russian and cultural classes to connect with her neighbors, she is an impassioned member of the newly-formed Residents Council. Throughout the retreat, Daria connected with other resident leaders to brainstorm ways to engage more residents.
During the day that focused on diversity, the group suggested ways to have more inclusive programming so that they can cultivate a community of acceptance within their buildings. While many buildings offer English as a second language classes, the group felt native-English speakers would benefit from Spanish or Russian as a second language classes as well. One resident, Jerry Fiman, of Covenant Place in St. Louis, shared his initiative to have a representative from each of the distinct cultural groups of his building acting as active members of the Residents Council.
The spirit of open-mindedness was exemplified that same night during a Havdalah ceremony to conclude the celebration of Shabbat. Most of the resident leaders are not Jewish, yet they approached the HaMotzi blessing that preceded each meal with respect and curiosity. Each resident leader placed their hands around the flame of the Havdalah candle, following a considerate discussion of interfaith values that morning. The culture of acceptance that was felt throughout the retreat is undoubtedly an integral part of their communities back home.
When the Resident Leadership Retreat concluded its week of living and learning, many expressed the instilled sense of confidence that the retreat provided. Helen Jordan from Pasadena, Texas expressed how the retreat not only fortified the beliefs she already had, but the curriculum gave her a means to implement them. A key component of the retreat was to harness this feeling of empowerment so that residents can serve as advocates once they return.
The retreat included an advocacy session led by Evan Carmen, B’nai B’rith assistant director for Aging Policy: “The goal of the advocacy session is to educate B'nai B'rith Housing Network residents on the best ways they can engage with their elected representatives; this way their members of Congress are aware of the issues which are important to them.”
One of the attendees, Martha Boyle, has confirmed a meeting with Sen. Bob Casey (D-Pa.) Boyle plans to discuss with him about rental subsidies as it relates to affordable housing for seniors.
For many of the resident leaders, a week at a sleep away camp tucked away in the Poconos Mountains provided an escape from their regular routine. For most low-income residents, a week of vacation has been an unavailable luxury to them for years. For others, the space to learn in a classroom environment was a reminiscent change, found to be invigorating.
From my perspective as a member of a younger generation, I am inspired by the commitment to learn and make a difference that I see in the generation before me. The leaders who I grew to regard as friends are the same leaders who pushed forward for the social changes I enjoy today. Since then, they have not quit moving and shaking. I regard the B’nai B’rith facilities across the country as a new ground for these leaders to make their mark.
Rachel Knopp is a student at The George Washington University studying International Affairs and Conflict Resolution. She is an Intern at the B’nai B’rith International Center for Human Rights and Public Policy in Washington, D.C. In the spring of 2017, she studied Anthropology and Spanish in Cusco, Perú. Prior to interning at B’nai B’rith, she interned at The Israeli Embassy to the United States and the Israeli Mission to the United Nations
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.
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.
Can Millennials Assume Responsibility for the Social Isolation Experienced by Older Adults by Creating Age-Friendly Communities?
We know that a whole range of societal changes contribute to isolation in aging. Changes in our birth rates, family structures and our proximity to relatives are all shifts that have been well documented. Additionally, there are common occurrences late in life that can create isolating circumstances: a late career job change, retiring, moving into different housing or a change in cultural surroundings. But, I think there is much more to this. As a result of the pervasive ageism in America, isolation as one ages is exacerbated. Throughout our society, we either stereotype older people or exclude them from critical planning efforts—or both. By excluding, whether purposefully or inadvertently, the contributions and perspectives of older adults from spaces where major decisions are made, we create a society where it is increasingly more difficult for them to thrive.
Our communities, whether rural or urban, should be safe and age-friendly from walkability to bus routes to housing design. Our workplaces should allow people to work as long as they are able to perform the duties of their job and recognize that older adults have a lot to offer, especially to young people who are newer to the workforce. Housing should be both affordable and available to everyone, and especially those that reach retirement age. We should design and build housing that will work for any resident, whether they are old, young or disabled. Technology should be accessible to those who did not learn how to operate personal devices at a very young age.
