John Randall (Annapolis mayor)

Transcription

>>> GOOD AFTERNOON, EVERYONE. IT'S GREAT TO SEE WHAT A WONDERFUL TURNOUT TODAY AND GREETINGS TO ALL OF YOU VIEWING THIS THROUGH THE WEB. HAPPY NEW YEAR AND WELCOME TO PDNR'S QUARTERLY HOUSING MARKET UPDATE. I CAN'T BELIEVE WE'RE IN OUR FOURTH YEAR AND WE HAVE A TERRIFIC PROGRAM IN STORE FOR YOU. THIS PROGRAM THEME IS ON VISIONS FOR AGING IN PLACE, CHALLENGES FOR THE FUTURE. SO, OF COURSE, TO START US OFF, WE HAVE KEVIN CANE, OUR CHIEF HOUSING MARKET ANALYST, AND HE'S GOING TO SHARE THE HIGHLIGHTS OF HOW THE HOUSING MARKET IS DOING BASED ON THIRD QUARTER INDICATORS. AND WE'LL BE HEARING SOME GOOD NEWS, THAT THE HOUSING MARKETS ARE RECOVERING, BUT, OF COURSE, THEY'RE STILL FRAGILE AND THERE IS GREAT VARIATION ACROSS THE REGIONAL MARKETS. WE'VE BEEN TYING THE PANEL DISCUSSIONS DIRECTLY TO OUR NEWEST ISSUE OF EVIDENCE MATTERS AND I HOPE THAT YOU'VE ALL RECEIVED A COPY OF THIS. IT IS ON AGING IN PLACE AND I'LL PUT IN A PLUG FOR OUR WEBSITE, WWW.HUDUSER.ORG. YOU CAN ALSO DOWNLOAD THIS ISSUE. WE HAVE A VERY DISTINGUISHED PANEL TODAY AND IT'S MODERATED BY JENNIFER HULL, WHO IS THE SECRETARY SENIOR ADVISOR ON HOUSING AND SERVICES. AND OUR PANEL WILL EXAMINE THE ECONOMICS OF AGING IN PLACE, SOCIAL SERVICE DEMANDS, TECHNOLOGY AND PHYSICAL REQUIREMENTS AND OPPORTUNITIES, COMMUNITY PLANNING AND GOVERNMENT PROGRAMS. AND WE'RE ALSO HONORED TO HAVE AS OUR GUEST SPEAKER THE HONORABLE HENRY CISNEROS, OUR FORMER HUD SECRETARY UNDER PRESIDENT CLINTON. SECRETARY CISNEROS IS CURRENTLY EXECUTIVE CHAIRMAN OF CITY VIEW AND HE HAS WRITTEN EXTENSIVELY ON AGING IN PLACE ISSUES. WE'RE PLEASED TO HAVE MR. CISNEROS WITH US TODAY AND HE'S GOING TO SET THE STAGE FOR THE PANEL DISCUSSION, EXPLAINING WHY THE ISSUE IS IMPORTANT TO HIM. WE'LL PROVIDE US WITH A BACKGROUND ON THE NATIONAL TRENDS AND STATISTICS AND HE'LL BE DETAILING HIS EFFORTS AND HIS EXPECTATIONS FOR THE FUTURE. BEFORE I TURN TO KEVIN, I'D LIKE TO SHARE ONE OF THE MANY WAYS BE SECRETARY CISNEROS HAS MADE A POSITIVE IMPACT ON PD AND R. UNDER HIS WATCH, PD&R CREATED THE U.S. HOUSING MARKET CONDITIONS REPORT FROM WHICH KEVIN IS GOING TO SHARE HIGHLIGHTS. I'D HIKE TO SHARE -- LIKE TO SHARE SOME REFLECTIONS FROM OUR FORMER DEPUTY SECRETARY FOR ECONOMIC AFFAIRS. HE RECENTLY WROTE ON THE HISTORY OF THE U.S. HMC, AND I'LL BE QUOTING HIM. I HAD THE PRIVILEGE OF BEING THE EDITOR OF U.S. HMC FROM ITS BIRTH IN FEBRUARY 1994 UNTIL I RETIRED IN DECEMBER 2000. TRUTH BE TOLD, I DID NOT APPRECIATE THIS HONOR AT FIRST WHEN IN 1993, ASSISTANT SECRETARY MICHAEL STACKMAN TOLD ME THAT SECRETARY HENRY CISNEROS WANTED HUD TO HAVE A QUARTERLY PUBLICATION THAT WOULD DEMONSTRATE THE DEPARTMENT'S KNOWLEDGE AND LEADERSHIP IN THE HOUSING MARKET. I HAD TWO UNSPOKEN REACTIONS: I DON'T HAVE ANY EXPERIENCE IN PRODUCING A PERIODICAL AND WHERE DO I FIND TIME TO DO THIS? BUT THE ROLE OF A BUREAUCRAT IS NOT TO REASON WHY. [ LAUGHTER ] GETTING USHMC STARTED WAS AN ADVENTURE. SECRETARY CISNEROS ENVISIONED A REPORT SIMILAR TO THE REPORT COMPILED BY THE REGIONAL FEDERAL RESERVE BANKS ON OVERALL ECONOMIC ACTIVITY IN THEIR REGIONS WHICH IS COMBINED AND RELEASED AS A SO-CALLED STAGE BOOK BY THE FEDERAL RESERVE BOARD. THE FIRST STEP WAS ACCOMPANYING THE SECRETARY ON A VISIT TO ALAN GREENSPAN. BASED ON THAT DISCUSSION, WE DECIDED TO IMITATE THE FED BY CALLING UPON THE ECONOMISTS IN THE TEN HUD REGIONAL OFFICES TO REPORT ON HOUSING MARKSES AND TO SPOTLIGHT CONDITIONS IN IMPORTANT HOUSING MARKETS IN EACH OF THEIR REGIONS. THIS SECTION ORGANIZED BY ECONOMIC AND MARKETING ANALYST SUBDIVISION DIRECTOR DAVE CHENG BECAME A POPULAR FEATURE OF THE USHMC AND HAD VALUABLE BENEFITS. WORKING ON THIS STRENGTHENED THE CONNECTION BETWEEN ECONOMISTS IN HUD'S CENTRAL OFFICE AND THOSE IN THE FIELD. IT ALSO HELPED STANDARDIZE TECHNIQUES USED IN THE FIELD FOR HOUSING MARKET ANALYSIS. SO MR. SECRETARY, THIS IS LIKELY TO CONTINUE TO LIVE ON AND COME FULL CIRCLE. THE USHMC IS THE GO-TO REPORT FOR POLICY MAKERS AND THE PUBLIC. WE'VE GONE A LONG WAY FROM JUST PROVIDING A PAPER COPY. WE RECENTLY STREAMLINE THE REPORT SO IT'S MUCH MORE WEB FRIENDLY AND WE JUST DEVELOPED AN APP FOR IT, SO I HOPE ALL OF YOU WILL DOWNLOAD USHMC ON YOUR SMARTPHONES. I ALSO WANT TO SHOUT OUT UNDER SECRETARY CISNEROS'S WATCH, HE ALSO ESTABLISHED IN PD&R THE OFFICE OF UNIVERSITY PARTNERSHIPS AND THAT'S STILL WITH US TODAY. SO I WANT TO THANK THE SECRETARY FOR HIS STEADFAST SUPPORT OVER 20 YEARS AGO FOR PD&R AND HIS CONTINUED SUPPORT TODAY. LET ME TURN NOW TO KEVIN CANE AND INVITE HIM TO THE PODIUM AND TO SHARE HOW THE STATE OF THE NATION'S HOUSING MARKETS ARE DOING. THANK YOU. >> THANK YOU, JEAN. A LITTLE MORE NERVOUS THAN USUAL HERE WITH THE FORMER SECRETARY BEING HERE, SO WELCOME BACK, MR. SECRETARY. OUR SECOND QUARTER BRIEFING LAST YEAR WAS CANCELLED BECAUSE OF THE GOVERNMENT SHUTDOWN, SO TODAY I'LL BE TALK ABOUT THE THIRD QUARTER NUMBERS, BUT WE GOT A WAVE OF PHONE CALLS THAT CAME IN, PEOPLE WERE SO DISAPPOINTED, WONDERING WHEN WE WERE GOING TO GIVE OUR NEXT BRIEFING, SO IT'S GOOD TO BE BACK HERE TODAY AND I'D JUST LIKE TO GIVE A SHOUTOUT TO MY FAMILY FOR ALL THOSE PHONE CALLS THAT THEY MADE ON MY BEHALF. SO BEFORE I BEGIN, AS ALWAYS, I'D LIKE TO THANK WENDY AND RANDALL GOODNIGHT, TWO OF OUR FIELD ECONOMISTS WHO PUT TOGETHER ALL THE MAPS THAT YOU WILL SEE IN MY PRESENTATION THIS AFTERNOON. JUST A NOTE ABOUT THE MAPS, THE COLOR THEMES OF THE MAPS ARE ALL THE SAME. WHERE BROWN INDICATES WORSE OFF CONDITIONS OR DECLINES IN THE VARIABLE, AND BLUE INDICATES IMPROVEMENTS OR BETTER CONDITIONS. SO FIRST, LET'S TAKE A LOOK AT THE NATION'S ECONOMY. THIS FIGURE SHOWS THE YEAR OVER YEAR PERCENTAGE CHANGE IN NON-FARM PAYROLLS SINCE 2003. AND THIS IS LOOKING AT BOTH THE 12-MONTH AND THREE-MONTH AVERAGES THROUGH SEPTEMBER OF 2013. NON-FARM FAIRLS ARE A MEASURE OF THE -- PAYROLLS ARE A MEASURE OF THE NUMBER OF JOBS IN THE ECONOMY. THE 12-MONTH AVERAGE SHOWN IN BLUE SHOWS AN ANNUAL EXCHANGE AND IS A MORE STABLE MEASURE OF ECONOMIC PERFORMANCE. THE THREE-MONTH AVERAGE CHANGE KNOWN IN RED IS A GOOD INDICATOR FOR WHERE THINGS ARE HEADED. DURING THE 12 MONTHS ENDING SEPTEMBER 2013, NON-FARM PAYROLLS AVERAGED NEARLY 135.4 MILLION JOBS. THIS WAS UP 1.6% OR 2.2 MILLION JOBS COMPARED WITH A YEAR AGO. THE THREE-MONTH AVERAGE WAS UP BY 1.7% FROM A YEAR AGO. THE RATES FOR BOTH SERIES HAVE BEEN RELATIVELY STABLE SINCE JULY OF 2012 AND YOU CAN SEE THAT WITH THE FLATTENING OF THE CURVE. FOR THE TENTH CONSECUTIVE QUARTER, EVERY REGION IN THE COUNTRY ADDED JOBS RELATIVE TO A YEAR AGO AND YOU CAN SEE THAT THE ENTIRE COUNTRY IS IN BLUE. THREE REGIONS GREW AT A RATE THAT WAS FASTER THAN THE NATIONAL AVERAGE AND THOSE ARE SHOWN IN DARKER BLUE, AND THAT'S THE ROCKY MOUNTAINS, THE SOUTHWEST AND THE NORTHWEST. FOR THE FOURTH CONSECUTIVE QUARTER, GROWTH WAS SLOWEST IN THE MID-ATLANTIC REGION AT 1%. RELATIVE TO A YEAR AGO, THE RATE MUCH GROWTH WERE UP OR THE SAME IN EVERY REGION OF THE COUNTRY EXCEPT THE PACIFIC WHICH GREW AT 1.6% COMPARED WITH 2% LAST YEAR. LET'S TAKE A CLOSER LOOK AT THE SOUTHWEST REGION BY METROPOLITAN AREA AND YEAR OVER YEAR GROWTH IN THIS REGION DURING THE THIRD QUARTER WAS 2.1%. THIS WAS LED BY A 4.2% GAIN IN THE CONSTRUCTION SECTOR AND A 4.1% INCREASE IN THE LEISURE AND HOSPITALITY SECTOR. THE AREAS IN THE TWO DARKEST SHADES OF BLUE GREW FASTER THAN THE NATIONAL AVERAGE, LED BY GROWTH OF MORE THAN 5% IN BOTH FAYETTEVILLE AND MIDLAND. THE SEVEN AREAS IN BROWN HAD A DECLINE IN JOBS RELATIVE TO A YEAR AGO, LED BY A 1.3% DECLINE IN SHREVEPORT. THE NATIONAL UNEMPLOYMENT RATE WAS 7.3% DURING THE THIRD QUARTER OF 2013. THIS WAS DOWN FROM 8.1% A YEAR AGO. THE SIX REGIONS IN BLUE HAD A RATE THAT WAS LESS THAN THE NATIONAL RATE LED BY THE ROCKY MOUNTAINS AT 5.3%. THE FOUR REGIONS IN GROUND HAD A HIGHER RATE THAN THE NATIONAL AVERAGE, LED BY THE PACIFIC REGION AT 8.7%. AND ON A STATE LEVEL, NORTH DAKOTA STILL HAS THE LOWEST RATE IN THE NATION AT 2.5% AND NEVADA HAS THE HIGHEST RATE AT 9.4%. WHAT ABOUT THE CHANGE IN THE UNEMPLOYMENT RATE FROM A YEAR AGO ON A NATIONAL LEVEL? THE EMPLOYMENT RATE DURING THE THIRD QUARTER WAS DOWN 0.8 PERCENTAGE POINTS FROM LAST YEAR. THE UNEMPLOYMENT RATE DECLINED IN EVERY REGION OF THE COUNTRY, SO THE WHOLE COUNTRY, ONCE AGAIN, ALL IN BLUE. THE FIVE REGIONS IN DARK BLUE DECLINED AT A RATE THAT WAS GREATER THAN THE NATIONAL DECLINE. THE LARGEST DECLINE OCCURRED IN THE PACIFIC AT 1.4 PERCENTAGE POINTS. THE RATE FELL FROM 10.1% TO 8.7% AND THIS WAS LED BY DECLINES OF 1.6 PERCENTAGE POINTS IN NEVADA AND CALIFORNIA. SO LET ME GIVE AN OVERVIEW OF CURRENT HOUSING MARKET CONDITIONS. SALES MARKET CONDITIONS ARE BALANCED THROUGHOUT MOST OF THE COUNTRY. AS A BIT OF BACKGROUND, BALANCED CONDITIONS EXIST WHEN THE QUANTITY OF HOUSING SUPPLIED EQUALS THE QUANTITY DEMANDS. SOFT MARKETS OCCUR WHEN THE QUANTITY OF HOUSING SUPPLIED EXCEEDS THE QUANTITY DEMANDED AND WE HAVE A SURPLUS AND TIGHT MARKETS OCCUR WHEN DEMAND EXCEEDS SUPPLY AND WE HAVE A HOUSING SHORTAGE. ALL THREE HOME PRICE INDEXES SHOW THAT HOME SAILS PRICES -- SALES PRICES CONTINUED TO INCREASE DURING THE THIRD QUARTER RELATIVE TO A YEAR AGO WITH THE LARGESSE GAINS THAT WE'VE SEEN -- LARGEST GAINS THAT WE'VE SEEN IN YEARS. EXISTING HOME SALES INCREASED BY 10% DURING THE 12 MONTHS ENDING SEPTEMBER 2013 RELATIVE TO A YEAR AGO. INVENTORIES OF NEW HOMES FOR SALE WERE UP 32% FROM A YEAR AGO AND THEY WERE UNCHANGED FOR EXISTING HOMES. BASED ON THE CURRENT RATE OF HOME SALES, THERE'S A 7.2-MONTH SUPPLY OF NEW HOMES COMPARED WITH A 4.8-MONTH SUPPLY A YEAR AGO AND THERE'S A 4.9-MONTH SUPPLY OF EXISTING HOMES DOWN FROM A 5.4-MONTH SUPPLY A YEAR AGO. THE SALES VACANCY RATE WAS 1.9% IN THE THIRD QUARTER, UNCHANGED FROM A YEARING, AND -- YEAR AGO, AND RENTAL MARKET CONDITIONS ARE BALANCED TO TIGHT THROUGHOUT THE COUNTRY. AN ESTIMATED 67% OF NEW APARTMENTS THAT WERE COMPLETED DURING THE SECOND QUARTER WERE ABSORBED WITHIN THREE MONTHS. THIS WAS UNCHANGED FROM A YEAR AGO. AND MULTIFAMILY PRODUCTION INCREASED BY 8% IN THE THIRD QUARTER RELATIVE TO A YEAR AGO. AND NOW LET'S TAKE A LOOK AT REGIONAL CONDITIONS AROUND THE COUNTRY. THESE ARE PROVIDED BY OUR FIELD ECONOMISTS. RELATIVE TO LAST QUARTER, IMPROVEMENTS IN AN AREA ARE SHADED IN BLUE AND DECLINES ARE SHADED IN BROWN. SO YOU CAN SEE NOT A WHOLE LOT OF CHANGE FROM LAST QUARTER. SALES MARKET CONDITIONS ARE BALANCED IN MOST OF THE COUNTRY WITH SOME SOFTNESS IN A FEW REGIONS, THE NEW YORK-NEW JERSEY REGION, MID-ATLANTIC, THE SOUTHEAST AND THE PACIFIC. IN THE NORTHWEST, CONDITIONS ARE BEGINNING TO MOVE FROM BALANCED AND ARE STARTING TO SHOW SOME TIGHTENING WITH LOW INVENTORIES OF AVAILABLE HOMES AND REDUCED LEVELS OF HOME CONSTRUCTION. OUTSIDE OF THE NORTHWEST, MARKETS IN THE REST OF THE COUNTRY REMAIN RELATIVELY STABLE COMPARED WITH LAST QUARTER. RENTAL MARKET CONDITIONS ARE ALSO RELATIVELY STABLE COMPARED WITH LAST QUARTER WITH A MIXTURE OF PRIMARILY BALANCED AND TIGHT CONDITIONS. THE ONLY EXCEPTION WAS IN THE ROCKY MOUNTAIN REGION WHERE PREVIOUSLY TIGHT CONDITIONS HAVE IMPROVED A LITTLE AND ARE MOVING TOWARDS A MORE BALANCED STATE. FOR THE SIXTH CONSECUTIVE QUARTER, ALL THREE HOME PRICE INDICES SHOW AN INCREASE RELATIVE TO A YEAR AGO AND THE RATE OF GROWTH CONTINUES TO GOUP. THE CASE-SHILLER HOME PRICE INDEX WAS UP BY 11.2%, THE FHFA INDEX WAS UP BY 8.4% AND THE CORE LOGIC INDEX WAS UP BY 11.6% AND TO PUT THIS INTO PERSPECTIVE, A YEAR AGO, ALL OF THESE INDEXES WERE UP BY 5%, SO WE'RE SEEING ABOUT DOUBLE THE RATE OF HOME PRICE GROWTH. THIS NEXT MAP SHOWS THE CHANGE IN THE CORE LOGIC INDEX BY REGION FROM THE THIRD QUARTER OF 2012 TO THE THIRD QUARTER OF 2013. THIS IS NOT SEASONALLY ADJUSTED DATA AND IT INCLUDES DISTRESS SALES. NATIONALLY THE INCREASE WAS 11.6% WITH PRICES UP IN EVERY SINGLE REGION, AGAIN, ALL IN BLUE. THE WEST COAST, WHICH IS IN DARK BLUE, WAS UP BY MORE THAN THE NATIONAL AVERAGE WITH GAINS OF 21% IN THE PACIFIC REGION AND 12.2% IN THE NORTHWEST. THE SOUTHEAST REGION ALSO HAD DOUBLE-DIGIT INCREASE OF 10%. FOR THE FIRST TIME SINCE WE'VE BEEN DOING THESE BRIEFINGS, WHICH GOES BACK TO 2010, PRICES WERE UP IN EVERY SINGLE STATE. 