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HOUSING NAVIGATION SERVICES 1 To: the Office of Governor Janet Mills From: Celena Zacchai, Primary Researcher; Dr. James Cook

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HOUSING NAVIGATION SERVICES 1 To: the Office of Governor Janet Mills From: Celena Zacchai, Primary Researcher; Dr. James Cook HOUSING NAVIGATION SERVICES 1 To: The Office of Governor Janet Mills From: Celena Zacchai, Primary Researcher; Dr. James Cook, Research Advisor The University of Maine at Augusta and Margaret Chase Smith Policy Center Subject: Increasing Access to Affordable Housing Options for Maine Seniors Through Comprehensive Navigation Services Issue: Maine’s median age of 44 years makes it the oldest state in the country. According to recent projections, the number of working-age adults in Maine will decline by six percent by 2026, while the senior population is expected to grow by thirty-seven percent (Maine State Economist, 2018). As age demographics shift, housing needs change as well. In their 2017 report, Housing for Seniors: Challenges and Solutions, the US Department of Housing and Urban Development (HUD) states that “the nation’s existing housing stock — in terms of options, affordability, and accessibility — is ill-suited to meet the housing needs of an increasingly older population that overwhelmingly wishes to age in place” (US Department of Housing and Urban Development, 2017). Housing is considered to be unaffordable if the household spends more than 30% of its income on housing related costs (Maine State Housing Authority, 2016). Over 30% of Maine residents age 65 and over live in housing that is unaffordable. (U.S. Census, 2018). Housing affordability impacts all other aspects of a person’s health and wellbeing. As housing costs increase, putting more of a strain on families and individuals, stress levels increase, while resources for quality foods and health care shrink (Center on Budget and Policy Priorities, 2020). Access to affordable housing is associated with improved physical and mental health outcomes, as well as lowered healthcare costs (Center on Budget and Policy Priorities, 2020; Maqbool, Viveiros, and Ault, 2015). Recognition of the relationship between housing access and physical and mental health can lead to mutually beneficial solutions. Given this connection between health outcomes and housing access, one major hurdle is that the institutions charged with addressing these issues have traditionally functioned in a siloed fashion with limited communication and very little overlap in terms of services between agencies. Current Policies and Solutions: There are many dedicated people and entire organizations working on the issue of affordable housing for seniors throughout the state of Maine. Over the course of the last several months, I have spoken to directors and administrators from MaineHousing, Penquis CAP, Maine Council on Aging, both the Maine and Federal Departments of Health and Human Services, Community Housing of Maine and Avesta Housing, as well as state representatives. All of the individuals I interviewed agreed that the efforts made to address this issue are not sufficient to catch up, much less to get ahead of the problem. This past January, MaineHousing released bond funds that, “combined with MaineHousing resources and other funds, will generate over $45.8 million to build 212 new affordable housing units for Mainers aged 55 and older” (MaineHousing, 2020). A month later, LD 1645, “An Act to Create Affordable Workforce and Senior Housing and Preserve Affordable Rural Housing” was passed. LD 1645 not only preserved existing affordable housing, but also paved the way for HOUSING NAVIGATION SERVICES 2 the creation of 1,000 new units over the next four years (Maine State Legislature, 2020). At a maximum, these two solutions create just over 1,200 new affordable units. A 2020 report from the DHHS (published before the Covid-19 Outbreak), projected that the shortage of affordable units available to seniors would increase from 9,000 to 15,000 units by 2022 (Maine Department of Health and Human Services, 2020). In 2015, a MaineHousing report stated that 6,000 new units would need to be built to accommodate the increasing number of seniors over the following seven years (MaineHousing, 2015). MaineHousing’s annual reports show the construction of 1,050 new units between 2015 and 2019 (MaineHousing, n.d.). New construction of affordable housing is the most expensive way to provide housing. The recently released bond money will provide enough funding to build only 212 units at $216,000 per unit (MaineHousing, 2020). While new construction is needed, there are other options that can provide more affordable ways to assist Maine seniors to age in place. Each community has its own sets of strengths, resources, and challenges; there is no single solution to this problem. Housing affordability is a hyper-local issue. As seen in the map below, while