However, in order for these things to exist in our society, we must address the underlying causes of systemic ageism. Without doing so, we will continue to exclude a great portion of our population. We, inevitably, will continue to tell our future, older selves, “At some point, your opinion and needs are no longer important to greater society.” We must recognize that the risk factors of isolation are only more pronounced as a person ages because of their inability to have a “seat at the table.” In every industry, and particularly in technology, it is imperative that we stop expecting older people to create their own solutions without ever giving them the tools to do so.
Millennials have a unique role in addressing the ageism that has fostered a culture of leaving seniors out of the equation. Now the largest generation in the workforce, millennials are represented in every industry. Instead of being yet another generation that expects older people to adapt and integrate themselves in a society built around the young and able-bodied, what if we strived for deliberate inclusion? And, what does taking responsibility look like?
First, the thoughts, solutions and perspectives of those experiencing isolation should be at the forefront of every initiative around social isolation and age-friendly communities. This can look as simple as reconciling the gap in communication used by different generations. It may also involve urban planning that includes realistic walk times at intersections, or smart phones that do not operate on intuition that only a young app developer may possess. Including all people in our society is not just an idealistic, fuzzy feeling, it’s good for business! Imagine having a community where transportation was not a barrier to carrying out daily errands, or relying on technology to purchase home goods was not a frustrating, humiliating experience.
What if, from the beginning, we were cognizant of the difficulties that can result from a society increasing its dependency upon technological advances? What if—by simply asking—we were to realize that seniors are more than capable of providing solutions to the barriers one experiences as they age?
Until we make the conscious, purposeful decision that older members of our community not only should, but have to be a part of planning the society we want to live in, we will find ourselves trying to fix the mistakes we’ve made or, worse, assume that the opinions and lives of seniors are not important. We must be aware that the built environment and social environment are interdependent. The culture shift necessary for such consideration would require the empathy to understand that most all of us, if we are so lucky, will experience the changes presented through aging. When we talk about the “special needs of seniors,” we should remember that these are considerations that we all deserve throughout our lifetime.
As a young, able-bodied person, accessibility and inclusion should be tenets I lift up out of empathy for others and, at the very least, out of self-interest! I know that a society in which there are barriers to participation and socialization for some of us will, inevitably, hurt us all.
(Photo via Flickr)
Rachel Goldberg, who served as our director of aging policy and authored this column for many years, has moved on to the AARP, or the “big” house, as we playfully refer to the country’s largest advocacy group for seniors. For more than 13 years, Rachel was my right hand in analyzing, reporting and generally trying to make sense of the myriad changing policies and programs that affect our aging population. We are grateful for the many years she spent with us. She will be missed.
But we’re not the only ones experiencing changes. As you are no doubt aware, the entire country is in the midst of a sea change, affecting the role of the federal government in our lives. For B’nai B’rith, this presents an enormous challenge, as a new administration with an announced intention of cutting back on federal programs takes office. Not the least of these is providing low-cost housing to seniors.
I began at B’nai B’rith as the director of our Senior Citizens Housing Program. Some years earlier, a group of dedicated B’nai B’rith volunteers, all experts in the building trades, petitioned the organization to allow them, under B’nai B’rith auspices, to sponsor affordable housing for low-income seniors in their communities.
Using a remarkable program from the U.S. Department of Housing and Urban Development (HUD) that made grants available to nonprofit sponsors, this group provided the “sweat equity” and opened the first B’nai B’rith-sponsored senior community in 1971 in Wilkes-Barre, Pa. Since then, the B’nai B’rith Senior Housing Network has grown to be the largest national Jewish sponsor of HUD-assisted housing in the country. It is currently available in 28 communities nationwide, and we’re proud to say that nightly 8,000-10,000 seniors call a B’nai B’rith sponsored property home.
Obviously, we take this commitment to these communities and to our residents seriously. That’s why we work throughout the year to provide resources, training and information to the dedicated people who manage, lead and staff these properties.