13 STATES HAD DOUBLE-DIGIT PRICE INCREASES AND THAT WAS LED BY NEVADA AND CALIFORNIA WHERE PRICES WERE UP BY MORE THAN 120%. ACCORDING TO THE CENSUS BUREAU, THE MEDIAN PRICE OF A NEW HOME IN THE THIRD QUARTER WAS $267,000, UP 3% FROM A YEAR AGO AND ACCORDING TO THE NATIONAL ASSOCIATION OF REALTORS, THE MEDIAN PRICE OF AN EXISTING HOME WAS $207,300, UP 13% FROM A YEAR AGO. THIS NEXT MAP SHOWS THE PRICE CHANGES IN THE NORTHWEST REGION AT THE METROPOLITAN LEVEL DURING THE THIRD QUARTER. PRICES WERE UP IN EVERY METRO AREA EXCEPT FOR FAIRBANKS, WHICH WAS DOWN BY LESS THAN 1%. EIGHT AREAS INCREASED AT A FASTER RATE THAN THE NATIONAL AVERAGE SHOWN IN THE DARK BLUE, AND THAT INCLUDES SEATTLE, PORTLAND, AND BOISE CITY. THE LARGEST INCREASE WAS IN BEND, OREGON, AT 18%. THIS NEXT MAP SHOWS THE PERCENT OF HOME LOANS THAT ARE 90 DAYS OR MORE DELINQUENT, IN FORECLOSURE OR IN REO AS OF SEPTEMBER 2013. REO STANDS FOR REAL ESTATE OWNED, WHICH MEANS THE LENDER NOW OWNS THE PROPERTY. THE NATIONAL AVERAGE WAS 6% OF ALL LOANS IN THOSE THREE CATEGORIES. THIS WAS DOWN FROM 7.5% IN SEPTEMBER OF 2012. THE FOUR REGIONS IN GROUND HAVE A RATE HIGHER THAN THE NATIONAL AVERAGE WHILE THE SIX REGIONS IN BLUE ARE BELOW THE NATIONAL AVERAGE. THE RATE DECLINED IN EVERY REGION OF THE COUNTRY AND, IN FACT, THE RATE DECLINED IN EVERY SINGLE STATE. THE MOST DRAMATIC CHANGE WAS IN THE PACIFIC, DOWN 2.5 PERCENTAGE POINTS AND THE SOUTHEAST DOWN 2.4 PERCENTAGE POINTS, AND THESE WERE LED BY DECLINES IN FLORIDA OF 4.3 PERCENTAGE POINTS, NEVADA OF 3.7 PERCENTAGE POINTS, AND CALIFORNIA OF 2.5 PERCENTAGE POINTS. LET'S STEAK A CLOSER LOOK AT THE -- TAKE A CLOSER LOOK AT THE ROCKY MOUNTAIN REGION, WHICH HAS THE LOWEST RATE OF DISTRESSED LOANS IN THE COUNTRY. EVERY METRO AREA HAS A RATE BELOW THE NATIONAL AVERAGE AND OUTSIDE OF UTAH AND COLORADO, ALL THE METRO AREAS ARE IN DARK BLUE, INDICATING A RATE THAT'S AT LEAST 3 PERCENTAGE POINTS BELOW THE NATIONAL AVERAGE. IN ADDITION, THE PERCENTAGE OF DISTRESSED LOANS DECLINED IN EVERY METROPOLITAN AREA IN THE REGION DURING THE PAST YEAR WITH THE LARGEST DECLINE OF 2.2 PERCENTAGE POINTS IN ST. GEORGE, UTAH. EXISTING HOME SALES INCREASED BY 10.1% DURING THE 12 MONTHS ENDING SEPTEMBER 2013. SALES INCREASED IN EVERY REGION, ONCE AGAIN THE WHOLE COUNTRY IS IN BLUE, WITH DOUBLE-DIGIT INCREASES IN THE DARK BLUE REGIONS WHICH INCREASED AT A RATE FASTER THAN THE NATIONAL AVERAGE. THE LARGEST INCREASE IN SALES OCCURRED IN THE NORTHWEST AT 17.4%, FOLLOWED BY THE SOUTHEAST AT 16.3%. AND JUST TO NOTE SOMETHING THAT'S NOT SHOWN ON THE MAP, NEW HOME SALES WERE UP BY JUST 1% FROM THE THIRD QUARTER OF 2012 TO THE THIRD QUARTER OF 2013. LOOKING CLOSER ONCE AGAIN AT THE NORTHWEST REGION, WHICH HAD THE LARGEST INCREASE, SALES WERE UP IN EVERY METROPOLITAN AREA AND THE SIX AREAS IN THE LIGHTEST SHADE OF BLUE INCREASED AT A RATE THAT WAS BELOW THE NATIONAL AVERAGE. THE AREAS IN THE TWO DARKER SHADES OF BLUE INCREASED FASTER THAN THE NATIONAL AVERAGE, WITH THOSE TEN AREAS IN THE DARKEST SHADE INCREASING BY MORE THAN 20% AND THAT INCLUDES SEATTLE, SPOKANE, BREMERTON AND PORTLAND. LET'S TAKE A LOOK AT SINGLE-FAMILY HOME BUILDING AS MEASURED BY BUILDING PERMITS ISSUED. THIS INCREASED BY 20% DURING THE THIRD QUARTER OF 2013, TO 152,600 HOMES. SINGLE-FAMILY HOME BUILDING INCREASED IN EVERY REGION OF THE COUNTRY WITH GAINS RANGING FROM 9% IN THE NORTHWEST TO 43% IN NEW YORK-NEW JERSEY. AND IT'S VERY TELLING TO LOOK AT THESE NUMBERS ON A MAP TO SEE THE REGIONAL DIFFERENCES. THE EASTERN HALF OF THE COUNTRY INCREASED BY MORE THAN THE NATIONAL AVERAGE SHOWN IN THE DARKER BLUE. THE NUMBER OF MULTIFAMILY PERMITS WAS UP BY 8% TO 86,300 UNITS DURING THE THIRD QUARTER. INCREASES OCCURRED IN SEVEN REGIONS AND RANGED FROM 13% IN THE PACIFIC TO 48% IN THE MIDWEST AND NEW ENGLAND. MULTIFAMILY PERMITS DECLINED IN THE SOUTHWEST, THE SOUTHEAST AND THE NORTHWEST. VACANCY RATES CONTINUE TO DECLINE THROUGHOUT MUCH OF THE COUNTRY. YOU CAN SEE THIS IN THE THREE SHADES OF BROWN DOT. ACCORDING TO REESE DATA, WHICH COVERS 275 MARKET AREAS, VACANCY RATES WERE DOWN IN 208 MARKET AREAS, UP IN 56 AREAS AND UNCHANGED IN 11 AREAS. THE AVERAGE U.S. VACANCY RATE DECLINED BY HALF A PERCENTAGE POINT FROM 4.7% A YEAR AGO TO 4.2%. THERE WERE TEN MARKETS WITH A DECLINE OF 2 PERCENT STAGE POINTS OR MORE AND THOSE ARE SHOWN IN DARK BROWN, FOUR OF WHICH WERE IN FLORIDA. THE LIGHT BROWN AREAS DECLINE BY LESS THAN THE NATIONAL DECLINE AND THE MEDIUM BROWN AREAS DECLINED BETWEEN HALF A PERCENT AND TWO PERCENTAGE POINTS. ACCORDING TO THE CENSUS BUREAU FOR THE ENTIRE U.S., THE RENTAL VACANCY RATE WAS DOWN FROM A YEAR AGO. LET'S TAKE A CLOSER LOOK AT THE PACIFIC REGION. VACANCY RATES DOWN IN 29 OF THE 35 AREAS, AGAIN SHOWN IN BROWN W DECLINES OF MORE THAN ONE PERCENT IN RENO, LAS VEGAS, PHOENIX AND TUCSON. RATES WERE UP IN THE SIX AREAS SHOWN IN BLUE, ALTHOUGH ONLY TWO OF THOSE BY MORE THAN ONE PERCENT. RENTS WERE UP BY 2.8% NATIONALLY ACCORDING TO REESE FROM THE THIRD QUARTER OF 2012 TO 2013. THE AVERAGE MARKET RENT FOR THE 275 AREAS WAS $1,122 AND THIS COMPARES WITH $1,091 A YEAR AGO. RENTS INCREASED IN 266 OF THE 275 AREAS. THEY WERE DOWN IN ONLY SIX AREAS SHOWN IN BROWN AND THEY WERE UNCHANGED IN THREE AREAS. RENTS INCREASED BY MORE THAN 4% IN 11 MARKET AREAS AND THOSE ARE SHOWN IN DARK BLUE. AREAS IN LIGHT BLUE INCREASED BY LESS THAN THE NATIONAL AVERAGE. AND NOW LET'S TAKE A CLOSER LOOK AT THE SOUTHEAST REGION. RENTS WERE UP IN 61 OF THE 65 METROPOLITAN AREAS. THE THREE AREAS IN BROWN HAD DECLINES AND ONE AREA REMAINED UNCHANGED. 11 AREAS INCREASED BY MORE THAN THE NATIONAL AVERAGE AND THOSE ARE SHOWN IN THE TWO DARKER SHADES OF BLUE. THIS WAS LED BY NASHVILLE AT 4.7% AND SEVEN OF THOSE AREAS ARE IN FLORIDA, INCLUDING MIAMI. SO JUST AS A SUMMARY, YEAR OVER YEAR JOB GROWTH FOR THE THIRD QUARTER WAS 1.7%. SALES MARKETS ARE BALANCED THROUGHOUT MOST OF THE COUNTRY, AND PRICES HAD THE MOST SIGNIFICANT INCREASE IN YEARS. AND SALES WERE UP AS WELL. RENTAL MARKET CONDITIONS ARE BALANCED TO TIGHT THROUGHOUT THE COUNTRY WITH RENTS CONTINUING TO RISE AND VACANCY RATES CONTINUING TO DECLINE. FOR ADDITIONAL INFORMATION, PLEASE GO TO THE U.S. HOUSING MARKET CONDITIONS REPORT ON OUR WEBSITE ON HUDUSER.ORG. YOU CAN TALK WITH YOUR LOCAL REGIONAL OR FIELD ECONOMISTS OR FEEL FREE TO CONTACT ME. JEAN HAD MENTIONED IN HER DISCUSSION THE NEW U.S. HOUSING MARKET CONDITIONS APP FOR NOBLE DEVICES. IT'S PART OF OUR ONGOING EFFORTS TO MODERNIZE THE U.S. HOUSING MARKET CONDITIONS REPORT AND ALLOW OUR DATA ANNALS TO BE ACCESSED MORE EAST EASILY AND BY MORE USERS. THE NEW APP IS GEARED TOWARD NATIONAL AND REGIONAL HOUSING MARKET USERS. THE NEW APP WILL ALLOW USERS TO SEE A CURRENT SNAPSHOT OF IMPORTANT HOUSING MARKET INDICATORS AS WELL AS HISTORIC CHARTS AND NEARLY 80 HOUSING MARKET INDICATORS. YOU CAN GO TO THE U.S. HOUSING MARKET CONDITIONS WEBSITE FOR INSTRUCTIONS ON HOW TO DOWNLOAD THIS APP. NOW IT IS MY PLEASURE TO PASS THINGS OVER TO JENNIFER HULL, WHO IS THE SENIOR ADVISOR ON HOUSING AND SERVICES TO THE SECRETARY WHO'S GOING TO MODERATE OUR PANEL THIS AFTERNOON. >> THANK YOU SO MUCH. [ APPLAUSE ] >> THANKS, KEVIN. THAT'S GREAT NEWS. CLEARLY A SIGN THAT THE HOUSING MARKET IS IMPROVING AND THANKS FOR WALKING US THROUGH THAT REPORT. WE'RE HERE TODAY TO THINK ABOUT THE CHALLENGES AND THE OPPORTUNITIES ASSOCIATED WITH AGING IN PLACE. I DO A LOT OF WORK IN THE AREA OF HOMELESSNESS AND IT'S SOMETHING THAT WE KNOW THAT WE WANT NO ONE TO EXPERIENCE. WE WANT NEVER TO HAVE HAPPEN IN AMERICA. THIS IS GREAT FOR ME TO BE INVOLVED IN A CONVERSATION ON AGING IN PLACE, WHICH IS SOMETHING THAT I THINK WE ALL WANT. WE WANT FOR OUR PARENTS AND WE WANT FOR OURSELVES. AND SO THIS IS AN OPPORTUNITY TO THINK ABOUT WHAT DOES IT REALLY MEAN TO AGE IN PLACE AND WHAT IS IT THAT NEEDS TO HAPPEN IN THIS COUNTRY AS WE MOVE FROM THE WAY THINGS ARE BUILT AND ORGANIZED TODAY TO THE WAY THAT THINGS NEED TO BE BUILT AND ORGANIZED IN THE FUTURE AS WE ANTICIPATE OUR OWN NEEDS AS WE MOVE THROUGH LIFE. WHAT I'M GOING TO DO IS TO INTRODUCE THE MEMBERS OF THE PANEL ALTOGETHER AND THEN THEY WILL SPEAK TOGETHER AND THEN WE'LL HAVE AN OPPORTUNITY FOR A PANEL DISCUSSION AND THEN OPEN IT UP FOR FAITION BOTH BY THE -- PARTICIPATION BOTH BY THE AUDIENCE AND ALSO FROM FOLKS VIEWING US ONLINE. SO I WANT TO START BY GOING IN REVERSE ORDER AND START WITH JAMES HAYES. SO JAMES IS A GREAT PARTNER TO US AT HUD OVER AT THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES INSIDE OF THE ADMINISTRATION FOR COMMUNITY LIVING WHERE HE'S A SENIOR POLICY ANALYST. MOST OF JAMES'S CAREER WAS SPENT IN THE STATE OF OREGON WHERE THEY REALLY DID SOME AMAZING WORK TRANSFORMING BOTH THEIR DISABILITY AND THEIR AGING SYSTEMS, AND HE'S WORKED ON THIS ISSUE FROM MANY, MANY DIFFERENT ANGLES AND BROUGHT THAT SUCCESS TO WASHINGTON, D.C., WHEN HE CAME IN NOVEMBER OF 2011, WHERE HE JOINED THE OFFICE OF DISABILITIES AS A SENIOR POLICY ANALYST AND THEN BECAME A SENIOR POLICIES ADVISOR. JAMES, BLAD TO HAVE YOU -- GLAD TO HAVE YOU HERE BUT ALSO GLAD TO HAVE YOU AS A PARTNER IN THIS WORK. WE ALSO HAVE SOME GUEST. JUDY AS SENIOR PROFESSIONAL WITH 30 YEARS OF MARKETING AND EXPERIENCE IN ELDER SERVICES. SHE WAS THE PRESIDENT OF SPRING HOUSE RETIREMENT COMMUNITY, DIRECTOR OF NEWTON COOPERATIVE LIVING, AND HAS RUN MANY NONPROFIT ORGANIZATIONS AND CONFERENCES THAT OFFERED ELDERS CREATIVE HOUSING OPTIONS. SHE WAS THE FOUNDING EXECUTIVE DIRECTOR OF BEACON HILL VILLAGE, A PIONEERING AND NATIONALLY RENOWNED AGING IN COMMUNITY OPTION THAT HELPED ELDERS STAY IN THEIR HOMES. SHE'S THE NATIONAL DIRECTOR OF THE VILLAGE TO VILLAGE NETWORK, A PEER-TO-PEER ONLINE, NONPROFIT THAT SERVICES COMMUNITIES THAT ARE OPERATING AND CREATING VILLAGES ALL OVER THE COUNTRY, SOMETHING THAT SHE WILL