Aging-in-Place Resources

In many of these documents, you can search for "Accessory" to skip to the discussion of Accessory Dwelling Units and how it supports Senior Aging-in-Place. Or you can skim through the articles. I am always amazed at the wealth of information and resources available online.

http://www.jchs.harvard.edu/publications/seniors/lawler_w01-13.pdf

• mentions accessory dwellings as a form of Supportive Housing
• The ratio of working Americans to retired Americans will drop from 5 to 1, to 2 to 1 over the next fifty years.
• Aging-in-place is the most desirable and most cost-efficient (ie. least expensive) method of aging. 
• Housing vs Health Care. Two categories have historically been funded and handled be completely separate entities at fed/state/local level. Aging in Place requires more coordination (upfront and ongoing) between Housing and Health Care than ever before.

http://www.fundersnetwork.org/files/learn/aging_paper.pdf

• supports ADU and ECHO housing
• otherwise, article lacks specific recommendations as to what states can do to support aging-in-place

http://hawaii.gov/health/eoa/Docs/Plan.pdf

• Demographics of Seniors in Hawaii: The majority (74%) of older adults are homeowners and 20% are paying 30% of their income for housing. Table 13 (page II-17) further describes works status (full/part time) and median income by island. Table 14: Household Income by age.
• Statewide data collection reports: 
• A Compilation of Issues, Barriers,and Solutions Designed to Provide Inputto the Policy Committee of the 2005 White House Conference on Aging (December 2004-April 2005)
• A Compilation of Issues, Barriers, and Solutions for Consideration by Delegates Attending the June 30, 2005 Aging Agenda Conference
• Policy Advisory Board of Elderly Affairs Community Forums (2006)
• Aging Issues 2007, A Briefing Guide for the Hawaii State Legislature (2007)
• Conference on Desinging Livable Communities for an Aging Society (2007)
• Report to the Twenty-Fourth Legislature, State of Hawaii 2007 (Pursuant to Senate Concurrent Resolution 115 S.D.1, Requesting that the State Executive Office on Aging Convene a Focus Group with Other Stakeholders to Assess Yearly Service Delivery Needs and Long-Term Strategic Planning for Kupuna Care)

http://www.nw.org/network/comstrat/agingInPlace/nwresources.asp

• NeighborWorks
• Develop Best Practices as a community to support Seniors
• Medicaid Waiver programs - for low-income seniors, allows them to live in assisted living facilities

http://www.n4a.org/pdf/07-116-N4A-Blueprint4ActionWCovers.pdf

• Covers ADU's extensively as supportive housing for Seniors. Blueprint for Action

http://www.n4a.org/pdf/MOAFinalReport.pdf

• To address housing: communities should assess their land use plans, zoning ordinances and building codes to promote the development of a range of housing options (Accessory Dwellings) that meet the needs of an aging population.
• includes survey of 10,000 local gov'ts and found 46% already have zoning/building codes that support senior housing options, while 42% do not.
• Elder-friendly communities: The interdependent needs of older adults may require a completely new comprehensive, holistic approach to service delivery organization and management. The needs of older adults are often interrelated. For example, providing housing will not be sufficient if residents lack transportation to get to basic services such as medical offices, the pharmacy or grocery store. 

http://www.caring.com/articles/medicaid-waiver-programs

• While many states do not recognize funds from Medicaid waiver programs for assisted living, those that do offer many options to aging Americans needing assistance with daily living activities.
• Hawaii is not included on the list on the above website. Perhaps this is an area that can be addressed through state legislation?  

http://www.cms.gov/MedicaidStWaivProgDemoPGI/MWDL/list.asp?intNumPerPage=all&submit=Go

• Scroll down to see Hawaii. Appears that all Hawaii's Medicaid Waiver programs have expired except extended Quest.

http://jfs.ohio.gov/ohp/bcps/FactSheets/ABD_Medicaid.pdf

• A Medicaid waiver is a program that "waives," or sets aside, certain requirements of Medicaid. The waivers provide services to people who would otherwise be in a nursing home. Medicaid usually cannot cover these services. Medicaid waivers help you stay at home instead of going into a nursing home or hospital. They can also shorten your stay in a nursing home. 
• This is an FAQ fact sheet for Ohio, but it lists income restrictions to qualify and a description of benefits.
• Can we get more federal dollars into Hawaii through a Medicaid Waiver Program?

http://www.aspe.hhs.gov/daltcp/reports/primer.htm

• Understanding Medicaid Home and Community Services: A Primer (Oct 2000) by the US Dept of Health and Human Services

http://www.aarpinternational.org/usr_doc/livablecommunities.pdf

• An international perspective. 
• Emphasizes affordable housing, adequate options for mobility and community features and services that can facilitate personal independence and continued engagement in civic and social life.
• My impression is that Senior housing will either occur dispersed, in a multigenerational home setting (where family members serve as primary caregivers) supplemented by neighborhood community centers, or in concentrated multi-unit structures where a critical #'s of clients are needed to develop an economy of scale to sustain the costs to provide needed medical and ancillary social services.