Our program exists for the benefit of the residents and their extended families. That’s why we do what we do. But, we cannot do it alone. We need the government’s help because housing costs money. And we are committed to working with the federal, state and local governments to provide the resources to make affordable housing a reality.
For 30-some years, I have led the organization’s efforts to advocate for the federal housing finance program that has allowed us to build such excellent communities, and to continue to provide them to low-income residents at a fraction of market rate rents. As an advocate, I champion not only the current residents, but the tens of thousands of people currently on waiting lists for low-income housing like those we sponsor. I speak on behalf of the hundreds of thousands of boomers who will find themselves, very shortly, in retirement, and in similar need.
The “graying of America” is not something in the far-off future. It is here now and will only grow larger. Every day, more people turn 65. B’nai B’rith, along with other nonprofit groups, had been instrumental in shaping, expanding and improving HUD’s housing program for the elderly. But, the program is no longer being funded. This has put the future in jeopardy for residents, both present and future. And that is unacceptable.
The program is fiscally troubled. Affordable housing is scarce, and we need to build more for moderate and low-income people. Affordable housing appropriate for the needs of older adults, and where services can be brought to them in a more cost-efficient way, is essential. But building housing—something we absolutely must do if we want to address the long-term affordable housing crisis in this country—is more expensive than simply subsidizing rents in existing apartments.
On average, nationwide, there are more than 10 people waiting for every low-income rental unit available. In other words, we must build, but we don’t have sufficient federal resources to do it.
The key may be a combination of vigilant advocacy and a new strategy supported by recent housing research. One thing the government is very good at is counting things: From missiles bought, to meals served, to millions taxed, the government keeps a tally. But it is not as good at counting how spending in one area can save money in another.
We often say Washington works in silos: lots of communication (and counting) up and down a federal department but very little communication between them. This poses many problems, especially when people’s needs don’t fit into one of those silos. In the 1980s, the federal government established a task force across departments, including housing and health, to work on homelessness. It turned out that many of the homeless were mentally ill, had substance abuse problems, were veterans and, in some cases, all three. So, solving the problem of homelessness really meant tackling a variety of issues.
With elderly housing, we know there is a similar crossover because supportive housing for older adults, with appropriate services, is an alternative to unnecessary nursing home placements and other pricier options. Many of our residents are able to live independently with support, but without those services, many would be unable to do so; and, with no financial resources, a nursing home placement through Medicaid would be their only alternative. A month in a nursing home costs Medicaid about $8,000. A year in a nursing home costs just under $100,000. For one person! So yes, housing is expensive, but so is health care. Combining the two, taking advantage of economies of scale, work to the long-term benefit of the resident and, at the same time, saves money on health care. So, if new research on the health care savings generated by affordable housing is taken into account, building new housing doesn’t seem so expensive. And, that’s just one way in which subsidized housing can reduce health care spending.
Housing is necessary and more affordable than other options, and it meets the needs and wants of older adults. People do not want to be in a nursing home if they have more independence with some regular service support. The bottom line is that spending money on bricks and mortar can save money by reducing the amount spent on health care. Hopefully, this will help the number crunchers in Washington to see the light.
Over the years, I haven’t had many opportunities to be on the front lines of these policy debates, but I guess it’s time to get back into the game and step up to the plate.
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
Dear Secretary Carson,
On behalf of B’nai B’rith International, its members, supporters and more than 8,000 residents of B'nai B'rith sponsored HUD assisted rental units; I want to welcome you as the newest secretary of Housing and Urban Development (HUD). I hope that it brings you pride to oversee a department whose responsibility to the greater population is shaped by extending opportunity to low-income Americans.
Five HUD programs provide affordable rental housing that is designated for low-income senior households. Section 202 provides housing exclusively for older adults and people with disabilities, while four other HUD programs provide housing for all age groups but have devoted the property to housing senior residents. These include Section 236 and Section 221 (d)(3) programs, public housing and project-based Section 8 programs dedicated primarily for use by senior households. After the Section 202 program, project-based Section 8 housing provides the most housing dedicated specifically to elderly households.