EXPLAIN TO US AND SPEAK MORE ABOUT. UP NEXT TO JUDY IS ALISA SANDERS. SHE'S A SENIOR POLICY RESEARCH ASSOCIATE AT THE CENTER FOR APPLIED RESEARCH AND THE MANAGING DIRECTOR OF THE CENTER FOR HOUSING PLUS SERVICES, BOTH WITHIN LEADING AGE. HER WORK WITH BOTH GROUPS FOCUSES ON IDENTIFYING, EVALUATING AND ADVANCING MODELS AND STRATEGIES TO LINK LOW INCOME SENIOR HOUSING WITH HEALTH AND SUPPORTIVE SERVICES TO HELP RESIDENTS MEET THEIR NEEDS, MAINTAIN THEIR QUALITY OF LIFE AND SUCCESSFULLY AGE IN PLACE. PRIOR TO JOINING LEADING AGE, SHE WAS THE ASSOCIATE DIRECTOR OF PUBLIC POLICY FOR AGING SERVICES OF CALIFORNIA WHERE SHE ADVOCATED FOR IMPROVED AFFORDABLE HOUSING OPPORTUNITIES FOR CALIFORNIA'S LOWER INCOME SENIORS. BEFORE I INTRODUCE SECRETARY CISNEROS, I'M NOT GOOD AT JOKES, BUT I WAS TRYING TO FIGURE OUT HOW TO START ONE WITH, WHAT HAPPENS WHEN TWO HUD SECRETARIES GET IN A ROOM TOGETHER, BECAUSE WHEN SECRETARY CISNEROS CAME TODAY, HE HAD AN OPPORTUNITY TO SIT WITH SECRETARY DONOVAN, AND I THINK FOR ANYBODY WHO WORKS AT HUD, YOU KNOW THAT WHEN YOU HAVE AN ENCOUNTER WITH ONE SECRETARY, YOU ALWAYS LEAVE WITH WORK TO DO, SO I THINK THE ANSWER IS THAT WHEN TWO SECRETARIES GET TOGETHER, YOU NOT ONLY END UP WITH WORK TODAY, BUT YOU END UP WITH VERY CHALLENGE, HARD AND DIFFICULT WORK THAT'S URGENT AND NEEDS TO BE DONE RIGHT NOW. SO THE CHALLENGE THAT WE HAVE TODAY IS THAT AS THEY WERE TALKING, THEY THOUGHT THAT A GOOD OUTCOME OF THIS DIALOGUE WOULD BE THAT WE WOULD IDENTIFY A HANDFUL OF THINGS THAT ARE THE MOST IMPORTANT THINGS THAT WE AT HUD CAN DO IN ORDER TO WROTE MOAT AGING IN PLACE -- PROMOTE AGING IN PLACE. SO AS YOU LISTEN TO THE PANELISTS TODAY AND AS THEY'RE ENGAGED IN CONVERSATION AND AS YOU JOIN THE CONVERSATION, I INVITE YOU TO THINK ABOUT THAT, BECAUSE IT IS A GREAT OPPORTUNITY FOR US TO JUST PAUSE AND THINK ABOUT WHAT ARE THE MOST IMPORTANT THINGS THAT WE CAN DO, BECAUSE IF WE AREN'T DOING THINGS RIGHT NOW TODAY, THE AGING OF AMERICA IS HAPPENING. YOU KNOW, IT'S NOT GOING TO STOP BECAUSE, BECAUSE WE WERE TOO BUSY WITH OTHER THINGS OR BECAUSE OTHER THINGS HAPPENED. WE NEED TO BEGIN TODAY TO BE MAKING SURE THAT WE ARE REDESIGNING AND BUILDING AND CRAFTING THE HOMES AND COMMUNITIES THAT ARE GOING TO MAKE IT POSSIBLE TO AGE IN PLACE. SO THAT'S OUR CHALLENGE AS WE MOVE INTO THIS SESSION. SO IT IS MY GREAT PLEASURE AND HONOR -- I KNOW YOU SAID I COULDN'T SAY ANYTHING MORE, BUT IT'S MY GREAT PLEASURE AND HONOR TO BE ABLE TO INTRODUCE FORMER HUD SECRETARY HENRY CISNEROS TODAY. A LOT OF PEOPLE PROBABLY HAD THE OPPORTUNITY TO WORK WITH HIM OVER THE YEARS AND SO I WON'T GO ON AT LENGTH ABOUT HIS HISTORY OR BACKGROUND, BUT IT'S STRIKING TO ME AS I WAS PREPARING FOR THIS, JEAN MENTIONED THE NUMBER OF LEGACY PROJECTS THAT THERE ARE FROM YOUR LEADERSHIP AND MARK JOHNSTON MENTIONED AS YOU CAME IN THE WORK ON THE CONTINUUM OF CARE THAT IMPACTS HOMELESSNESS, THE WAY THAT YOU BROUGHT HOPE 6 TO LIFE, WHICH HAS TRANSFORMED INTO CHOICE NEIGHBORHOODS AND NOW IS A PART OF THE NEW PROMISE ZONES. SO MANY THINGS HAVE YOUR SIGNATURE ON THEM. IN THIS AREA OF AGING IN PLACE, YOU'VE NOW PUBLISHED THIS BOOK, INDEPENDENCE FOR LIFE, HOMES AND NEIGHBORHOODS FOR AN AGING AMERICA, TO HELP SPUR HOW WE THINK ABOUT THIS IMPORTANT ISSUE. BUT I THINK THAT FOR FOLKS WHO HAD AN OPPORTUNITY TO WORK WITH YOU AT HUD, THE THING THAT THEY REMEMBER THE MOST IS YOUR PASSION AND YOUR FIERCE DEFENSE OF -- AND THE PROMISE TO FIGHT FOR OUR NATION'S COMMITMENT TO PEOPLE WHO NEED HELP AND PROVIDE SHELTER AND ASSISTANCE TO MILLIONS OF LOW INCOME AMERICANS. SO WITH THAT, I PLEASE ASK YOU TO GIVE A WARM HUD WELCOME TO SECRETARY HENRY CISNEROS. [ APPLAUSE ] >> THANK YOU. THANK YOU VERY MUCH. JENNIFER, THANK YOU SO MUCH FOR YOUR KIND WORDS. THANK YOU ALSO FOR MODERATING THE SESSION TODAY. I CAN ASSURE YOU WE'RE GOING TO HAVE A LIVELY DISCUSSION AS WE GET THROUGH THE PRESENTATIONS AND ACTUALLY ENGAGE IN A DISCUSSION AMONGST EACH OTHER AND WITH YOU BECAUSE OF THE WAY THAT JENNIFER IS GOING TO MANAGE TODAY'S DIALOGUE, SO THANK YOU, JENNIFER, FOR ALL YOU DO FOR OUR DEPARTMENT AND THEREFORE FOR OUR COUNTRY. AND IT'S A SPECIAL TREAT TO JOIN JAMES AND JUDITH AND ALISHA, EACH OF WHOM BRINGS EXTENSIVE EXPERIENCE IN THIS FIELD AND, AGAIN, I CAN ASSURE YOU YOU'RE GOING TO LEARN SOME THINGS TODAY ABOUT THIS EMERGING FIELD OF NOT JUST HOUSING FOR AGING AMERICANS, BUT PARTICULARLY FOR THOSE WHO WANT TO LIVE IN THEIR OWN HOMES IN THEIR OWN COMMUNITIES FOR THE LONG RUN. IT'S A TRULY PRESSING NATIONAL ISSUE AND OPPORTUNITY TO TRY TO REDUCE SOME OF THE COSTS OF HEALTHCARE, TO TRY TO CREATE QUALITY LIVES FOR PEOPLE, TO TRY TO ENSURE THE SUSTAINING OF VIBRANT COMMUNITIES BECAUSE, AS PEOPLE AGE, THEY CAN STAY IN THE PLACES THAT THEY MOST WANT TO BE. THANK YOU VERY MUCH TO DEPUTY ASSISTANT SECRETARY JEAN LIMPO FOR HER KIND WORDS. THANK YOU FOR YOUR RECOLLECTION OF SOME OF THOSE THINGS WE WORKED ON IN THOSE YEARS, AND IT'S A TREAT TO BE BACK IN THE BUILDING. THIS IS ONLY MY THIRD TIME BACK SINCE I WAS -- I LEFT HERE IN 1997, AND IT WAS REFLECTED IN MY GREETING AT THE BUILDING THIS MORNING. I WALKED IN AND THE LADY SAID, WHAT'S YOUR NAME. I SAID HENRY CISNEROS. SHE SAID, HAVE YOU BEEN HERE BEFORE? [ LAUGHTER ] I SAID, YES, MA'AM, I USED TO COME EVERY DAY. I USED TO BE THE SECRETARY HERE, AND SHE SAID, NOT WHILE I'VE BEEN HERE. [ LAUGHTER ] SO I HAD MY OWN AGING IN THIS PLACE. [ LAUGHTER ] EXPERIENCE TODAY. BUT THANK YOU, MADAM SECRETARY, FOR YOUR IMPORTANT STEWARDSHIP OF THE DATA AND RESEARCH RESPONSIBILITIES AT PD&R, AND KEVIN, I DON'T KNOW WHETHER YOU'VE THOUGHT ABOUT A CAREER IN BROADCASTING, BUT THAT WAS WONDERFUL DELIVERY. I CAN HEAR YOU ON CNBC OR SOME OTHER SUCH PLACE. BUT I'M VERY PROUD OF THE WORK THAT YOU'VE DONE IN KEEPING THE "H" IN HUD. THE COUNTRY TENDS TO THINK OF HUD AS SPECIALIZING IN ASSISTED HOUSING AND PUBLIC HOUSING AND OTHER STRATEGIES, BUT AS I WAS TOLD LITERALLY, THE DAY OF MY CONFIRMATION HEARING ON THE HILL, NEVER FORGET THAT THE FIRST LETTER OF THE WORD HUD IS HOUSING. IT IS THE DEPARTMENT THAT'S RESPONSIBLE FOR THIS INCREDIBLY IMPORTANT SECTOR OF AMERICAN LIFE, AND OVER THE YEARS, WORKING IN HOMELESSNESS AND A LOT OF OTHER DIMENSIONS OF HOUSING, YOU KNOW, IT'S BEEN DRIVEN HOME TO ME OVER AND OVER, WORKING IN DISASTER SETTINGS WHERE PEOPLE ARE FORCED OUT OF THEIR HOUSING IN AN INSTANT, JUST WHAT AN ESSENTIAL PIECE OF LIFE HOME, HOUSE, APARTMENT, PLACE TO LIVE, DECENT SHELTER IS. NOT JUST IN AN ECONOMIC SENSE, 20% OF GDP WITH ACCESSORIES AND FINANCE TOSSED IN, AND NOT JUST IMPORTANT IN THE LIVES OF INDIVIDUALS FINANCIALLY, BUT IT IS TRULY A SACRED PLACE WHERE THE LIFE OF AMERICA PLAYS OUT AND THAT'S WHAT THIS RESPONSIBILITY, THIS DEPARTMENT IS CHARGED WITH. I THINK KEVIN CAPTURED THE IDEA OF A REBOUND IN THE HOUSING MARKETS AS JENNIFER SAID. I SPOKE EARLIER THIS WEEK AT THE OUTLOOK CONFERENCE FOR THE GREATER SAN ANTONIO BUILDERS ASSOCIATION IN MY HOMETOWN AND WITH SOME OF THE RESEARCH THAT MIRRORS WHAT KEVIN SUGGESTED, AND EXPERTS ARE CALLING IT, FINALLY, AT THIS POINT IN THE RECESSION AND REBOUND, THE BREAKOUT YEAR IN WHICH THE HOUSING SECTOR WILL PLAY ITS TRADITIONAL ROLE IN TAKING THE RECOVERY TO ITS FULL POTENTIAL. BUT AS A HOUSING SECRETARY ON THE SIDELINES FOR MUCH OF THIS, ONE EXPERT SAID THE HOUSING SECTOR FEELS LIKE THAT QUESTION THAT CHILDREN ASK WHEN WE'RE ON A TRIP IN THE BACK SEAT OF THE CAR: ARE WE THERE YET? AND WE HAVEN'T BEEN THERE YET IN TERMS OF HOUSING PLAYING ITS FULL ROLE IN THIS RECOVERY, BUT IN NOVEMBER, WE HIT A 7% UNEMPLOYMENT RATE WITH 2.5% GROWTH RATE, AND IT IS SUGGESTED THAT IN 2014, THAT 6 -- THAT 7 MAY BE ABLE TO DROP TO 6% UNEMPLOYMENT RATE AND GROWTH WILL BE MORE IN THE 3 TO 3.5% RATE BECAUSE OF THE EVIDENCE THAT THE HOUSING SECTOR IS COMING BACK STRONGLY ENOUGH TO PLAY THE ROLE THAT IT'S TRADITIONALLY PLAYED IN RECOVERY. SO THIS IS GOOD INFORMATION. THANK YOU, KEVIN, FOR YOUR WORK. TODAY IS A DIFFERENT SUBJECT. TODAY IS FOCUSING ON PEOPLE WHO WILL BE, QUOTE, AGING IN PLACE, AND I'M GOING TO ZIP THROUGH SOME POINTS HERE, BUT LET ME JUST BEGIN BY SAYING, THIS IS AN IMPORTANT SUBJECT BECAUSE OF DEMOGRAPHIC CHANGE IN AMERICA. TODAY, WE HAVE ABOUT 20 MILLION PEOPLE OVER -- I'M SORRY, WE HAVE ABOUT 40 MILLION PEOPLE OVER 65 YEARS OF AGE. IT IS ANTICIPATED THAT NUMBER WILL BE 80 MILLION OVER THE COURSE OF THE NEXT FOUR YEARS. SO THAT WILL DOUBLE. WE HAVE SOMETHING LIKE 6 MILLION PEOPLE OVER 85 TODAY AND THAT SAME TIME FRAME, THE NUMBER WILL BECOME 20 MILLION, SO A TRIPLING OF THE POPULATION OVER 85 YEARS OF AGE. JUST BRIEFLY, THIS IS A PHENOMENA BEING EXPERIENCED IN MANY COUNTRIES, PARTICULARLY THE NORTHERN INDUSTRIAL NAPETION, WHERE PEOPLE ARE -- NATIONS, WHERE PEOPLE ARE LIVING LONGER FOR A VARIETY OF REASONS AND WHERE REPLACEMENT IS NOT OCCURRING. IN THE UNITED STATES, WE'LL NOT BE FOLLOWING THE TRAJECTORY OF JAPAN OR FRANCE OR PORTUGAL OR SPAIN OR OTHER COUNTRIES THAT WILL ACTUALLY BE DECLINING IN POPULATION AS THEY ARE AGING. REAL TOUGH ISSUES. WE DON'T HAVE TIME TODAY TO GO INTO THAT, BUT THIS IS TRULY SIGNIFICANT GLOBAL SECURITY AND ECONOMIC CRISES THAT THEY WILL CONFRONT ALL AROUND THIS QUESTION OF DEMOGRAPHICS. WE WON'T CONFRONT THAT BECAUSE EVEN THOUGH WE'RE GETTING CONSIDERABLY OLDER, WE'RE ALSO ADDING YOUNGER POPULATION PRINCIPALLY THROUGH IMMIGRATION, AND AS A RESULT, WE'RE GOING TO CONTINUE TO GROW. IN FACT, BY 100 MILLION PEOPLE BETWEEN 2010 AND 2050. WE GO TO ABOUT 410 MILLION FROM THE 306 MILLION WE HAD IN 2010, BUT WE ARE GOING TO HAVE A LARGER, MUCH LARGER NUMBER OF PEOPLE WHO ARE MUCH OLDER LIVING INTO THEY'RE 80s AND 90s, AND WE NEED TO THINK ABOUT HOUSING SOLUTIONS FOR THEIR WELL-BEING AS WELL AS FOR THE WAY OUR COMMUNITIES FUNCTION AND THE WAY OUR NATIONAL ECONOMY FUNCTIONS BECAUSE WE'RE GOING TO HAVE HUGE COST ISSUES ASSOCIATED WITH SOCIAL SECURITY, HEALTH SYSTEMS, ETCETERA. THIS IS A MASSIVELY IMPORTANT ISSUE FOR THOSE OF US WHO CALL OURSELVES HOUSERS. NOW, ABOUT 93% OF PEOPLE WHO ARE OF ADVANCED AGE AT ANY GIVEN MOMENT IN TIME DO NOT LIVE IN ASSISTED HOUSING, NURSING HOMES, OR OTHER PLACES THAT ARE BUILT SPECIFICALLY FOR THE ELDERLY. THEY ARE, QUOTE, AGING IN PLACE IN THEIR OWN HOMES, IN APARTMENTS. SOMETIMES IN ASSISTED HOUSING, NOT ASSISTED LIVING, BUT GOVERNMENTALLY SUBSIDIZED HOUSING, BUT THEY'RE LIVING ON THEIR OWN ESSENTIALLY. AND I HAVE -- I FIRST GOT INTO THIS SUBJECT AREA BECAUSE I REMEMBER IN THE YEARS THAT I WAS MAYOR OF SAN ANTONIO, I WOULD GO TO COMMUNITY MEETINGS, TOWN HALL TYPE MEETINGS ON A WEEK NIGHT, AND EVERYONE THERE WAS OLDER AND THE PROBLEMS THAT THEY DESCRIBED TO ME WERE UNIQUE TO THE ELDERLY. THAT IS TO SAY, THE PROBLEMS THAT THEY DESCRIBED ARE SECURITY OR ARE TRANSPORTATION, IT JUST SEEMED TO ME, YOU KNOW, IF WE DID A GPS ANALYSIS OF THIS NEIGHBORHOOD, WE COULD SERVE IN NEIGHBORHOOD IN A DIFFERENT WAY. WE COULD OFFER POLICING SERVICES IN A DIFFERENT WAY AND SHOULD. WE COULD OFFER HOUSING ASSISTANCE IN A DIFFERENT WAY AND SHOULD. AND