EVANSTON,
IL – Residents of the 9th Congressional District tonight joined U.S. Representative
Jan Schakowsky (D-IL) for a discussion on the long-term care needs of aging
parents. Schakowsky said, “Our challenge is to create housing, health
care, retirement and support services that don’t just address a theoretical
“senior” population – but address the individual needs of individual seniors
and their families.”
Below
is the full text of Schakowsky’s statement:
For
decades, we have been committed to expanding the life-span of Americans,
and we have been successful. Greater access to health care through Medicare,
new treatments, exercise and activities, has allowed our parents and grandparents
to live longer and live better.
Policy
makers are looking at these demographics carefully. According to
the U.S. Census Bureau, the number of persons age 65 and older will grow
to over 53 million by 2020, a 50 percent increase from today. As
important, the number of persons age 85 and older will grow by even more.
In 20 years, that number will grow by 62% -- to 6.5 million.
Each
one of those numbers represents real people – our parents, grandparents,
friends and neighbors. As we know, each one of those people has different
needs and different concerns. Our challenge is to create housing,
health care, retirement and support services that don’t just address a
theoretical “senior” population – but address the individual needs of individual
seniors and their families.
In
housing, that means that we must have a vibrant continuum of care and services
that starts by ensuring that seniors can stay in their own homes and be
active members of their communities. We need to protect seniors
from scam artists, so that they don’t lose their homes. I have introduced
H.R. 2531, the Save Our Homes Act, to ban predatory lending practices.
Predatory lenders often prey on seniors, hooking them into high-interest
loans that all too often result in massive debt and foreclosures.
Many
of our parents and grandparents, however, also need housing assistance.
According to the 1999 American Housing Survey, there are 25 million households
headed by a person age 62 or older. 1 in 5 – 20% -- are renters.
And half of those renters pay more than 30 percent of their income on housing.
This heavy rent burden is on top of the very heavy health care burdens
many of them face. One-third of all households receiving federal
housing assistance (not including mortgage deductions) are headed by seniors.
Many senior citizens benefit from Section 8, a voucher program that provides
rental subsidies. However, as the housing market becomes more expensive
and Section 8 contracts expire, the pressures on this program are growing.
The
major federal housing program for the elderly is Section 202, administered
by HUD. Section 202 is the only federally-funded, new construction
housing program that focuses on meeting the needs of senior citizens.
Section 202 funds can be used for construction or rehabilitation of housing
projects. They can also be used to improve housing by providing supportive
services such as meals, transportation, housekeeping, personal care
and health services. Finally, they can be used to convert existing
projects into assisted living facilities. This is a critical program,
yet it is seriously underfunded. According to an AARP survey, there
are 9 senior citizens waiting for every Section 202 vacancy. And
that number is growing. While new facilities are being built to meet
the needs of new tenants, the AARP survey also found that managers of existing
Section 202 housing don’t have the funds to retrofit the oldest projects,
where many of the oldest residents are concentrated.
The
need for senior housing is growing but federal funding is not. Last
year, Congress passed a VA/HUD appropriations bill that includes $783 million
for senior citizen housing building and retrofitting programs. We
provided $50 million to provide support service coordinators in Section
202 projects and $50 million to convert housing to assisted-living programs.
We
had to fight hard for what is only a one percent increase in the budget
for senior housing programs – not even enough to keep pace with inflation.
And, as we know, those 9 senior citizens are still in line waiting for
a vacancy. We need to find the resources so that housing is both available
and affordable. But that is not enough. Housing must also be
appropriate.
Once
again, the demographics are important. Many senior citizens are healthy
and active. But many are not. A study by the Lewin Group for
the AARP estimates that the number of senior citizens who need help with
2 or more activities of daily living (walking, bathing, eating, dressing,
transferring from a bed or chair or using the toilet) will grow by 65%
over the next twenty years. By 2020, there will be nearly 3 million
parents and grandparents who need help with major life activities.