As you become more familiar with how HUD works to combat poverty for individuals and families all over our country using a modest portion of the federal budget, I want to bring your attention to the estimated 2 million seniors, most often low-income single women in their mid-70s to early-80s, who are housed through HUD subsidies or call HUD-assisted facilities home. HUD, a department that long ago began prioritizing the well-being of our most vulnerable seniors, has wavered in recent years on its commitment to take care of the oldest among our nation’s poor. I have the privilege of working directly with residents and staff of our 38 low-income supportive senior housing facilities, housing about 8,000 seniors across the country. Working with these buildings has transformed my understanding of what HUD-supportive housing is, and of who lives there. One thing has become particularly clear: We must include seniors in all of our conversations about publicly-funded housing.
I was disappointed that your remarks to the Senate Banking, Housing, & Urban Affairs Committee did not include comments about affordable housing for seniors. However, I was pleased to read you indicated in your written responses to Sen. Sherrod Brown that the Section 202 program is “an important tool” for senior housing and that you will lobby President Trump for the inclusion of this vital program as part of a comprehensive infrastructure package. Across the spectrum of publicly-assisted housing, seniors are everywhere. Not only are they served by senior-specific programs, but they are a significant part of the population in every other category of HUD’s portfolio. Frankly, I am worried that within your focus on eliminating “government dependence,” you do not account that many people who benefit from HUD are retirees and disabled people whose incomes will never really improve, and whose need for housing assistance cannot be dismissed. Many of your statements spoke to the desire to get people off of public assistance and to move them towards gainful employment through a “development of innate talent” and “work requirements.” While economic success and independence are laudable goals to facilitate for the working poor, they are not realistic for fixed income older adults.
Many seniors living now in HUD assisted housing—who are in your terms “dependent” on it—have worked their entire lives and are still only able to afford housing by combining meager Social Security benefits with assistance from your department. While many of these individuals live in senior-specific facilities, about a third of households that make up public housing are senior-led homes or include a family member who is a senior. I believe it is important to remember that work should not be the sole focus when we discuss assisting those experiencing poverty. If we forget about the special needs required by millions of seniors who are now unable to work, we have committed a great injustice. I, and many senior housing advocates, believe the focus should instead be placed upon addressing the root causes of the shortage in affordable housing. We believe that accessing affordable housing is prevented by systematic issues including, but not limited to, predatory mortgage lending, a stagnant and unrepresentative COLA used for Social Security and astronomical price surges in many areas where seniors hoped to “age in place” due to gentrifying neighborhoods.
I am encouraged to know that you will be able to apply a health perspective on housing, because good health outcomes are incompatible with unstable or inappropriate housing. Further, housing can be a platform for prevention and early health intervention services. I look forward to the integration of your medical knowledge into your approach to HUD programs and hope that you will ensure “aging in place” and preventative care are tenets of your leading this department. Research tells us that ensuring the well-being of an aging person while they are healthy or maintaining a chronic condition prevents hundreds of thousands of dollars being spent at the end of that individual’s life. We know that these end-of-life prices surges can occur through Medicaid funded nursing home care or through receiving emergency medical services. We also know that this can be prevented when folks are able to “age in place” with comfort and dignity. More so, those in the supportive housing industry know that co-location of services and housing is crucial to maintaining one’s health as they age. Affordable, supportive housing not only allows people access to “healthy” aging, but helps people avoid injuries and unnecessary nursing home placements.
I think it’s only fair that a society be judged on the way it takes care of its oldest members. While we experience a growing population of seniors who are currently 75 years of age and older, the senior population, those aged 65 and over, is projected to double by the year 2030, from 35 million to 71.5 million. In 2010, more than 44,000 people aged 65 and over were homeless. In many ways, I am saddened our country has not done a better job of creating and preserving housing for older adults. However, I hope that I can appeal to you, as a man of faith, that we lift up and support our older neighbors who face significant financial barriers, and deserve a warm place to call home!