IT SORT OF WAS WITH ME BUT I NEVER REALLY ACTED ON IT. AT HUD, AGAIN, YOU CAN SEE THE DATA, BUT WE NEVER REALLY INITIATED MUCH IN THAT ARENA AND THEN SOME YEARS AGO, I'M BACK IN THE HOUSING FIELD, I'VE BEEN FOR THE LAST 13 YEARS BUILDING WORKFORCE HOUSING ACROSS THE COUNTRY, AARP ASKED ME TO SPEAK TO THAT SUBJECT AT AN AARP CONFERENCE. AARP MEETING, TOWN HALL TYPE MEETING. AND IN DOING THE RESEARCH, IT JUST WAS DRIVEN CRYSTAL CLEAR TO ME THAT WE'VE GOT A PROBLEM. WE HAVE A PROBLEM BECAUSE THERE'S A LOT OF PEOPLE WHO ARE SUFFERING, BECAUSE TH TRYING TO LIVE IN THEIR OLD HOMES AND IN THEIR OLD NEIGHBORHOODS AND THEY HAVEN'T BEEN ADAPTED FOR THE REALITY THAT THEY'RE NOW MORE FRAIL, OLDER, ISOLATED, CHILDREN HAVE MOVED ON, SPOUSES DIED, ALL THE THINGS THAT HAPPEN AS PEOPLE AGE. SO LET ME SEE WHAT THE BEST WAY TO ADVANCE THIS IS. SO THESE ARE THE KINDS OF CONCERNS THAT I HEARD AS I LISTENED TO PEOPLE. THE DETERIORATION OF THE HOUSE, THE LACK OF MONEY FOR HOME IMPROVEMENTS, THE UTILITY COSTS ASSOCIATED WITH IT. I AM MOBILITY AND ISOLATION, EVEN THOUGH IT'S LISTED HERE AS NUMBER FOUR, IT WAS THE MOST FREQUENT THING I HEARD. LONELINESS, A SENSE OF ISOLATION, A SENSE OF BEING UNABLE TO RUN ERRANDS, UNABLE TO DEPEND ON PEOPLE TO GET TO PLACES, THE MOMENT WHEN THE CAR -- THE PERSON CAN NO LONGER DRIVE THEMSELVES. SO ISSUES OF FAST TRAFFIC IN THE NEIGHBORHOOD AND WORRIES ABOUT CRIME, FEAR OF FALLING AND GETTING SICK AND BEING LEFT ALONE. INADEQUACY IN BEING ABLE TO MANAGE THINGS LIKE PAYING ONES BILLS AFTER A POINT, SO THE UTILITIES ARE CUT OFF. MY MOTHER IS 89 YEARS OLD, LIVES IN THE HOME THAT SHE AND MY DAD BOUGHT TWO YEARS BEFORE I WAS BORN, AND THEY MOVED IN THERE IN 1945, AND SHE ABSOLUTELY WANTS TO LIVE IN HER OWN HOME. AFTER A LITTLE BOUT WITH SICKNESS THIS SUMMER, WE HAD HER IN AN ASSISTED LIVING FACILITY, AND AFTER A WHILE, I FRANKLY DID NOT WANT TO GO VISIT HER BECAUSE THE MESSAGE WAS THE SAME EVERY DAY. ARE YOU TAKING ME HOME TODAY? I WOULD ARRIVE THERE AND SHE WAS DRESSED WITH HER BAG PACKED, EVEN THOUGH THERE WAS NO SIGN THAT IT WAS TIME TO GO HOME. AND SO SHE'S BACK AT HOME. I PERSONALLY DROVE HER HOME WHEN WE GOT HER AT THE END OF THE TWO WEEKS THAT SHE WAS THERE, AND IT WAS AN ALMOST PALPABLE EXPRESSION OF PEACE AND JOY AS SHE WALKED THROUGH THE HOUSE, AS SHE WALKED BACK OUT TO THE YARD. I MEAN, THAT'S WHAT HOME MEANS TO SO, SO MANY PEOPLE. THEY'RE NOT GOING TO BE BLASTED OUT OF THEIR HOME WITH DYNAMITE EVEN THOUGH THEY'RE FACING THESE KINDS OF ISSUES. AS I SAID, OVER 90% OF OLDER AMERICANS ARE DETERMINED TO AGE IN PLACE AND THEY NEED A SUPPORTIVE PHYSICAL ENVIRONMENT TO PROMOTE LONGER HEALTH AND INDEPENDENCE. THAT'S A VERY IMPORTANT POINT. THERE'S A PROFESSOR AT STANFORD AND I'M GOING TO RUSH THROUGH THIS VERY QUICKLY TO WE CAN GET TO THE OTHER PANELISTS. THERE'S A PROFESSOR AT STANFORD WHO CAME UP WITH THIS CONCEPT HE CALLS COMPRESSION OF MORBIDITY AND IT'S ESSENTIALLY THIS. WE BELIEVE TRADITIONALLY THAT FROM AGE 55 OR SO, THERE IS AN ARC OF DECLINE AND IT'S JUST IS A SORT OF CONSISTENT RAPIDLY ACCELERATING ARC THAT GOES FROM 75 TO WHENEVER A PERSON FINALLY PASSES IN THEIR 80s OR WHATEVER. HIS ARGUMENT IS THERE'S A SERIES OF THINGS THAT WE HAVE DONE ALONG THE LINES OF SOCIAL SECURITY INCOME ASSISTANCE, BETTER HEALTHCARE, ETCETERA, BUT IMPORTANTLY, THE PHYSICAL SETTING IN WHICH PEOPLE LIVE THAT CAN CREATE A COMPRESSION OF THE PERIOD OF MORBIDITIES, SO YOU CAN HOLD PEOPLE UP AT A MORE CONSTANT LEVEL OF WELL-BEING, AND THEN INEVITABLY THERE WILL BE A POINT OF DECLINE, BUT IT CAN BE MUCH SHORTER, MUCH LESS PAINFUL, MUCH LESS SUFFERING, MUCH LESS COST AND THE PHYSICAL SETTING IN WHICH PEOPLE LIVE, THIS WORK WE DO, HOUSING, CAN BE PART OF THE SOLUTION. SO LET ME QUICKLY RUN THROUGH AND I PROMISE IT WILL BE QUICK, FOUR STRATEGIES THAT WE WROTE ABOUT IN THIS BOOK CALLED INDEPENDENT FOR LIFE. THE FIRST IS THE RETROFITTING OF EXISTING HOMES AND THEN THE CREATION OF NEW HOMES THAT ARE AGE-APPROPRIATE, WHAT WE ENDED UP CALLING THE LIFE SPAN HOME. THE HOME THAT YOU CAN BE IN FOR YOUR ENTIRE LIFE. AND BY THE WAY, MANY OF THOSE THINGS ARE GOOD FOR PEOPLE WHO ARE DISABLED OR THEY'RE NOT A PROBLEM FOR YOUNGER FAMILIES, SO THEY CAN BE BUILT INTO THE TRADITIONAL HOUSE. RETROFITTING OF EXISTING COMMUNITIES AND DEVELOPING NEW COMMUNITIES. VERY QUICKLY, FIRST OF ALL, WITH RESPECT TO RETROFITTING OF EXISTING HOMES, THERE ARE THINGS WE KNOW SHOULD BE DON'T LIKE LOWERING BATHROOM FIXTURES, LOWERING KITCHEN FIXTURES, BEING CAREFUL ABOUT ACCESSORIES IN THE KITCHEN. FOR EXAMPLE, STOVES THAT ARE PROPERLY IDENTIFIED SO THAT PEOPLE KNOW HOW THEY FUNCTION. WE PUT TAPE OVER THE INSTRUCTIONS IN MY MOM'S OVEN AND STOVE SO THAT SHE WOULDN'T LEAVE THE GAS ON FOR EXAMPLE AND KNEW WHICH SWITCH WAS WHICH IN A MODERN STOVE WE HAD REPLACED. GRAB BARS, GOOD LIGHTING FOR GETTING UP AT NIGHT, ZERO STEP ENTRY WHERE POSSIBLE, WIDER DOOR WAYS AND HALLWAYS, A LOT OF THINGS THAT CAN BE DONE. LET ME JUST SAY BECAUSE WE'RE BEING BRIEF IN THIS PART OF THE DISCUSSION THAT I HAVE MADE THE ARGUMENT IN THIS BOOK AND OTHER PLACES THAT JUST LIKE WE DID WEATHERIZATION AS A COUNTRY WHEN WE HAD A NATIONAL ENERGY CRISIS AND SAID WE CAN RETROFIT HOMES AND SERVE A NATIONAL PURPOSE, WITH SOME MINOR MODIFICATIONS TO THE CONCEPT OF WEATHERIZATION, WE CAN RETROFIT HOMES TO CREATE LIFE SPAN SETTINGS FOR OLDER PEOPLE. AND SHOULD BE THINKING ON A NATIONAL SCALE ABOUT EXACTLY HOW WE'RE GOING TO DO THESE THINGS. RAMPS, STAIRS, LIGHTS, GRAB BARS, ETCETERA. A SECOND SET OF STRATEGIES WOULD INVOLVE BUILDING NEW HOMES AND THERE I THINK HUD CAN BE HELPFUL BY WORKING WITH THE BUILDING COMMUNITY TO THINK ABOUT WHAT IS THE APPROPRIATE -- AGE-APPROPRIATE HOME. SMALLER SCALE, SMALLER SQUARE FOOT AGE. MANY TIMES AFTER A SPOUSE HAS PASSED, THEY MIGHT QUITE A BIT LESS SPACE, THEY DON'T NEED THE BIG HOUSE THEY HAD BEFORE. WALKABLE SETTINGS, NEAR TRANSIT, AS YOU SEE FROM THIS HOUSE, ZERO STEP ENTRY, BUT BUILT WITH AGING IN MIND. AND AGAIN, THE WHOLE BUSINESS, HUD IN ITS PAST, HAS FOCUSED ON PROTOTYPES FOR PARTICULAR PURPOSES. THIS IS THE TIME TO EXPERIMENT WITH PROTOTYPES OF HOUSING THAT ARE GOING TO SERVE THE COUNTRY FOR THE LONG HAUL. RETROFITTING EXISTING COMMUNITIES. THERE'S THE CONCEPT OF WHAT I EXPERIENCED WHEN I WAS MAYOR AND DESCRIBED A MOMENT AGO AS GOING TO PLACES WHERE EVERYONE SEEMED OLDER THAT ARE NOW CALLED NORCs, NATIONALLY OCCURRING RETIREMENT COMMUNITIES. IT JUST MEANS A PART OF THE CITY WHERE EVERYBODY HAS NATURALLY BECOME OLDER, AND WITH IT, FREQUENTLY THE HOUSING STOCK BECAUSE PEOPLE DON'T HAVE OLYMPIAN TO FIX IT. THE DIE -- MONEY TO FIX IT. THE DYNAMICS OF THE COMMUNITY, SCHOOLS CLOSE, CHURCHES CLOSE, ETCETERA. SO THERE ARE SERIOUS ISSUES IN CITIES RELATED TO THE AGING DEMOGRAPHIC. LUCKILY THERE ARE SOLUTIONS LIKE THE VILLAGE NETWORK, YOU'RE GOING TO HEAR FROM JUDITH IN A LITTLE WHILE, JUDY. I'M NOT ANGRY WITH YOU. SHE SAID SHE'S ONLY CALLED JUDITH WHEN SOMEBODY IS ANGRY AT HER. JUDY IS GOING TO TALK TO US ABOUT THE VILLAGE NETWORK NOW OPERATING IN OVER 120 AMERICAN COMMUNITIES WHERE PEOPLE SHARE SERVICES AND CREATE A VIRTUAL NETWORK OF CONNECTIONS FOR TRANSPORTATION, FOR GETTING TO THE DOCTOR'S OFFICE, FOR GOING TO THE PHARMACY, FOR DROPPING IN ON SOMEONE TO HELP THEM WITH COOKING OR TAKING APPROPRIATE MEDICINES OR OTHER THINGS THAT WE CAN DO TO HELP EACH OTHER AND CREATE A SENSE OF COMMUNITY THAT HASN'T EXISTED IN THESE NEIGHBORHOODS IN A LONG TIME. AND THEN THE FINAL POINT IS THE DEVELOPMENT OF ENTIRELY NEW COMMUNITIES. I JUST READ YESTERDAY OF A NEW DEVELOPMENT IN PHOENIX WHERE THE BUILDER IS EXPERIMENTING WITH BUILDING HOMES FOR PERFECTLY HEALTHY BUT OLDER PERSONS WITHIN THE CONTEXT OF A LARGER DEVELOPMENT. SO THEY'RE NOT ISOLATED AND OUT SOMEWHERE IN A SUN CITY MODEL, RIGHT? THEY'RE IN THE CONTEXT OF A LARGER DEVELOPMENT WITH SCHOOLS AND SO FORTH, BUT THE HOMES IN THIS PARTICULAR PART OF THE DEVELOPMENT ARE SPECIFICALLY BUILT AT THE SCALE, AT THE PRICE, WITH THE ACCESSORIZING THAT MAKES THEM AGE-APPROPRIATE. SO THE ISSUES ARE THINGS LIKE EXPANDING ACCESSIBILITY STANDARDS, BUILDING THE NECESSARY SUPPLY. THESE ARE WHAT THEY CALL GRANNY FLATS, THE HOMES FOR ELDERLY RELATIVE ON THE BACK SIDE OF SOMEONE'S HOME. A MOVEMENT ACROSS THE COUNTRY THAT EDUCATES THE PUBLIC ABOUT DEMOGRAPHIC REALITIES BECAUSE A LOT OF ANSWERS ARE GOING TO BE LOCAL, PLACE-BASED STRATEGIES, AND FINALLY, THAT FOCUSES ON THE SOCIETAL EQUIVALENT OF THAT COMPRESSION OF MORBIDITY IDEA. IF WE CAN EXTEND THE PERIOD IN WHICH PEOPLE ARE INDEPENDENT AND ON THEIR OWN FOR A LONGER PERIOD OF TIME, THERE IS A DIVIDEND TO THE SOCIETY BECAUSE IT IS THE END OF LIFE COSTS THAT ARE THE MOST EXPENSIVE BY FAR, AND IF INDEED WE CAN NOT JUST ESTABLISH THE IDEA, BUT ACT UPON THE IDEA THAT BY CREATING PHYSICAL SETTINGS WHERE PEOPLE NOT ONLY CAN BE INDEPENDENT AND HAVE PEACE OF MIND AND PHYSICAL WELL-BEING, BUT IT ACTUALLY DOES TRANSLATE INTO VALUE FOR THE SOCIETY, THEN THERE IS A DIVIDEND THAT THE SOCIETY REAPS FROM THIS WORK TOGETHER. THIS IS HUGELY IMPORTANT. MARK MY WORDS, THIS IS ONE OF THOSE ISSUES THAT WE'RE GOING TO BE LIVING WITH FOR A VERY LONG TIME AS A SOCIETY. IT HAS A LOT TO DO WITH HOW VIBRANT OUR COMMUNITIES CAN BE AND INDEED, EVEN ISSUES OF HOW WE FUNCTION TOGETHER AS A SOCIETY, THE NATURE OF THE SOCIETAL COMPACT, IF YOU WILL, BETWEEN YOUNGER GENERATIONS AND OLDER AMERICANS. THANK YOU VERY MUCH. I LOOK FORWARD TO HEARING FROM THE PANELISTS. [ APPLAUSE ] >> THANK YOU, SECRETARY CISNEROS, AND YOU LIVE UP TO THE PASSION AND THE VISION THAT WE EXPECTED HAVING YOU BACK AT HUD. SO THANK YOU SO MUCH. AND ALISA SANDERS NOW WILL TAKE THE STAGE. >> GREAT, THANK YOU. SO WHO DOESN'T WANT TO FOLLOW HENRY CISNEROS? [ LAUGHTER ] >> GREAT, THANKS. THANKS, GUYS, FOR THE LINE-UP. I'M GOING TO TALK TO YOU TODAY ABOUT THE STRATEGY OF LINKS AFFORDABLE SENIOR HOUSING SETTINGS WITH HEALTH AND AFFORDABLE SERVICES TO HELP PEOPLE AGE IN PLACE. READY? SO WE KNOW THERE ARE ABOUT TWO MILLION PEOPLE, TWO MILLION SENIORS, EXCUSE ME, THAT LIVE IN ALL TYPES OF SUBSIDIZED HOUSING ACROSS THE COUNTRY AND THAT'S ONLY LIMITED BY THE AVAILABILITY. ALL YOU THAT ARE HOUSERS OUT THERE PROBABLY KNOW THERE'S GREAT DEMAND FOR THESE UNITS. IN GENERAL WHAT WE KNOW ABOUT THE POPULATION IS THEY'RE POOR. THE MEDIAN INCOME OF RESIDENTS IN 202 PROPERTIES IS JUST OVER $10,000. WE ALSO KNOW THEY'RE GROWING OLDER, SO NOT ONLY ARE THE RESIDENTS THAT LIVE IN THE BUILDING AGING IN PLACE, BUT THEY'RE ALSO MOVING IN AT ADVANCED AGES. YOU CAN SEE SOME OF THE FIGURES UP THERE AND WHAT'S SIGNIFICANT IS SUCH A LARGE PERCENT STAGE, ROUGHLY ABOUT A THIRD -- PERCENTAGE, ROUGHLY ABOUT A THIRD OF THE RESIDENT POPULATION IS OVER THE AGE OF 80. WE ALSO KNOW THEY'RE VERY RACIALLY AND ETHNICALLY DIVERSE POPULATION AND EVEN THOUGH THE WHITE CATEGORY IS ROUGHLY HALF THE POPULATION, THERE'S A LOT OF ETHNIC DIVERSITY WITHIN A CATEGORY. SO WHAT RESEARCH SHOWS US ABOUT THAT CHRONIC CONDITIONS AND FUNCTIONAL LIMITATIONS