There
are many new ideas about how to provide that help and allow senior citizens
to stay in their communities. The assisted living movement is growing
here and around the country. There is no uniform definition of assisted
living but it is generally defined as a combination of housing, supportive
services, personalized assistance, and health care designed to respond
to individual needs and allow persons to live with the maximum amount of
dignity and independence. While we generally think of assisted living
as facility-based, there are some home-based or apartment-based models.
Assisted living receives a small amount of federal funding -- $50 million
– through HUD Section 202, and services are also partially funded through
the Medicaid Home and Community-Based Services program. Still, 85
percent of assisted living is privately funded.
One
challenge before Congress is to provide more support for those services.
But, in doing so, we also need to look at standards for those services.
Right now, assisted living providers argue that the federal government
should not impose quality and consumer protection requirements, since the
federal government doesn’t pay the bill. However, many others argue
that quality problems require federal oversight. A 1999 U.S. General
Accounting Office report found that 25 percent of assisted living facilities
had five or more quality of care or consumer protection violations.
1 in 10 were cited for 10 or more problems. Today, only the
states regulate those problems.
I
am a cosponsor of H.J.Res. 13 which calls on President Bush to convene
a White House Conference to develop national recommendations to promote
assisted living facilities while ensuring quality of care. For all
of us who believe that this is an important way to allow our parents and
grandparents to “age in place,” the need for greater federal support is
evident.
Some
seniors, however, will need greater access to medical or custodial care
and will need nursing home care. In March 2000, my colleagues Representatives
Blagojevich and Rush and I released a study of Chicago metropolitan area
nursing homes. We found that 79% of Chicago area nursing homes violated
federal health and safety standards. One in seven had been cited
for at least one violation that caused actual harm to residents or placed
them at risk of death or serious injury. A year later, we released another
study that found that those nursing homes that met minimum staffing ratios
had 60 percent fewer violations. However, only 16% of nursing homes
met the preferred staffing ratios.
Of
course, many nursing homes provide quality care, but we believe that every
person who enters a nursing home deserves to know that she or he will receive
the best possible care. That is why I introduced H.R. 3331, the Quality
Care for Nursing Home Patients Act of 2001 in November. That bill
would mandate that nursing homes meet the minimum staffing ratios developed
by groups like the National Consumers Coalition for Nursing Home Reform,
the National Committee to Preserve Social Security and Medicare, and nursing/gerontological
experts from universities like Harvard and the University of California.
At the same time, we would review payments to nursing homes to make sure
that they are adequate to provide new staffing and make recommendations
on how to attract more qualified health care workers to the field.
Whether
we are talking about creating more affordable and appropriate housing,
improving quality of care in assisted living facilities and nursing homes,
or expanding Medicare to cover prescription drugs and long-term care, we
are also talking about finding more federal resources to get the job done.
Many
of you have heard about Senator Kennedy’s speech yesterday calling for
a repeal of future reductions in the top 3 marginal tax brackets and a
repeal of the future elimination of the tax on estates over $4 million.
This is exactly the approach taken in H.R. 2999, the First Things First
bill, that I introduced last fall. Under this bill, like Senator
Kennedy’s approach, tax cuts for persons earning less than $130,000 would
go into effect. But, we would save over $350 billion by not implementing
additional tax cuts that would only affect those earning more than $130,000
a year. Under my bill, those additional cuts could not go into effect
until and unless we have met critical priorities: protecting Social
Security and Medicare, providing seniors with a comprehensive drug benefit,
creating affordable housing, repairing and building schools, and dealing
with the aftermath of September 11.
It
is important to remember that, even before the tragic events of September
11, the Congressional Budget Office and the Office of Management and Budget
had projected 10-year deficits because of the Bush tax cut. We have
the opportunity to stop implementation of tax cuts that have not yet gone
into effect but when they do, will help only the wealthiest 1 percent of
Americans. If we do not take advantage of that opportunity, our ability
to meet the needs we have discussed here today will be greatly damaged.” |