While I hope you will take my concerns to heart, I would love nothing more than for you to visit any of the 38 senior housing facilities my organization, B’nai B’rith International, sponsors across the United States from Maryland to California. We hope that a visit from you to any of our thriving communities would serve as a fact-gathering mission and support the good work that you will be leading!
Breana Clark, MSW
Premiums do not accurately indicate annual out-of-pocket for 2017
For 2017 plans, the benefit of paying less for a monthly premium may not outweigh the annual cost of medications you depend upon. I urge you to take the time to visit Medicare online and learn more before you choose. If you stick with me, I’ll go into how you can access the Medicare Plan Finder on the Medicare.gov website. But, before I can do that, I want to explain the reason behind my concern. If you had planned to default to your 2016 plan under the assumption a small change in your premium would be the only adjustment you’d make, you may be very disappointed.
Year-to-year costs of popular drugs are seeing major increases for the upcoming year, and Part D plans have changed the structure of their drug pricing in response. If you aren’t careful about picking a plan, or if you have added any medications this year, you could see jaw-dropping increases. For example, a co-pay for one single drug went from $7 to $350.
Several trends among insurers have made surprising shifts in cost sharing for beneficiaries possible. Some of the reasons you may be seeing this is because of:
- Tier shifting: more and more sophisticated drugs, for which there is no generic, and shifting of generic drugs from lower, less expensive tiers to higher, more costly tiers.
- Plans are charging coinsurance: a percentage of the full cost of a drug instead of set co-pays which are flat rates like $20, $45, or $60 dollars for any drug on a specific tier.
- Pressure on Medicare to keep premiums down.
Instructions for using the Medicare Plan Finder
Before starting, make a list of drugs you take. Then, access the Medicare Plan Finder by clicking here.
You’ll see prompts like the ones listed below:
- Step 1: Enter Your Information
You can perform either a general or personalized search with your own information. A personalized search will allow you to enter your zip code, Medicare number, last name, and date of birth, while a general search will only require a zip code for plans offered in your area. You will also be able to enter whether you have a Medigap policy (aka Medicare Supplemental Insurance) or if you receive any help from Medicaid or SSI (which might make you eligible for extra discounts in Part D).
- Step 2: Enter Your Drugs
Enter the list of drugs you have written down. You will be prompted to select the dosage, quantity, frequency, and whether you get your medicine from a retail or mail order pharmacy. Before entering, you will have the ability to select a lower cost generic for the drug if it is available.
- Step 3: Select Your Pharmacies
You can select up to two.
- Step 4: Refine Your Plan Results
You will be made aware of how many plans are available to you in your area, based upon the information entered. These plans can be narrowed down, dependent upon the type of coverage you need and the types of factors you’re looking for.
Additionally, on each of the plans, you will see “Lower Your Drug Costs.” Once selected, you will have an opportunity to select cheaper versions of the drugs you originally input based upon their projected annual cost. (Only do this for drugs where you know you could take either.)
When comparing plans, you want to focus on the heading “Estimate of What YOU Will Pay for Drug Plan Premium and Drug Costs.” This amount is what should be used to compare to what you spent last year, and what you’re budgeting for this coming year.
When I performed this exercise, I entered medications for a variety of needs such as: lowering cholesterol and high blood pressure, treating Type II Diabetes, as well as an anti-depressant—all fairly common prescription medications. In each case, when comparing plans in my area, the cheapest premium did not correlate to the least amount paid for annual out-of-pocket. In fact, in nearly every comparison, the most expensive premium often was paired with an annual out-of-pocket expense several hundred dollars less than other plans with cheaper premiums.
More than ever, this year, it does not make sense to stay with the same plan as you selected last year without comparing. And the best news is: it’s not too late! Enrollment is still open through Wednesday, Dec. 7, 2016.