ARE MORE PREVALENT AMONG PEOPLE AT ADVANCED STAGES WITH LOWER INCOMES AND MINORITY STATUS, CHRTION THE POPULATION I JUST DESCRIBED TO YOU, RIGHT? SO WE DON'T HAVE A LOT OF DATA ABOUT THE HEALTH AND FUNCTIONAL STATUS OF RESIDENTS IN THESE PROPERTIES YET. BUT FROM SOME NATIONAL STUDIES, WE DO KNOW THAT RESIDENTS OF ASSISTED HOUSING PROPERTIES HAVE ABOUT TWICE THE PREVALENCE OF DISABILITY AS THEIR HOMEOWNER COUNTERPARTS, ABOUT A THIRD HAVE DIFFICULTY WITH THEIR ROUTINE ACTIVITIES OF LIFE, ABOUT 12% HAVE CONINITIATIVE IMPAIRMENTS. I -- COGNITIVE IMPAIRMENTS. I SUSPECT THAT'S PROBABLY A LITTLE BIT HIGHER. JUST TO GIVE YOU A QUICK PROFILE OF SOME WORK WE DID IN PROPERTIES IN SAN FRANCISCO, SOME ASSESSMENTS WE DID OF THE RESIDENT POPULATION IN FOUR SUBSIDIZED SENIOR HOUSING PROPERTIES, I'M GOING TO CONCENTRATE ON THE FIGURES ON THE RIGHT THAT SHOW THAT ALMOST THREE-QUARTERS OF THE BUILDING REPORTED THEIR HEALTH WAS FAIR TO POOR. OVER HALF SUFFER FROM THREE OR MORE CHRONIC CONDITIONS, AND OVER HALF HAVE AT LEAST A LIMITATION WITH AT LEAST ONE ACTIVITY OF DAILY LIVING, AND THOSE ARE ACTIVITIES LIKE BATHING, DRESSING, SHOWERING, AND ARE OFTEN THE KIND OF ACTIVITIES THAT LEAD PEOPLE INTO HIGHER LEVELS OF CARE. OVER A THIRD HAD REPORTED A FALL IN THE LAST YEAR. ALMOST A THIRD HAD VISITED THE E.R. AND ABOUT A FIFTH HAD HAD A HOSPITAL STAY IN THE PAST YEAR, SO YOU CAN SEE THERE'S A HIGH UTILIZATION OF HEALTHCARE SERVICES. WE ALSO NOTICE FROM A COUPLE RECENT STUDIES, THERE'S A HIGH LEVEL OF MENTAL HEALTH RELATED NEEDS. A COUPLE RECENT STUDIES FOUND AROUND A QUARTER OF RESIDENTS SUFFER FROM ISSUES OF DEPRESSION AND ANXIETY, AND THEN SEVERAL ARE IN NEED OF MENTAL HEALTH CARE FOR AN ENTIRE RANGE OF ISSUES FROM DEPRESSION ON UP TO A MORE SEVERE MENTAL ILLNESS. SO I MENTIONED THAT WE DON'T HAVE A LOT OF INFORMATION ABOUT THESE RESIDENTS YET, BUT WE ARE CURRENTLY IN PARTNERSHIP WITH THE LUWAN GROUP WORKING ON A PROJECT FOR HUD AND HHS, A DESIGNED DEMONSTRATION MODEL FOR THE STRATEGIES OF LINKING HOUSING WITH SERVICES. AND THERE'S SEVERAL TASKS THAT WE'VE BEEN ASKED TO DO AS PART OF THAT KRKT BUT I'M GOING TO HIGHLIGHT -- CONTRACT, BUT I'M GOING TO HIGHLIGHT THE BOTTOM ONE FOR YOU RIGHT NOW WHICH IS THE DATA LINKAGE EXPLORATION WHERE WE'RE COMBINING THE DATA FOR RESIDENTS OF HUD-ASSISTED PROPERTIES IN ABOUT 12 GEOGRAPHIC AREAS WITH THOSE RESIDENTS' MEDICARE AND MEDICAID DATA, SO THAT'S GOING TO ALLOW US TO KNOW WHAT THE HEALTH CHARACTERISTICS ARE AND WHAT THE HEALTH UTILIZATION AND HEALTH COSTS ARE. WE HAVE PRELIMINARY ANALYSIS RIGHT NOW AND IT'S SHOWING THAT HUD-ASSISTED RESIDENTS HAVE MORE CHRONIC CONDITIONS, HAVE A HIGHER LEVEL OF HEALTH SERVICE UTILIZATION, AND THEREFORE HAVE MORE COSTLY -- HAVE HIGHER HEALTHCARE COSTS THAN A CONTROLLED POPULATION. THE DATA IS ALSO SHOWING US THAT ABOUT TWO-THIRDS OF THE RESIDENTS IN THOSE PROPERTIES ARE DUAL ELIGIBLE, MEANING THEY'RE ELIGIBLE FOR BOTH MEDICARE AND MEDICAID. I'M GOING TO TELL YOU MORE ABOUT THAT STUDY IN JUST A FEW MORE MINUTES. WE KNOW THAT THERE ARE SOME FEDERAL AND STATE LEVEL POLICY PRIORITIES AROUND HEALTH AND LONG-TERM CARE. SO WE KNOW MANY STATES ARE TRYING TO REBALANCE THEIR LONG-TERM CARE SYSTEM TO PROVIDE PEOPLE GREATER ACCESS TO SERVICES AND RESOURCES THAT WILL HELP THEM STAY IN THE COMMUNITY AND AVOID AN UNNECESSARY OR PREMATURE MOVE TO AN INSTITUTION. WE ALSO KNOW THAT THE AFFORDABLE CARE ACT AND OTHER HEALTHCARE REFORM EFFORTS ARE TRYING TO DRIVE BETTER MANAGEMENT OF HEALTH CONDITIONS, BETTER COORDINATION WITHIN AND ACROSS HEALTHCARE SYSTEMS AND TRYING TO DRIVE DOWN UNNECESSARY USE OF HEALTH SERVICES LIKE E.R. AND HOSPITALS. AND WE ALSO KNOW THAT AS THE BIGGEST USERS OF HEALTH AND LONG-TERM CARE SERVICES, THERE ARE A LOT OF INITIATIVES THAT ARE FOCUSING ON THIS DUAL ELIGIBLE POPULATION AND HELPING THEM BETTER MANAGE THEIR CONDITIONS AND BETTER COORDINATE THEIR CARE ACROSS BOTH THE HEALTH AND THE LONG-TERM CARE SYSTEMS. SO IF WE JUST KIND OF BRING ALL THOSE TRENDS, THE RESIDENT CHARACTERISTICS AND THE POLICY TRENDS TOGETHER, AND THE FACT THAT THESE RESIDENTS ARE AGING, THEY HAVE -- THEY'RE INCREASING IN THEIR MENTAL, THEIR PHYSICAL AND FUNCTIONAL LIMITATIONS, THAT WE KNOW AS EVERYONE HAS SAID, THAT THEY WANT TO REMAIN IN THEIR HOME AND THEIR COMMUNITY. WE KNOW FAIR HOUSING GENERALLY ALLOWS THEM TO STAY IN THEIR COMMUNITY, AND THERE AREN'T MANY ALTERNATIVES FOR THEM TO GO TO ANYWHERE WITH THEIR LOWER INCOMES, AND THEN GIVEN THOSE POLICY PRIORITIES I JUST DISCUSSED, WE THINK THIS CREATING A LOT OF POTENTIAL SYNERGIES TO CREATE NEW STRATEGIES TO HELP THIS PRIORITY POPULATION REMAIN IN THEIR HOME COMMUNITY. SO I'M GOING TO TELL YOU JUST ABOUT A COUPLE MODELS THAT ARE HAPPENING AROUND THE COUNTRY WITH AN EMPHASIS -- AND I SELECTED A COUPLE MODELS THAT BEAR ON THIS POLICY ISSUE THAT I DISCUSSED. AND GETTING BACK TO THAT, THE DEVELOPMENT THE DEMONSTRATION MODEL PROJECTS I DISCUSSED, PART OF THAT WORK WAS TO DO CASE STUDIES OF SEVERAL MODELS AROUND THE COUNTRY AND SO DOING THOSE CASE STUDIES AND OTHER WORK, RESEARCH THAT WE HAD DONE IN OUR -- LOOKING AT OTHER COMMUNITIES, WE NOTICED SOME KIND OF KEY ELEMENTS OF, KEY COMPONENTS OF STRATEGIES, AND THAT SEEMED TO BE A CARE COORDINATION PRESENCE, AND THAT WAS THROUGH A SERVICE COORDINATOR, WHICH MANY PROPERTIES HAVE, BUT NOT ALL HAVE. AND SOME SORT OF LINKAGE WITH A WELLNESS TYPE NURSE ROLE. SO ONE OF OUR RECOMMENDATIONS, AS KIND OF A CORE ELEMENT OF THESE DEMONSTRATION DESIGNS, IS TO HAVE THAT TEAM OF A SERVICE COORDINATOR AND A WELLNESS NURSE, TO HELP LOOK AT ALL SPECTRUMS OF A PERSON'S LIFE FROM THEIR SOCIAL TO THEIR HEALTH NEEDS AND THEN WORK TOGETHER TO HELP THEM COORDINATE ACROSS WHATEVER THEIR RANGE OF NEEDS MAY BE, WHEREVER THEY MAY BE AT THAT POINT IN THEIR LIFE. AND SO THIS MODEL I'M GOING TO TELL YOU ABOUT, THE SUPPORTIVE SERVICES AT HOME, THIS IS A CORE ELEMENT OF THAT MODEL. THIS WAS A MODEL THAT WAS DEVELOPED BY AFFORDABLE HOUSING PROVIDER IN VERMONT, CATHEDRAL SQUARE CORPORATION. IT IS A CARE COORDINATION MODEL THAT'S ANG KORD IN SENIOR HOUSING, SO THEY SERVE BOTH RESIDENTS IN THE HOUSING PROPERTY AND THEN PEOPLE IN THE SURROUNDING COMMUNITY. IT'S BASED ON AN INTERDISCIPLINARY TEAM MADE UP OF, AS I SAID, HOUSING-BASED STAFF, WHAT THEY CALL A COORDINATOR, SORT OF AN ENHANCED SERVICE COORDINATOR, TEAMED WITH AN ONSITE WELLNESS NURSE AND THEY HAVE A FORMAL NETWORK OF COMMUNITY-BASED PROVIDERS THAT ARE PART OF THIS INTERDIAGNOSIS MINUTE NARE TEAM THAT ARE -- INTERDISCIPLINARY TEAM THAT ARE DEDICATED TO THE PROPERTY AND WORK WITH THE RESIDENTS THERE AND THAT INCLUDES VARIOUS AGENCIES THAT OFTEN TOUCH ON THESE RESIDENTS, HOME HEALTH AGENCIES, AREA AGENCIES ON AGING, MENTAL HEALTH AGENCIES, OTHER COMMUNITY PROVIDERS. EVERY RESIDENT THAT CHOOSES TO PARTICIPATE IN THE PROGRAM RECEIVES A COMPREHENSIVE ASSESSMENT AND THEN TOGETHER WITH THE RESIDENT, THE SERVICE COORDINATOR AND WELLNESS NURSE CREATE A HEALTHY LIVING PLAN FOR THEM. AND THAT PLAN ADDRESSES WHATEVER COMES UP AS A NEED OR AN INTEREST IN THEIR ASSESSMENT. IT MAY BE FROM SOMETHING SIMPLE TO EXERCISING MORE TO LEARNING A CRAFT, ON UP TO NEEDING MUCH HIGHER LEVELS OF CARE AND ASSISTANCE. AND THEN THAT INTERDISCIPLINARY TEAM MONITORS AND COORDINATES THIS PLAN AND HELPS THE RESIDENT WITH IMPLEMENTING IT. THEY THEN AGGREGATE ALL THE INDIVIDUAL ASSESSMENTS UP INTO A COMMUNITY LEVEL AND CREATE A COMMUNITY HEALTH LIVING PLAN. THEY THEN BRING IN EVIDENCE-BASED PROGRAMMING TO HELP ADDRESS WHATEVER THE ISSUES ARE AT THAT COMMUNITY LEVEL. MAYBE IT'S DIABETES, MAYBE IT'S INTEREST IN MORE EXERCISE, WHATEVER THAT MAY BE. VERMONT HAS A STATEWIDE HEALTH REFORM EFFORT GOING ON AND CATHEDRAL SQUARE WAS ABLE TO GET THIS STRATEGY LINKED INTO THE HEALTH REFORM EFFORT, SO THROUGH THAT AND THROUGH A MEDICARE DEMONSTRATION THAT THE STATE IS PARTICIPATING IN, THE MODEL HAS BEEN SPREAD THROUGHOUT THE STATE. IT'S OPERATING IN OVER 80 HOUSING PROPERTIES NOW AND IT'S CONTINUING TO GROW. AND THROUGH THAT MEDICARE DEMONSTRATION, MEDICARE PAYS FOR THE FASH COORDINATOR AND THE WELLNESS NURSE TEAM AND THEN THERE'S VARIOUS OTHER RESOURCES THAT COME INTO THE MODEL. WE ARE CURRENTLY WORKING ON AN EVALUATION, AN HHS AND HUD-FUNDED EVALUATION OF THAT PROGRAM TOGETHER WITH THE -- WITH RTI INTERNATIONAL, AND IT'S A THREE-YEAR EVALUATION. WE'RE JUST IN THE FIRST YEAR OF IT, BUT THE PRELIMINARY DATA SHOWS THE PROGRAM IS HELPING TO SLOW THE RATE OF GROWTH OF THE HEALTHCARE COSTS FOR THE PARTICIPANTS IN COMPARISON TO A COMPARABLE GROUP. AND I'M JUST GOING TO TELL YOU ABOUT ONE MORE MODEL. THIS IS A PARTNERSHIP BETWEEN PRESBYTERIAN SENIOR LIVING AND HEALTH SYSTEM PINNACLE HEALTH IN HARRISBURG, PENNSYLVANIA. THEY ARE ALSO PILOTING A CARE NAVIGATION PROGRAM IN THEIR PROPERTIES. PINNACLE HEALTH PROVIDES A WEEKLY ONSITE CLINIC AT THE HOUSING PROPERTIES STAFFED BY A PHYSICIAN, A NURSE AND A MEDICAL SOCIAL WORKER WHO TEAMS WITH THE PROPERTY'S SERVICE COORDINATOR AND THE CORE OF THE PROGRAM IS TO I.D. THE HIGH UTILIZERS OF THE HEALTHCARE SYSTEM AND HELP THEM ELIMINATE WHATEVER THE BARRIERS TO CARE MAY BE FOR WHY THEY'RE GOING TO THE HOSPITAL FREQUENTLY, WHY THEY'RE NOT MANAGING THEIR DIABETES, WHY THEY'RE GOING IN AND OUT OF THE E.R. AND THEY ALSO, IN ADDITION TO TAKING ON HELPING SOLVE WHATEVER THOSE RANGE OF BARRIERS TO CARE ARE, COULD BE TRANSPORTATION, COULD BE NUTRITION, THEY ALSO COORDINATE WITH THEIR PRIMARY CARE PHYSICIAN TO HELP WITH THEM MANAGING THEIR HEALTH CONDITIONS AND THEY DO A RANGE OF OTHER PERIPHERY THINGS, MEDICATION RECONCILIATIONS, HOME SAFETY CHECKS AND SO ON. I JUST WANT TO WRAP UP BY SHOWING YOU SOME OF THE EARLY RESULTS OF THEIR EFFORTS. THE BARS ON THE LEFT-HAND SIDE -- SORRY, I STILL HAVE TO HOLD MY HANDS UP TO KNOW LEFT FROM RIGHT. ON THE LEFT-HAND SIDE REPRESENT THE NUMBER OF E.R. VISITS AND INPATIENT HOSPITAL STAYS FOR RESIDENTS IN THE SIX MONTHS BEFORE THEY STARTED THE PILOT, AND THEN THE NEXT TWO BARS AT THE SIX-MONTH POINT AND THE ONE-YEAR POINT AFTER THE PILOT. THERE'S ABOUT 140 RESIDENTS THAT LIVE IN THIS PROPERTY, SO YOU CAN SEE THAT OVER THE COURSE OF THE FIRST YEAR, THEY HAD ALMOST A 50% DROP IN E.R. VISITS AND A 70% DROP IN HOSPITAL VISITS. SO I JUST WANTED TO HIGHLIGHT THOSE TWO AS SHOWING HOW THE STRATEGY OF LINKING THESE AFFORDABLE SENIOR HOUSING PROPERTIES WITH VARIOUS HEALTH AND SUPPORTIVE SERVICES CAN NOT ONLY HELP THE RESIDENTS AGE IN PLACE WHERE THEY WANT TO BE, BUT HELP US MEET SOME OF OUR NATIONAL POLICY GOALS AS WELL. SO, OKAY. THANK YOU. [ APPLAUSE ] >> JUDD DI, WHILE YOU MOVE UP THERE, I JUST WANT TO SAY THANK YOU, ALISA. I DIDN'T WANT TO BRAG ON THE AWESOME COLLABORATION THAT'S HAPPENING BETWEEN HUD AND HHS, BUT YOU DID IT FOR US, SO I REALLY APPRECIATE THAT. THE ABILITY TO BRING OUR DATA TOGETHER AND THE ABILITY TO PARTNER TOGETHER WITH GROUPS LIKE YOURS SO WE CAN REALLY LEARN ABOUT WHAT'S GOING ON IN THE HEALTH OF HUD RESIDENTS AND WHAT'S GOING ON WITH THE COSTS WHEN WE DO THESE TYPES OF INTERVENTIONS, SO