the state average of housing burdened seniors is around 30%, there are areas where over 73% of Maine seniors are housing burdened—and some of the regions with the largest percentage of housing-burdened seniors are not in the counties most commonly associated with an affordable housing deficit. Percentage of Maine Seniors Spending 30% or More of Household Income on Housing Source: American Communities Survey 5-year estimates 2014-2018 HOUSING NAVIGATION SERVICES 3 Interviewees expressed support of innovative, small-scale solutions that help seniors to live out their lives in their own homes and communities whenever possible. These small-scale solutions include things like: • Promoting the building of accessory dwelling units (ADU’s) or “in-law apartments”; providing financing options for ADU construction (loan programs and tax incentives) • Increasing funding and expanding access to home repair and modification programs though outreach, education, and a comprehensive navigation tool • Developing third-party assisted home-sharing programs like HomeshareVermont which assists individuals in finding suitable roommates (Maine Council on Aging, 2018) • Researching and addressing zoning and land use laws that act as roadblocks for the creation of ADUs, duplexes, and home-sharing. LD 1956, “Resolve, To Establish a Commission To Increase Housing Opportunities in Maine by Studying Zoning and Land Use Restrictions” was carried over from last session. (Maine State Legislature, 2020) These solutions are all excellent ways to address the lack of affordable housing because they provide ways to utilize existing housing stock and save the state money by avoiding or postponing the high cost of assisted living. However, even if/when these programs are expanded, the real challenge is to make these options widely known throughout the state. Recommendations: In the fall of 2019, a task force comprised of multiple municipal officials, with the support of the Maine Municipal Association, convened to brainstorm solutions to issues facing Maine Seniors. In their report, they stated that a common phrase heard from town officials was, “We don’t know what we don’t know”. Since town offices are often the first place a person in need will go to seek services, the need to ensure accurate, up-to-date, comprehensive information to town offices is obvious. Therefore, the task force concluded in their “Next Steps” the need to “further develop data dashboards to help identify unmet needs of older adults…” (Maine council on Aging, 2019). The report further concluded the need to ensure that information about available services are easily accessible via town websites, publications, and front-line staff as a “core action that every town should take” (Maine Council on Aging, 2019). The task force’s findings led to the drafting of LD 1146, “An Act To Ensure the Provision of Housing Navigation Services to Older Adults and Persons with Disabilities”. LD 1146 first sought to create a state-wide Housing Navigator position within the Maine DHHS. There was some confusion about what exactly the navigator’s roles would be, and the bill subsequently died in committee. Jay McCreight’s characterization of Maine’s housing services as “fragmented, scattered, and difficult to obtain” in her testimony on LD 1146, was echoed by many of the housing professionals interviewed for this project (Maine State Legislature, 2020). My recommendation is that the inspiration for the drafting of LD 1146 be revisited and reassessed given the current implications of the upcoming strain on housing due to Covid-19, with consideration of the following: HOUSING NAVIGATION SERVICES 4 • The creation of a state-wide Housing Navigation Specialist could facilitate a partnership between Maine’s health and housing agencies. o Eleven states have enacted programs (many of them pilot programs) that allow the use of state Medicaid waivers and state plan amendments for housing-related services. In this partnership, an individual’s doctor, behavioral health counselor, or home health nurse is empowered to assist a client in accessing housing support services. This collaboration between health and housing services has many benefits including offsetting of health costs associated with housing instability (Center on Budget and Policy Priorities 2020). • As detailed in Senator Geoff Gratwick’s testimony on LD 1146 in a CMS Informational Bulletin, housing navigation services are, in many cases, Medicaid reimbursable (Maine State Legislature, 2020). This feature will significantly diminish, if not eliminate, the cost of housing navigation services throughout the state. • Comprehensive analyses of housing support services throughout the state would help to ensure that available programs are well-suited to meet the needs of the communities they serve. A state-wide Housing Navigation Specialist could conduct research and produce reports to MaineHousing and
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