AARP Medicare Resource Guide: Understanding Your Prescription Drug Coverage
Caregiver Support Bills: Protecting Social Security Benefits for Those who Leave Work to care for parents, children, Relatives
Secondly, women dramatically reduce their Social Security benefit because of Social Security’s “high 35” system for determining benefits, because of having fewer years of paid work. Your Social Security benefit is calculated with a formula which uses your highest 35 years of earnings. Those who take years out for child care and elder care are more likely to have $0 years factored in. Even those who have a 35 year work record may have fewer years at their career peak, and be including more of their early career, low-wage entry-level salaries compared to people in similar fields who didn’t take time out.
"As a nation we depend on family caregivers, and the least we can do is help make sure that the men and women who perform this service are protected in retirement."
For many families, the most cost effective—or only—option is for someone to take off from work to care for their parent. According to AARP’s public policy institute, family caregivers provide nearly half of a trillion dollars in care each year. Though they are generally not paid, they are working, and they are providing a service both to their families and the country as a whole.
Therefore, we should find a way to prevent this critically important caregiving role from diminishing the retirement security of caregivers. Americans overwhelmingly support the idea of a Social Security caregiver credit (click here to read more about it). The caregiver credit proposals in Congress (notably those from Senator Chris Murphy and Representative Nita Lowey) include giving credit for months out of the work force, based on a formula as if the person had earned a wage (generally a percent of the average wage). There are also bills emerging this year that would do the same, but only for parental caregiving for children, which is good, but not good enough. This would certainly not replace earnings credit an average or high wage worker would have achieved back in the work force, but it can at least prevent those $0 years from slashing benefits in a “high 35” formula.
B’nai B’rith International is very pleased to see these bills as part of the conversation in Congress, even though 2016 might not be the most productive legislative year, given all attention being focused on elections. As a nation we depend on family caregivers, and the least we can do is help make sure that the men and women who perform this service are protected in retirement.
Photos via Flickr (1) (2)
Rachel Goldberg, Ph.D has been the B’nai B’rith International director of health and aging policy since 2003 and the deputy director of the B’nai B’rith International Senior Services since 2007. Before joining B'nai B'rith International, she taught politics and government at the University of Puget Sound and Georgetown University. To view some of her additional content, Click Here.
But there is a good reason the D.C. metro area can’t respond as quickly to the snowfall, and it’s one we happily point out whenever this happens. We aren’t prepared to deal with storms like this because it doesn’t pay for us to be. Most years having enough salt, trucks and drivers to efficiently remove a blizzard would be a waste of money—money that D.C. area cities and states don’t have. It would be like Minnesota putting its money in shark attack prevention. So when the “big one” does hit, we are spectacularly and sometimes comically underprepared. And over shopped.
Sidewalks are a critical part of the transportation infrastructure, especially for low-income people and people with disabilities and mobility impairments, categories that include millions of older adults.
Often they haven’t plowed all the lanes because if they did they would have to shove that last lane’s snow right up onto the sidewalk, making pedestrian travel difficult, dangerous or downright impossible. And who travels on the sidewalks after a snowstorm? Kids (which is why schools are closed when your street is already clear), people with disabilities and many elderly and low-income people who don’t have or use cars.
While we all seem fairly aware of the roads being critical to our everyday city and community life, it’s easy to forget the role sidewalks play until they are covered by a 6 foot snow pile left by a plow. Sidewalks are a critical part of the transportation infrastructure, especially for low-income people and people with disabilities and mobility impairments, categories that include millions of older adults.
Yep. Snow removal is an aging issue.
And it’s not that transportation experts and disability/aging advocates didn’t already know this—we did. In fact, there are some great studies and planning tools out there to help, so that transportation and urban planning includes people with disabilities and the elderly.
So how are we doing at actually implementing pedestrian/aging/disability friendly transportation plans? Not great.
Other groups including disability groups have developed excellent resources, like Easter Seals’ Project Action, where I found a guide on pedestrian/disability friendly snow removal policies and planning.