THANKS SO MUCH FOR THAT AND WE'LL TURN IT OVER TO YOU, JUDY. >> OKAY. HELLO, EVERYONE. WE'LL BE TALKING JUST FOR A SHORT TIME RIGHT NOW ABOUT THE VILLAGE MOVEMENT AND VILLAGE TO VILLAGE NETWORK, AND SOME OF YOU MIGHT HAVE HEARD ABOUT IT AND MIGHT BE RELEVANT TO THE WORK YOU DO. IT ALSO MIGHT BE RELEVANT TO WHERE YOU LIVE OR WHERE YOUR PARENTS LIVE. SO HOPEFULLY IT WILL BE COMPLEMENTARY OF WHAT WE'RE TALKING ABOUT IN THE RESEARCH AND INTERESTING. I'LL START FIRST WITH A LITTLE STORY. ONE COLD FEBRUARY EVENING IN BOSTON, WE CAN ALL RELATE TO THAT CURRENTLY, NANCY AND LORI COOLIDGE CAME HOME TO FIND WATER FALLING THROUGH THEIR CEILING AND DOWN THEIR WALLS. LORI WENT AND GOT A ROPE AND AN AXE. THESE ARE PEOPLE IN THEIR 70s AT THAT POINT. WENT UPSTAIRS TO THE SECOND FLOOR OF THEIR HOME AND ASKED NANCY TO HOLD ON TO THE ROPE AS LORI TIED IT AROUND HIS WAIST AND CLIMBED OUT THE SECOND FLOOR WINDOW. AS HE'S STANDING OUT THERE WITH THE AXE CHOPPING THE ICE OFF TO BREAK UP THE ICE DAM, NANCY IS HOLDING ON FOR DEAR LIFE AND SHE IS SAYING TO HERSELF, THERE MUST BE A BETTER WAY. AND IN THAT BEGAN THE VILLAGE MOVEMENT BECAUSE WHAT SHE DID WAS SHE CALLED HER FRIENDS, AND THEY CALLED OTHER FRIENDS WHO HAD AN ENTREPRENEURIAL SPIRIT, AND ALSO HAD A PASSION TO STAY IN THEIR HOMES THE REST OF THEIR LIVES. THEY ALL LIVED IN BEACON HILL IN THE BACK BAY AREA OF BOSTON, AND THEY LOOKED -- RESEARCHED THE COUNTRY TO SEE IF THERE WAS ANYTHING WHAT THEY WERE THINKING OF PROVIDING. AND THEY DECIDED THAT THEY HAD TO PROVIDE IT THEMSELVES AT THAT POINT, VERY INDEPENDENT, STAUNCH, BOSTONIANS. WE'LL LEAVE IT AT THAT. AND THEY CREATED BEACON HILL VILLAGE AND THE IDEA AND THE MODEL BEHIND THE VILLAGES. STARTED RAISING FUNDS, ETCETERA. THAT WAS IN 2002. IN LOOKING AT THAT, THEY ALSO LOOKED AT DEVELOPING THE MODEL, WHICH IS REALLY A PARADIGM SHIFT IN AGING IN COMMUNITY, WHICH IS WHAT THE VILLAGE MOVEMENT CALLS IT MORE. NON-PROFIT MEMBERSHIP ORGANIZATIONS CREATED BY AND ACTUALLY RUN BY OLDER PEOPLE THEMSELVES, 50 AND OVER, IT'S VERY PER-VILLAGE. ONE-STOP SHOPPING, EVERYTHING AND ANYTHING THAT YOU WANT AND NEED. SO IT'S NOT JUST IF YOU'VE FALLEN, BUT IT'S REALLY TAKING MY SOCIAL WORKER HAT OFF AND LOONG AT IT MUCH MORE, WHAT DO WE WANT IN OUR LIVES, PROVIDING MEANING, ALONG WITH CONNECTIONS, FRIENDSHIP, AND MEMBERS, INDEPENDENT PEOPLE DRIVING THEIR OWN LIVES. THOSE ARE THE TYPES OF THINGS THAT ARE AT THE CORE OF WHAT MAKES A VILLAGE. THE OTHER THING WHAT MAKES A VILLAGE ARE THESE PARADIGMS, WHICH ARE GRASSROOTS MEMBERSHIP MODEL, ABOUT 85 TO 90% OF THE VILLAGES ACROSS THE COUNTRY AND THERE ARE 120 OF THEM OPEN CURRENTLY AND 125 DEVELOPING, SO GRASSROOTS MEMBERSHIP MODEL, SELF-GOVERNING, SELF-SUPPORTING, CONSOLIDATOR AND COORDINATOR OF SERVICES. THE VILLAGE DOES NOT MEAN TO DUPLICATE ANYTHING THAT ALREADY EXISTS, SO IT WORKS WITH STRATEGIC PARTNERS, HOUSING AGENCIES, AND MANY OF THE ALREADY EXISTING AGENCIES IN GOVERNMENT TO CREATE A COORDINATED SYSTEM. AND FOCUSES ON THE WHOLE PERSON, ON THE WHOLE MEMBER. THE ONE THAT I SKIPPED WAS VOLUNTEERISM BECAUSE IT PROBABLY SHOULD BE THE FIRST. IN LOOKING AT THAT, VOLUNTEERS FOR RUNNING THE VILLAGE, FOR PROVIDING SERVICES, FOR ALL THAT THE VILLAGE IS, IS REALLY AT THE MAIN CORE. THERE ARE THREE COMPONENTS OF THE VILLAGE. THEY ARE CONCIERGE, ASSISTANCE IN LIVING, AND COMMUNITY BUILDING. CONCIERGE TRULY IS OFFERING INFORMATION REFERRAL TO EVERYTHING AND ANYTHING PEOPLE WANT AND NEED. AND AGAIN, VILLAGES VARY IN DOING THIS BECAUSE THEY ALL COME FROM OLDER PEOPLE IN THEIR COMMUNITY, AND EACH VILLAGE IS INCREDIBLY UNIQUE, ALTHOUGH THE NATIONAL PEER-TO-PEER ORGANIZATION, VILLAGE-TO-VILLAGE NETWORK, WE'RE TRYING TO LOOK AT THE STREAM SO THAT IT IS MORE EASILY REPLICABLE ACROSS THE COUNTRY. BUT BACK TO THIS CONCIERGE. TRANSPORTATION, PERSONAL TRAINERS, CATERERS, DOG WALKERS, PLANT WATERERS, PLUMBERS, ELECTRICIANS, ALL THOSE KINDS OF THINGS. ASSISTANCE IN LIVING, IF YOU BREAK A LEG SKIING, YOU'RE IN YOUR 70s, 80s, AND YOU'RE SKIING, YOU BREAK A LEG, OR IF YOU HAVE A CHRONIC ILLNESS OR IF YOU GET OLDER AND THERE ARE THINGS YOU NEED ASSISTANCE WITH, WE -- VILLAGES GET DISCOUNTED, VETTED PROVIDERS. HOME CARE PROVIDERS, GERIATRIC CARE MANAGERS, MEALS DELIVERED, AND AGAIN, TRANSPORTATION. A LOT OF SERVICES ARE DONE, LIKE CAPITOL HILL VILLAGE HERE IN THE CAPITOL HILL AREA IS CALLED VOLUNTEER FIRST. AND THEY ACTUALLY PROVIDE 85% OF THEIR MEMBER REQUESTS ARE PROVIDED THROUGH VOLUNTEERS. MANY OF THOSE ARE MEMBERS OF THE VILLAGE, BUT ALSO ARE COMMUNITY PEOPLE OF ALL AGES. THE THIRD COMPONENT IS COMMUNITY BUILDING, AND COMMUNITY BUILDING IS WHAT YOU MIGHT THINK OF. IT'S PROGRAMS, IT'S SEMINARS, IT'S TRIPS, BUT THEY ARE INITIATED BY THE MEMBERS THEMSELVES THROUGH PROGRAM COMMITTEES, BUT ALSO THROUGH JUST MEMBERS CALLING AND SAYING, HEY, LET'S START AFFINITY GROUPS, A SINGLES CLUB, POLITICAL ACTION CLUBS, BRIDGE CLUBS. AGAIN, THEY'RE VERY DIVERSE ACROSS THE COUNTRY. ONE THING THAT IS ALSO VERY INTERESTING IS MOST VILLAGES HAVE MUSEUM TRIPS AND MUSIC AND ANYTHING THAT MEMBERS MIGHT WANT AND ANYTHING YOU WOULD THINK THAT YOU WILL WANT TO ENHANCE YOUR LIVES AND MEET FRIENDS, BUT THE OTHER THING IS THAT THEY DO VERY UNIQUE ONES. TERRACE VILLAGE IN SAN DIEGO, THERE WAS A GROUP OF 20 PEOPLE WHO WERE MEMBERS WHO WANTED TO GO TO ALASKA. SO THAT WAS ORGANIZED AND THEY WENT UP TO ALASKA FOR TWO WEEKS. ANOTHER ONE WAS BEACON HILL VILLAGE AND THEY ORGANIZED A COMMUNITY ORGANIZING STANCE WHEN, AFTER HURRICANE KATRINA, PEOPLE WANTED TO GO DOWN TO NEW ORLEANS AND BUILD HOUSES. AND THEY DID THAT FOR TEN DAYS. SO AGAIN, THINK BROAD WHEN YOU THINK VILLAGES. WHEN WE LOOK AT VILLAGES, AGAIN, THEY'RE CONSUMER DRIVEN, NO MATTER HOW THEY'RE FUNDED, FOUNDED, OR STAFFED. GOING TO LOOK NOW AT THE FIVE TOP SERVICES UTILIZED AND OFFERED BY VOLUNTEERS AND THEN PAID SERVICE PROVIDERS, AND THAT IS RECREATION AND FITNESS, SO EXERCISE CLASSES, PEOPLE STAYING ENGAGED, HEALTHY AND ACTIVE. TRANSPORTATION, HEALTH REASSURANCE CALLS, FRIENDLY VISITORS, AND HEALTHCARE ADVOCACY. TRANSPORTATION, AS I'M SURE YOU KNOW, IS THE NUMBER ONE SERVICE REQUEST THAT ALL VILLAGES GET AS ALMOST SOCIAL SERVICE AGENCIES DO ALSO. PAID PROVIDERS, HOME MAINTENANCE AND HOME REPAIRS. WEATHERIZATION, ALL THOSE KINDS OF THINGS, SO THE PEOPLE CAN STAY IN THEIR OWN HOMES. WHATEVER THAT HOME IS, WHETHER THEY OWN IT, IT'S A CONDO, THEY RENT, OR THEY ARE IN HUD HOUSING OR EVEN ASSISTED LIVING. SOMETIMES THEY DON'T NEED THOSE BECAUSE THEY'RE TAKEN CARE OF, BUT HOME HEALTH AND PERSONAL CARE ASSISTANCE. HOUSEKEEPING, TRANSPORTATION, IN-HOME TECHNOLOGY. ONE EXAMPLE WAS MY SON WHO WAS AT THAT POINT 18 OR 19, HE WAS ASKED -- HE WAS DRIVING FOR BEACON HILL VILLAGE MEMBERS AND HE WAS ASKED, WE CALLED HIM AND SAID CAN YOU TAKE ONE OF OUR MEMBERS TO A FUNERAL. HE DROVE HER DOWN TO THE FUNERAL AND THEN SHE ASKED IF HE WOULD COME IN AND BE HER ESCORT, AND HE WENT IN WITH HER AND HER QUOTE WAS THAT IT MADE A HARD DAY MUCH EASIER. HE WAS A LITTLE MORTIFIED BECAUSE HE WAS IN SHORTS AND DIDN'T REALIZE THAT HE WAS GOING TO GO INTO THE FUNERAL, BUT IT ALL WORKED OUT BEAUTIFULLY AND THAT'S THE KIND OF OUT-OF-THE BOX KINDS OF THINGS THAT PEOPLE HELP WITH FOR VILLAGES. THE AVERAGE AGE FOR VILLAGE MEMBERS IS 75. SO THINK YOUNG, SOLID, HEALTHY, ONLY 5% ARE PAYING FOR HOME CARE SERVICES. BUT I'M SURE IT'S A LOT LARGER THAN THAT AS MOST CAREGIVERS ARE FAMILY MEMBERS. THE YOUNGEST VILLAGE MEMBER IS 50. THE ELDEST THAT WE KNOW OF IS 104, SO AGAIN, THINK OF THE DIVERSITY OF WHAT PEOPLE ASK FOR. THE AVERAGE MEMBERSHIP FEE IS $450 FOR AN INDIVIDUAL ANNUALLY, 650 FOR A HOUSEHOLD, THREE FOURTH OF THE VILLAGES HAVE A LOW MODERATE INCOME PROGRAM AND IT'S GENERALLY ABOUT $100 FOR A MEMBERSHIP FOR AN INDIVIDUAL AND 160 FOR A HOUSEHOLD, AND THEY GET CREDIT TOWARDS SERVICES SO THAT THEY CAN ACTUALLY ENGAGE. THE OTHER THING IS THAT VILLAGES ARE FUNDED BY MEMBER FEES, FOUNDATIONS, WHICH FUND MOSTLY THE LOW MODERATE INCOME PROGRAM, INDIVIDUAL DONATIONS, CORPORATE DONATIONS, AND THEN A FEW HAVE PUBLIC SUBSIDIES AT THIS POINT AND THOSE ARE INTERESTING AND WE'LL BE INTERESTED IN IN THE FUTURE IN CHANGING POLICIES TO LOOK AT. THE VILLAGE MOVEMENT IS IMPORTANT NOW BECAUSE IT IS, AS WE TALKED ABOUT BEFORE, THE AGE WAY AS WE ALL KNOW IS NOT -- AGE WAVE, AS WE ALL KNOW IS NOT ONLY COMING, IT IS HERE. IT'S BECAUSE WE'RE CRAVING COMMUNITY, COMPANIONSHIP TO DECREASE ISOLATION, BUT ALSO IT'S WHAT GIVES MEANING TO OUR LIVES. WE ALSO -- IT WOULD BE DIFFICULT TO BUILD ENOUGH SENIOR HOUSING AND IT WOULD TAKE TOO LONG AND COST A LOT AND EVERYTHING, THOSE TYPES OF THINGS ARE BEING CUT BACK, AND AS SPOKEN BEFORE, 90% OF PEOPLE 60 AND OVER WANT TO AGE IN THEIR OWN HOMES AND IN THEIR OWN COMMUNITIES, INTERGENERATIONAL WHERE THEY LIVED AND RAISED THEIR CHILDREN. THE OTHER THING IS THAT MY BET IS, ALTHOUGH I HAVEN'T SEEN A STUDY YET, BABY BOOMERS, THAT WOULD BE EVEN HIGHER. IN LOOKING AT -- IN LOOKING AT VILLAGE-TO-VILLAGE NETWORK, THAT IS A PEER-TO-PEER ORGANIZATION THAT ESTABLISHES OR HELPS INDIVIDUALS AND GROUPS ESTABLISH VILLAGES AND THEN MAINTAIN THEM, OPEN VILLAGES. WE ARE ALL OVER THE COUNTRY NOW. AS SAID BEFORE, THERE ARE 120 VILLAGES THAT ARE OPEN. YOU CAN SEE THAT WE ARE MORE ON THE EAST COAST AND THE WEST COAST, BUT GAINING MOMENTUM IN THE CENTER OF THE CITY. 25,000 MEMBERS IN VILLAGES SO FAR AND GAINING EVERY MONTH. 125 GROUPS ARE DEVELOPING VILLAGES ALL OVER THE COUNTRY. IN 39 STATES AND THREE OTHER COUNTRIES, AUSTRALIA, CANADA, AND THE NETHERLANDS, BUT 40 OTHER COUNTRIES HAVE COME TO THE VILLAGES AND ASKED FOR INFORMATION, HAVE VISITED VILLAGES, ETCETERA. CURRENTLY THERE ARE 210 VILLAGE-TO-VILLAGE NETWORK MEMBERS AND THE VILLAGE-TO-VILLAGE NETWORK IS SO THAT YOU DON'T HAVE TO DUPLICATE THE WHEEL. TO HELP VILLAGES GET STARTED MORE QUICKLY, SO ALL VILLAGES WORK WITH FORUMS, TALKING TO EACH OTHER, WEBINARS, DOCUMENT SHARING FOR JOB DESCRIPTIONS, ALL THE WAY TO BUSINESS PLANS, ETCETERA. VILLAGE-TO-VILLAGE NETWORK ALSO PROVIDES NATIONAL DISCOUNTS, AGAIN, TO RUN YOUR VILLAGE. AND IS SEARCHABLE. QUALITY OF LIFE IMPACTS ARE JUST COMING OUT BECAUSE ALTHOUGH BEACON HILL VILLAGE IS 12 YEARS OLD, MOST OF THE VILLAGES RUN BETWEEN FIVE TO THREE YEARS OLD AND MORE THAT HAVE JUST OPENED, SO IT'S A NEW MOVEMENT AND NOW IT'S TIME TO START REALLY SHOWING THE EFFICACY OF IT IN TERMS OF COST SAVINGS, ETCETERA. STATS FROM THE UNIVERSITY OF BERKELEY RESEARCH FUNDED BY THE ARCHSTONE FOUNDATION IN CALIFORNIA WITH THE HELP OF VILLAGE-TO-VILLAGE NETWORK, YOU START TO SEE THE TREND FOR THE QUALITY OF LIFE THAT VILLAGES ARE OFFERING AND PROVIDING. AND I'LL LEAVE IT AT THAT. YOU CAN READ THOSE YOURSELF. VILLAGES AND THE FUTURE, WE'RE LOOKING AT RESEARCH AND EXPANDING THAT ACROSS THE COUNTRY. PUBLIC POLICY IN THE IMPLEMENTATION FOR THE VILLAGES TO TRULY BE IN HOUSING BUILDINGS AND IN EVERY COMMUNITY THAT WANTS IT, TO SUPPORT PEOPLE TO STAY IN THEIR HOMES, AND ADVOCACY. LIVE-LONG LEARNING, LIVEABLE COMMUNITIES, WORKING WITH THE ALREADY EXISTING NORCs, ETCETERA, TO AGING COMMUNITY, AND THIS LAST IS A QUOTE THAT IS THE COMMUNITY AS A WHOLE WAS STRENGTHENED IF ITS OLDEST RESIDENTS STAY PUT AND LOCAL RESOURCES ARE ENGAGED IN A NETWORK OF SUPPORT. I'D LIKE TO END WITH THAT BECAUSE IT IS A LOVELY RENDITION AND DESCRIPTION OF WHAT VILLAGES ARE. THANK YOU. >> GREAT. [ APPLAUSE ] >> THANK YOU, JUDY. HENRY, YOU SAID SOMEBODY IN THE AUDIENCE MIGHT BE MOVED BY THIS BECAUSE IT'S SO PERSONAL. IT'S LIKE, OH MY GOD, THIS IS MY PARENTS. I AM SO GOING TO TELL THEM ABOUT THIS BECAUSE MY MOM IS THE ONE WHO DRIVES EVERYBODY TO THE GROCERY STORE AND MY DAD WILL -- COME ON UP. I'M GOING ON. MY DAD IS THE ONE WHO WILL FIX YOUR COMPUTER AND THEY'RE ON THIS. I'M SO HOOKING THEM UP, SO THANK YOU SO MUCH. GREAT, JAMES. >> THANKS. SO THANK YOU SO MUCH TO HUD FOR PUTTING THIS ON. THIS IS AN INCREDIBLY IMPORTANT TOPIC THAT HAS SUCH A HUGE IMPACT AND I'M SURE THERE'S LOTS OF YOU IN THE ROOM ALREADY THAT ARE PERSONALLY INVOLVED IN THESE KIND OF SITUATIONS. 