The federal government has money (called Section 5310) allocated to efforts on disability transportation, including pedestrians. While I would like to say that includes a resource listing the right phone numbers to call for every city or county when you see an impediment to pedestrian travel or a mobility challenge, it doesn’t mean that. We do have regional contacts and state contacts listed together and the National Center for Mobility Management, and that gets you off to a good start. You can find other related resources on their main page. The Federal emphasis on transportation planning for people with mobility challenges has produced some excellent planning tools and raised awareness about best practices.
So how are we doing at actually implementing pedestrian/aging/disability friendly transportation plans? Not great. It has been clear during this week’s “snowzilla” how much tension remains between the need to plow roads and the need to maintain sidewalks. And the sidewalks often lose. We’ve seen pedestrian access to public transportation (Metro) limited because the parking lot’s snow got dumped on the sidewalks leading to the stations. In my neighborhood—already a hot spot for pedestrians being struck by cars—bus stops have been obliterated, the bus shelters are half filled with snow and often there is nowhere for riders to stand but in the slick, snow-banked roadways. So far no pedestrians have been injured in my neighborhood, but I am frankly almost as surprised as I am relieved.
But advocates know it takes more than having information about how best to do things to get them actually done. I guess we all know that.
So what do we do? Three things come to mind. First, do your part. Shovel your sidewalk as soon as you can after a storm. It’s required by law most places, and is neighborly. If you can’t shovel, ask a neighbor to help. If you can, shovel for the neighbor you know can’t. Local governments often need to do more to make sure that commercial and public areas (where no homeowner is responsible) are also plowed. In good weather, don’t block sidewalk access with a vehicle, trash can, etc., especially the curb cuts designed to let wheelchairs ease from sidewalk to street. As a driver remember that pedestrians have rights, and are easy to injure. Remember that not all pedestrians are STANDING, and some may be seated and harder to see. Be aware.
Second, if you see something wrong, tell someone. If the sidewalk is blocked, report it. If stores plowed snow into the handicapped spots, tweet about it. If you see people walking on a snowy roadway because there is no sidewalk to be found, call your city or county.
And third, after you figure out how to report these problems, think about getting more involved. Ask how you can become part of an advisory committee on transportation issues. Transportation planning is a big deal for most states and municipalities, and advocates for the elderly and disabled have made it a particular point to make sure those concerns are part of all planning, whether it’s public transportation, new road designs or services especially for the disabled. And there is plenty of information available about how planning can be done to accommodate the needs of people with mobility challenges—and how to keep the snow from trapping them at home or making them unsafe when they are out.
Last year we participated in the once-a-decade White House Conference on Aging, and the final report calls for more planning and coordination on transportation issues. Cities, states and the federal government are always planning transportation initiatives, from maintaining what exists to expanding mass transit and building new highways. All that planning needs to take into account the needs of people with mobility challenges. It was great to hear last year about the $2.5 million allocated for a plan to launch the National Aging and Disability Transportation Center at the U.S. Department of Transportation, which will “provide technical assistance to improve the availability and accessibility of transportation options that serve the needs of people with disabilities, seniors, and caregivers.”
But the kind of planning—and frankly pressure—required to make sure seniors, the disabled and pedestrians are not left out of the future of our roads and bridges requires us to get involved. There are so many issues at play, and so many future consequences of today’s decisions, that we have to make sure we represent these issues at the table. If you want to learn more about volunteering your insights, start at the National Center for Disability Management. Or call a disability rights group. Or call us—we’ll help you find the right access point for wherever you live.
Even those of us who don’t have any mobility challenges (yet) are sometimes pedestrians. It can be complicated to sort out how to support growth and safety, roads and sidewalks.
And, if you see a sidewalk covered in a snow mountain made by a snow plow, take a picture and send it to us.
Rachel Goldberg, Ph.D has been the B’nai B’rith International director of health and aging policy since 2003 and the deputy director of the B’nai B’rith International Senior Services since 2007. Before joining B'nai B'rith International, she taught politics and government at the University of Puget Sound and Georgetown University. To view some of her additional content, Click Here.
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