25% OF ALL INDIVIDUALS OVER 65, AGE 65, WILL NEED SOME SUPPORTING ACTIVITIES OF DAILY LIVING, EATING, DRESSING, TOILETING, MEDICATION MANAGEMENT, THINGS OF THAT SORT. WHEN YOU GET TO 80, 85 YEARS OF AGE, IT'S UP TO 50%, SO THE VAST MAJORITY OF PEOPLE AS THEY AGE WILL NEED SOME FORM OF ASSISTANCE, IN MANY CASES MAJOR ASSISTANCE. AS WE ALREADY SAID, MOST EVERYBODY WANTS TO STAY AT HOME. THE VAST MAJORITY. AND YET, THERE ARE MANY, MANY BARRIERS TO THAT THAT WE CAN TALK ABOUT TODAY. I WANT TO FOCUS ON TWO AND THEN I WANT TO FOCUS ON THREE INITIATIVES THAT HEALTH AND HUMAN SERVICES, THE DEPARTMENT IS WORKING ON TO TRY TO MITIGATE THOSE RISKS. THE FIRST IS CAREGIVER SUPPORT. 85% OF ALL CAREGIVING IN THIS COUNTRY IS DONE BY FAMILY CAREGIVERS. IT'S A STUNNING STATISTIC. THE ECONOMIC VALUE OF THAT IS ABOUT FOUR TIMES WHAT WE ACTUALLY PUT OUT IN PUBLIC DOLLARS FOR LONG-TERM CARE ASSISTANCE. 40 MILLION AMERICANS ARE PROVIDING LONG-TERM CARE SUPPORT TO FAMILY MEMBERS. 15 MILLION, THE FAMILY MEMBERS WITH DEMENTIA. AGAIN, JUST A STUNNING FIGURE. A RECENT STUDY BY THE UNITED HOSPITAL FUND HAS DONE THE MOST DETAILED PROFILE OF FAMILY CAREGIVERS AND SAID 46% OF THOSE INTERVIEWED IN A VERY DETAILED, MULTI PRONG SURVEY, REPORT THAT THEY ARE DOING COMPLEX MEDICAL AND NURSING TASK MANY. MEDICATION MANAGEMENT, OPEN WOUND CARE, TUBE FEEDINGS, TRACH CLEANINGS, ALL KINDS OF WHAT ARE TYPICALLY CONSIDERED MEDICAL AND NURSING TASKS AND KNOWLEDGE OF THEM HAVE RECEIVED VERY NOMINAL IF NECESSITY SUPPORT -- IF ANY SUPPORT FROM THE HEALTHCARE COMMUNITY AND I'VE TALKED TO MANY FAMILIES WHO DESCRIBE THE NIGHTMARE OF THE HOSPITAL DISCHARGE PROCESS WHERE OFTEN AFTER AN INITIAL CATASTROPHIC EVENT THEY'RE GOING HOME WITH THEIR PARENT OR FAMILY MEMBER AND THEY'RE GIVEN FIVE MINUTES OF RUSHED INSTRUCTION ON HOW TO DO THIS, HOW TO DO THAT. THEY'RE GIVEN BAGS AND EQUIPMENT, MEDICATIONS, AND SENT OUT THE DOOR. IT IS ALMOST SCANDALOUS IN MANY CASES HOW THIS HAPPENS. AND SO CAREGIVER BURNOUT, WHEN THOSE KIND OF CIRCUMSTANCES APPLY, IS VERY, VERY SIGNIFICANT. SOME OF THE EMERGING RESEARCH ABOUT CAREGIVERS SAYS THAT THE MOST IMPORTANT VARIABLE ABOUT CAREGIVER BURNOUT IS NOT THE COMPLEXITY OF CARE THAT'S REQUIRED, BUT IT'S THE EMOTIONAL, FINANCIAL, SOCIAL SUPPORTS THAT ARE AVAILABLE TO THE CAREGIVERS OF THEMSELVES. WE HAVE PROGRAMS ALL OVER THE COUNTRY THAT PROVIDE DIFFERENT ELEMENTS OF CAREGIVER SUPPORT, BUT NO COMPREHENSIVE STRATEGY ON HOW WE'RE GOING TO SUPPORT CAREGIVERS NOW AND IN THE FUTURE. THE SECOND THING, BARRIER THAT I WOULD CALL -- AND I DON'T MEAN TO BE DISPARAGING ABOUT THE INDUSTRY, BUT THERE ARE HUNDREDS AND HUNDREDS OF THOUSANDS OF ELDERS IN THIS COUNTRY THAT I THINK ARE PREMATURELY AND UNNECESSARILY INSTITUTIONALIZED. I THINK IT'S A NATIONAL TRAGEDY, QUITE FRANKLY. WHEN YOU LOOK AT THE PERFORMANCE ACROSS THE STATES FOR STATES WHO SPEND PUBLIC DOLLARS ON COMMUNITY SERVICES, IT RANGES FROM THE HIGH OF 0E7% IN ONE -- 70% IN ONE STATE TO A LOW OF 10% IN ANOTHER STATE WITH ALL THE OTHER STATES SCATTERED BETWEEN. SO PEOPLE LIVING IN NURSING HOME IN ONE STATE CAN CROSS THE BORDER AND THEY COULD LIVE AT HOME WITH PAID PUBLIC SUPPORTS. IT VARIOUS SO DRAMATICALLY. THE NURSING HOME UTILIZATION RANGES PER 100,000 OF POPULATION TO 80 PER 100,000 IN ONE STATE TO 880 IN ANOTHER STATE. THE DISPARITY OF PERFORMANCE IS ABSOLUTELY HUGE, BUT THE BIG ISSUE IN PREMATURE UNNECESSARY INSTITUTIONALIZATION IS WHAT HAPPENS AFTER THE THE CATASTROPHIC HEALTH PEOPLE. PEOPLE GO INTO A HOSPITAL, THEY'RE ON MEDICARE, AND THEY COME OUT OF THE HOSPITAL WITH A MEDICARE 20-DAY POST ACUTE BENEFIT, WHICH IS A REHAB STAY IN A NURSING HOME, THAT MEDICARE PAYS FOR BECAUSE MEDICARE DOESN'T PAY FOR LONG-TERM CARE AS MANY PEOPLE FALSELY ASSUME, SO THEY WILL PAY FOR THAT 20-DAY POST ACUTE BENEFIT. OF THOSE 20-DAY POST ACUTE STAYS, 25% END UP STAYING FOR LENGTHY PERIODS OF TIME. AND IF THEY STAY FOR UP TO SIX MONTHS, ALMOST INEVITABLE THEY THEN HAVE SPENT ALL THEIR PERSONAL RESOURCES, SPENT DOWN THE MEDICAID, IMPOVERISHED THEMSELVES AND AT THAT POINT, IT'S VERY, VERY DIFFICULT FOR THEM TO RETURN HOME. ONE WOULD THINK THAT'S THE SICKER PEOPLE, THE COHORT OF PEOPLE THAT HAVE EXTENSIVE NEEDS, REALLY SICK. IT'S NOT TRUE. MANY OF THEM HAVE MINIMAL CARE NEEDS AFTER THAT POST ACUTE BENEFIT, BUT ALL KIND OF CIRCUMSTANCES INTERVENE. THE FAMILY, YOU KNOW, LIVES MANY, MANY STATES AWAY OR THE CAREGIVER AFTER ANOTHER CATASTROPHIC HEALTH EVENT CAN'T STEP UP TO THE INCREASED LEVEL OF CARE. THERE'S MANY, MANY FACTORS THAT INTERVENE. A COUPLE OF SOLUTIONS WE'RE WORKING ON AT HHS. ONE ARE AGING AND DISABILITY RESOURCE CENTERS. WE'VE PILOTED GRANTS IN ALL 50 STATES, BUT THEY WERE ALL OVER THE MAP. MORE RECENTLY IN EIGHT STATES, WE'VE EXPANDED THOSE PILOTS, BOTH THE DEPARTMENT OF VETERANS AFFAIRS AND HHS HAS COLLABORATED NOW IN TRYING TO FIGURE OUT NATIONAL STANDARDS THAT AT THE END OF THREE YEARS, WE CAN ARTICULATE IN EVERY SINGLE STATE YOU HAVE TO HAVE A SINGLE, NO WRONG DOOR, AND ANYBODY, NO MATTER WHETHER THEY'RE ELIGIBLE FOR PUBLIC BENEFITS OR TRYING TO SURVIVE ON THEIR PRIVATE RESOURCES, WHEN THAT HEALTH EVENT OR THAT CATASTROPHIC EVENT HAPPENS, THERE IS A TOLL-FREE NUMBER, A WEBSITE, THERE'S NOT ONLY A CALL CENTER, BUT THERE ARE PERSONAL INTERVIEWS AND FACE-TO-FACE ASSISTANCE THAT CAN ACTUALLY HELP YOU SORT OUT WHAT YOUR OPTIONS ARE AT THAT POINT. AND IN MANY CASES, IT'S IMPORTANT TO HELP THE PERSON UTILIZE THEIR PRIVATE RESOURCES, WHICH IF DONE WRONGLY, CAN CAUSE UNNECESSARY EXPENSES, UNNECESSARY INSTITUTIONALIZATION, SO WE HOPE TO HAVE THAT MAPPED OUT AND VIRTUALLY -- OR NOT VIRTUALLY, BUT IN PLACE IN EVERY STATE IN A MATTER OF YEARS. I USED TO RUN THE LONG-TERM CARE PROGRAM IN OREGON. NOT A MONTH WENT BY WHEN I WOULDN'T GET A CALL FROM SOME GENTLEMAN IN NEW JERSEY, MY MOM IS IN A HOSPITAL IN EUGENE, OREGON. SHE HAD A MINOR STROKE, I DON'T KNOW WHAT TO DO. THEY GAVE ME A LIST OF THREE NURSING HOMES WHERE SHE CAN GO. SHE'S CRYING, HYSTERICALLY. I'M 3,000 MILES AWAY, I DON'T KNOW WHAT TO DO. AND I, YOU KNOW, JUST ON MY OWN, I START SAYING TELL ME ABOUT YOUR MOM, DOES SHE LIVE BY HERSELF, DOES THEY HAVE NEIGHBORS, THERE IS SOMEONE WHO CAN STAY WITH HER OVERNIGHT, CAN SHE PAY FOR HOME HEALTHCARE THAT MAY BE MEDICARE MIGHT PAY PART OF IT, AND THEN JUST SORT OF START BUILDING A PROFILE OF WHAT DINE OF SUPPORTS -- WHAT KIND OF SUPPORTS MIGHT BE AVAILABLE RATHER THAN RISK GOING INTO A NURSING HOME AND POTENTIALLY GETTING TRAPPED THERE. WE'VE CREATED THIS PROGRAM IN THE FEDERAL GOVERNMENT CALLED MONEY FOLLOWS THE PERSON, TO ACTUALLY PAY FOR TRANSITION COSTS AND FOR A FULL YEAR OF FEDERAL FUNDING TO GET SOMEONE OUT OF THE NURSING HOME AND EITHER BACK HOME OR INTO ANOTHER KIND OF COMMUNITY FACILITY. EVERY SINGLE REPORT INDICATES THAT THE LACK OF HOUSING IS THE BIGGEST BARRIER AND FIVE YEARS AFTER THIS PROGRAM WAS CREATED, WE'VE ONLY MOVED 30,000 INDIVIDUALS ACROSS THE COUNTRY. WHICH IS GREAT, BUT IT'S A VERY, VERY SMALL NUMBER IN TERMS OF THE NEED. CONGRESS CHANGED, IT USED TO BE YOU HAD TO BE IN A NURSING HOME FOR SIX MONTHS BEFORE YOU WERE ELIGIBLE FOR A PROGRAM. THEY PEELED THAT BACK TO 90 DAYS, BUT EVEN AFTER 90 DAYS, PEOPLE REPORT, PEOPLE ARE BEGINNING TO LOSE THEIR NATIONAL SUPPORTS, HOUSING SUPPORTS, THE RENT HASN'T BEEN PAID ON THE APARTMENT, AND SO NOW SUDDENLY TO GET THEM BACK HOME, IT CREATES A WHOLE NEW DEMAND TO CREATE HOUSING OPTIONS FOR THEM. CAREGIVER SUPPORT, WE'RE STUDYING CAREGIVER PROGRAMS, GOING TO DO A MAJOR NATIONAL STUDY HERE IN THE COMING MONTHS TO REALLY LOOK AT ALL THE BEST PRACTICES, BUT NOT IN INDIVIDUAL PILOTS OR MODELS, BUT WHAT CAN BE ACTUALLY SCALED UP TO SAY THIS IS A GOLD STAR CAREGIVER SUPPORT PROGRAM THAT ULTIMATELY OUGHT TO BE IN PLACE IN EVERY STATE, THAT MEDICAID OUGHT TO PAY PART OF IT, THAT MANAGED, DUAL DEMONSTRATIONS, WHATEVER WE'RE DOING TO ADDRESS THE NEEDS OF THIS POPULATION CAN INCORPORATE THOSE KIND OF SUPPORTS. AND IN NURSING HOME DIVERSION, WE'RE ACTUALLY LOOKING AT SEVERAL STATES THAT INTERVENE QUICKLY. I HAD A STAFF MEMBER WHO USED TO TALK ABOUT THE GOLDEN WEEK AND I SAID WHAT'S THE GOLDEN WEEK? AND THEY SAID, YOU KNOW, THE GOLDEN HOUR WHEN YOU'RE BADLY HURT IN AN ACCIDENT TO GET TO THAT TRAUMA CENTER WITHIN AN HOUR AND INTO SURGERY, AFTER THAT YOUR CHANCES ARE SURVIVAL OR REGAINING YOUR CAPACITIES REALLY GOES DOWN. THE GOLDEN WEEK, THIS PERSON DESCRIBED, IS IF A PERSON GETS INTO AN INSTITUTION, IF YOU'RE NOT IN A PLACE, IN A NURSING HOME OR FACILITY WITHIN A WEEK, BEGINNING TO PLAN, TO GET THEM THINKING ABOUT WHAT IT WOULD TAKE TO GET BACK HOME, TO GET THE FAMILY THINKING ABOUT THAT, EVERY DAY AFTER THAT THEY STAY, THE CHANCES OF THAT HAPPENING START TO GO DOWN. MINNESOTA, IT PROBABLY HAS THE MOST SOPHISTICATED PROGRAM IN THE COUNTRY THAT WE'RE DOING A LOT OF RESEARCH AROUND WHERE THEY GET PEOPLE BACK HOME. THEY ACTUALLY BASED ON DATA FROM NURSING HOMES, THEY HAVE SET UP AN ENCRYPTED HIPAA COMPLIANT WEBSITE THAT GENERATES, BASED ON AN ALGORITHM, THE NAMES OF INDIVIDUALS THAT HAVE GONE INTO NURSING HOMES WHO ARE MOST AT RISK OF LONG STAYS, NOT THE ONES THAT GO FOR REHAB STAY AND GO HOME, BUT MOST AT RISK OF LONG STAYS AND THEN THEY SEND THOSE NAMES OUT TO THEIR LOCAL CONTACT INDIVIDUALS WHO GO IN, DEVELOP A PLAN. THEY'VE BEEN DOING THAT FOR THREE YEARS. AFTER THREE YEARS, ALL THE PEOPLE THEY HAVE ASSISTED TO GET BACK HOME, 91% HAVE STAYED AT HOME FOR 24 FULL MONTHS AFTER THAT. WE'RE ACTUALLY LOOKING, IF WE COULD SCALE THAT, BECAUSE AGAIN THE PROTOCOLS, THE DATA, AND WE'RE DOING FEDERAL FUNDING TO MEASURE THE POTENTIAL SAVINGS IN MEDICAID AND MEDICARE TO DO THAT, IF YOU SCALE THAT EVERYWHERE AROUND THE COUNTRY, OUR BACK OF THE ENVELOPE ESTIMATE IS THE RETURN ON INVESTMENT WOULD BE ABOUT $2.81 AND THAT'S A STRATEGY THAT'S ALMOST OFF THE SHELF THAT MINNESOTA HAS PERFECTED AND OTHER STATES ARE DOING THAT AS WELL. SO THOSE ARE JUST SOME OF THE IDEAS THAT WE THINK ARE VERY IMPORTANT. I DIDN'T TOUCH SO MUCH ON THE HOUSING SIDE. THAT WILL COME UP IN THE DISCUSSION, BUT WE HAVE SOME WONDERFUL PARTNERSHIPS WITH HUD AND HHS THAT ARE REALLY LOOKING AT THE HOUSING SIDE OF THAT EQUATION. THANK YOU. [ APPLAUSE ] >> I'LL ASK MY FRIENDS HERE TO HIT YOUR PUSH BUTTON SO WE CAN MOVE INTO CONVERSATION. JAMES, THANK YOU, AND THANK YOU SO MUCH. ONE OF THE COOLEST THINGS ABOUT MY JOB IS THAT I GET TO WORK WITH PEOPLE LIKE JAMES AS WE TRY TO FIGURE OUT HOW TO TAKE HUD'S HOUSING RESOURCES AND DO A BETTER JOB SO THAT THEY MARRY UP BETTER WITH THE HEALTH AND HUMAN SERVICES AND SUPPORTS THAT ARE OVER AT HHS, SO THANK YOU FOR THAT. THAT'S SOBERING IN THE STATISTICS, BUT I THINK A GREAT VISION OF HOW YOU WANT TO MOVE FORWARD. SO YOU ALL HAVE BEEN LISTENING TO ONE ANOTHER AS YOU GIVE YOUR PRESENTATIONS. WHAT STRIKES YOU MOST? JAMES, I NEED YOUR MIC. >> I GUESS ONE OF THE THINGS THAT STRIKES ME IS THE, THE WAY ALL OF OUR DIFFERENT INITIATIVES CAN COINCIDE WITH EACH OTHER. I THINK THAT PEOPLE TRY TO THINK ABOUT THEIRS ONE SOLUTION TO THIS -- THERE'S ONE SOLUTION TO THIS AGING IN PLACE PROBLEM AND THERE'S NOT. THERE'S MULTIPLE SOLUTIONS. THERE'S MULTIPLE WAYS AND PLACES THAT PEOPLE CAN LIVE AND GET SERVICES, BUT I THINK THERE'S A LOT OF WAYS THAT THEY CAN COLLABORATE. WE TALKED EARLIER ABOUT, BEFORE WE STARTED HERE, ABOUT SOME AFFORDABLE HOUSING PROPERTIES THAT ARE INVOLVED IN THE VILLAGE MOVEMENTS, THAT ARE ACTUALLY SERVING AS AN EXAMPLE, ONE IS THE PRESBYTERIAN VILLAGES IN MICHIGAN DOING, INITIAL HI IN THE DETROIT AREA -- INITIALLY IN THE DETROIT AREA WHERE THE AFFORDABLE HOUSING COMMUNITIES ARE SERVING AS THE HUB OF THE VILLAGE NETWORK, SO THEY'RE ABLE TO LEVERAGE THE RESOURCES OF THE HOUSING PROPERTY, THE SERVICE COORDINATOR, THE SPACE. THEIR SERVICE NETWORKS ALREADY TO GET SERVICES OUT TO THE COMMUNITY, BUT ALSO TO INTEGRATE THE HOUSING PROPERTIES INTO THE COMMUNITY AS WELL. I THINK A LOT OF COMMUNITIES TEND TO NOT THINK ABOUT THEIR AFFORDABLE HOUSING PROPERTIES. THEY KIND OF ISOLATE THEM AND SEE THEM AS KIND OF STAND-ALONE BUILDINGS, AND TO START THINKING ABOUT THEM AS PART OF THE COMMUNITY NETWORK AND THE RESOURCES THEY COULD BRING TO THE COMMUNITY. >> I ALSO THINK THAT ONE THING THAT STRUCK ME IS THINKING ABOUT AGING IN GENERAL AS AN OPPORTUNITY, NOT A PROBLEM, AND KEEPING ALL OF US, KEEPING OURSELVES AND OUR SURROUNDINGS, YOU KNOW, ALL THE OTHER PEOPLE, AT THAT -- WHAT DID YOU CALL IT, HENRY? >> MORBIDITY. >> RIGHT, EXACTLY. SO THAT IS THE GOAL FOR ALL OF THE PROGRAMS THAT WE'RE LOOKING AT, AND THE VILLAGES, THE NORCs, ALL THE THINGS ARE -- AND FOR OURSELVES INDIVIDUALLY, ARE LOOKING AT KEEPING THAT AS LONG AS POSSIBLE AS AGING AS A POSITIVE THING. AGING AS ENGAGED IN OUR LIVES, AGING AS ENGAGED IN THE COMMUNITY, AND NOT AS A PROBLEM. >> JUDY, DO YOU THINK THAT, THAT THE PHYSICAL BUILT ENVIRONMENT, LIVING AT HOME, IS AN ELEMENT? I MEAN, WE ACCEPT THAT, YOU KNOW, I ACCEPT THAT, BUT IF YOU TESTED IT, A PERSON WITH YOUR EXPERIENCE, IS THAT REAL? IS THAT ACTUALLY AN ELEMENT? OR DO PEOPLE REALLY WANT TO BE AT HOME OR JUST WHAT DO YOU THINK? >> YOU ALL CHIME IN ALSO. I THINK THAT PEOPLE HAVE A VERY STRONG AFFINITY TO THEIR COMMUNITY, AND THAT'S WHY WE CALL IT AGING IN COMMUNITY, NOT NECESSARILY AGING IN PLACE, BUT THEY'RE THE SAME THING. BUT YOUR HOME MEANS SO MUCH TO YOU AT SO MANY DIFFERENT LEVELS, BUT SO DOES YOUR COMMUNITY. YOU CAN ACTUALLY CHANGE YOUR PHYSICAL HOME, BUT PEOPLE BASICALLY WANT TO STAY IN THEIR COMMUNITY. THEY WANT TO STAY ENGAGED, THEY WANT TO STAY INVOLVED WITH OTHER PEOPLE, AND -- >> AND THAT TRANSLATES INTO WELL-BEING, LONGEVITY, HEALTH. >> IT DOES. >> ACTIVITY, ETCETERA. >> IF YOU START LOOKING AT THE RESEARCH ON SOCIAL ISOLATION AND THE RESEARCH ON HEALTH AND WELLNESS, THEY GO RIGHT TOGETHER. >> MM-HMM. >> ABSOLUTELY. >> WHAT STRUCK YOU? >> WELL, SO MANY THINGS. I MEAN, THIS WAS A VERY RICH SET OF IDEAS, BUT IT'S CONNECTING THEM AND SO MUCH OF WHAT I DID WAS IN THE PUBLIC SECTOR AROUND THE MEDICAID PROGRAM AND, YOU KNOW, WE HAD A GREAT MEDICAID PROGRAM, BUT IT WAS ONLY VERY LATE IN MY CAREER I STARTED -- AND ACTUALLY I WAS AT A MEETING OF STATE MEDICAID DIRECTORS AND ONE GOT UP AND SAID, IF YOU'RE A SMART MEDICAID DIRECTOR, YOU WILL SPEND MOST OF YOUR TIME THINKING ABOUT PEOPLE NOT YET ON MEDICAID. AND THAT'S WHERE SOME OF THESE OTHER STRATEGIES BECOME SO IMPORTANT IN TERMS OF VILLAGES AND NORCs AND CONCENTRATED PUBLIC STRATEGIES TO SUPPORT PEOPLE, BOTH ON THE HOUSING SIDE AND THEIR SUPPORT NEEDS AND THE RISK OF ISOLATION. AND WE HAVE TO -- I MEAN, SO MANY WONDERFUL THINGS ARE HAPPENING, BUT IN MANY CASES, IT'S NOT A NATIONAL STRATEGY OR IT'S NOT A COMPREHENSIVE STRATEGY STATE BY STATE, AND IF WE COULD TAKE THESE BEST PRACTICES AND REALLY INCULCATE EVERY STATE TO SAY LAY OUT THIS RANGE OF OPTIONS THAT IS NOT JUST IN YOUR PUBLICLY PAID PROGRAMS WHERE PEOPLE END UP SPENDING DOWN, I THINK THAT'S VERY IMPORTANT AND THAT REALLY STRIKES ME. >> WHAT STRUCK ME, I THINK, ALTHOUGH I'VE BEEN PREACHING THE PHYSICAL SIDE, THE HOUSING SIDE FOR YEARS, AND I DO BELIEVE IT MATTERS IF PEOPLE CAN BE IN A PLACE THAT'S AGE-APPROPRIATE AND SO FORTH, IT'S VERY CLEAR FROM THIS CONVERSATION THAT -- AND FROM THINGS I'VE SEEN WITH MY OWN EYES, THAT WITHOUT A COMMENSURATE HUMAN SERVICES SET OF CONTEXT, THE PHYSICAL AND BUILT ENVIRONMENT IS NOT THE COMPLETE ANSWER. WHEN YOU PEEL THE LAYERS OFF THE ONION AND TRY TO GET TO THE TRUTH ABOUT PEOPLE AGING IN COMMUNITY, YOU FIND MANY WHO ARE LONELY, A SPOUSE HAS PASSED, THEY'RE SAD ABOUT THAT. THEIR CHILDREN LIVE IN OTHER PLACES BECAUSE MODERN AMERICAN SOCIETY SENDS FAMILIES ALL OVER THE COUNTRY. THEY'RE NO LONGER IN THE SAME NEIGHBORHOOD AS WE USED TO BE. THEY DON'T EAT BECAUSE IT'S HARD TO EAT -- PREPARE MEALS FOR ONE PERSON. THAT'S WHAT THEY SAY, THEY DON'T WANT TO PREPARE A MEAL FOR A SINGLE PERSON, SO WHEN THEY DON'T EAT, THEN MALNUTRITION SETS IN AND YOU COMBINE THAT WITH THE NATURAL FRAILTIES THAT COME WITH DIABETES, ETCETERA, AND ALL OF A SUDDEN PEOPLE ARE REALLY SICK BECAUSE THEY HAVEN'T EATEN CORRECTLY. WE HAVE PROBLEMS OF DEMENTIA, ALZHEIMER'S, OTHER MENTALLY RELATED THINGS THAT HAPPEN AS PEOPLE AGE, SO IT IS A WITCH'S BREW OF PROBLEMS THAT ALMOST NO RATIONAL EXPLANATION OR ANSWER ADDRESSES, SO CLEARLY THE PHYSICAL ENVIRONMENT IS NOT THE WHOLE THING. >> BUT LET'S STAY FOR A MOMENT WITH -- I MEAN, I LOVE THAT HUMAN SERVICES PIECE AND I THINK THAT THIS IS THE THING WE HAVE TO BRING TOGETHER, BUT LET'S TAKE THE CHARGE THAT YOU AND SECRETARY DONOVAN GAVE US, WHICH IS HERE WE ARE AT HUD. WHAT IS IT THAT HUD NEEDS TO BE DOING NOW, WHAT ARE THE FIVE THINGS THAT WE COULD BRING BACK TO SECRETARY DONOVAN AT THE END OF THIS AND SAY IF HUD DID THESE FIVE THINGS, WE COULD REALLY MAKE A DIFFERENCE WITH THE CHALLENGES AND THE OPPORTUNITIES YOU ALL LAID OUT? >> WELL, KEEPING UP WITH THE THEME THAT I JUST ARTICULATED, FINDING A WAY TO TAKE THE VILLAGE NETWORK OR ANALOGIES TO IT BECAUSE I THINK IT'S GOING TO HAVE MANY FORMS AND THERE WILL BE OTHER STRUCTURES AND SO FORTH OVER TIME, BUT THIS IS A BRILLIANT AND WONDERFUL START, AND MATCH THEM UP WITH SOME OF THE PHYSICAL ENVIRONMENT, THAT WOULD BE REALLY, REALLY IMPORTANT. IT WOULD MAKE A REAL DIFFERENCE IN PEOPLE'S LIVES. THAT'S ONE. >> WHAT ABOUT THE REST? >> I WAS VERY STRUCK BY THE SECRETARY'S COMMENT ABOUT THE WEATHERIZATION PROGRAM. I NEVER EVEN THOUGHT ABOUT THAT BECAUSE IN SO MANY CASES, THE HOUSING MODIFICATIONS AFTER A CATASTROPHIC HEALTH EVENT ARE ON THE SPOT AND THEY'RE, THEY'RE TIED TO THAT SPECIFIC HEALTH EVENT, SO SUDDENLY YOU GET GRAB BARS, YOU RAISE THE TOILET SEAT, YOU DO A COUPLE OTHER THINGS. NOBODY HAS REALLY LOOKED AT YOUR HOUSE OR HELPED YOU THINK THROUGH THE PROFILE OF THAT LONG-TERM CARE EVENT AND HOW THAT WILL CHANGE OVER THE YEARS AND WHAT MODIFICATIONS MIGHT NEED TO TAKE PLACE. I'VE BEEN IN HOUSES WITH, YOU KNOW, THE GRAB BARS AND THE RAISED TOILET SEATS FOR SOMEONE WHO'S HAD MULTIPLE FALLS AND THERE'S STILL THROW RUGS ALL OVER THE HOUSE. SO THE MOST ELEMENTAL -- ELEMENTARY THINGS THAT I THINK FROM A HOUSING PERSPECTIVE, IF WE HAD TRAINED PEOPLE, AND SOME PEOPLE I'M SURE DO THIS VERY WELL, BUT SYSTEMATICALLY, WE HAD A WAY OF DOING THAT, THAT WOULD BE, I THINK, EXTRAORDINARY. >> YOU KNOW, ALISA AND JUDY, I KNOW YOU HAVE THOUGHTS TOO, BUT I WANT TO BE MINDFUL THERE ARE A TON OF IDEAS AND THOUGHTS OUT OF IN THE AUDIENCE AND I HAVE PROMISED THAT I'M GOING TO GET EVERYBODY OUT OF HERE ON TIME. SO I JUST WANT TO LET FOLKS KNOW THAT WE'LL START QUESTIONS FROM THE AUDIENCE IN JUST A MOMENT OR TWO. THERE'S MICROPHONES DOWN THE MIDDLE, SO IF YOU WANT TO OFFER A QUESTION AND I'M GOING TO SWITCH OVER HERE BECAUSE WE MIGHT HAVE QUESTIONS COMING IN FROM ONLINE. YOU CAN SEND THEM IN FROM ONLINE IF YOU WANT TO. JUDY OR ALISA, IF YOU WANT TO THROW IN YOUR IDEAS, BUT GO AHEAD AND PLEASE START COMING TO THE MICS AND WE'LL GET SOME QUESTIONS IN. BRIEFLY. >> YES, ONE EASY THING IS TO START EDUCATING THE HUD OFFICERS, REGIONAL AND EVEN THE BUILDING MANAGERS, WITH THE AGING IN COMMUNITY OPTIONS SO THAT PEOPLE LIVING IN THOSE BUILDINGS CAN BECOME MEMBERS OF VILLAGES. >> RIGHT. >> AND QUICKLY, MY THOUGHT IS THAT HUD SHOULD LOOK AT THE OPPORTUNITY TO EXPAND BOAST THE NUMBERS AND THE -- BOTH THE NUMBERS AND THE ROLE OF SERVICE COORDINATORS IN THEIR PROPERTIES TO HELP WITH THAT COORDINATING, CONNECTING ELEMENT. >> GREAT. WE'LL WORK FROM THE FRONT. CAN YOU PLEASE LET US KNOW WHO WE'RE TALKING TO? >> I'M ART WITH THE AMERICAN PUBLIC TRANSPORTATION ASSOCIATION. A LOT OF GREAT IDEAS HERE A LOT OF ACTUALLY, I THINK, CONSENSUS ON IDEAS WHOSE TIME IS HERE. MY POINT IS ABOUT TEN YEARS AGO, THERE WAS A WHITE HOUSE CONFERENCE ON AGING TO TAKE THE ISSUES ALL THE WAY TO THAT LEVEL AND I THINK IT HAPPENS ABOUT EVERY TEN YEARS, AND THE TEN YEARS IS UP, SO IS IT TIME, IT WOULD BE A GOOD IDEA TO SPARK ANOTHER ONE OR IS THERE MAYBE IDEAS KICKING AROUND FOR SUCH A THING, OR WHAT DO WE DO TO MAKE THAT HAPPEN? >> LET'S DO ALL THIS AS LIGHTNING BECAUSE WE HAVE TO LOT OF PEOPLE TO TALK. >> I WOULD SAY PUTTING A WHITE HOUSE CONFERENCE IS A MASSIVE ENDEAVOR, IT TAKES YEARS. IT'S NEGOTIATED, EXPENSE SIEVE, BUT MAYBE FOCUS IS MORE PRECISELY ON THE HOUSING ISSUES FOR AGING IS SOMETHING THAT COULD BE DONE MUCH MORE TARGETED AND WE HAVEN'T DONE THAT AS A COUNTRY. THAT WOULD BE MY THOUGHT. >> I'M GOING TO JUMP TO THE SECOND MICROPHONE. MA'AM, IDENTIFY YOURSELF. >> YES, I'M JEAN MORROW FROM ANNAPOLIS AND I'VE BEEN WORKING IN THE SENIOR HOUSING AND CARE FIELD SINCE 1985, SO I REALLY -- 1983, SO I REALLY APPRECIATE ALL THAT ALL OF YOU HAVE ALREADY DONE, BUT ONE THING I WOULD REALLY ENCOURAGE HUD AND HHS TO DO IS TO WORK WITH A LOT OF THE RESEARCH THAT'S BEEN DONE AND BEING DONE ON AGING. THERE IS SO MUCH WONDERFUL INFORMATION OUT THERE ABOUT HOW PEOPLE CAN AGE WELL OR AS MR. CISNEROS SAID, WHAT I CALL LIVING LONG AND DYING SHORT, WHICH MAY BE IS A DIFFERENT WAY OF SAYING THE SAME THING YOU SAID. BUT THERE'S WONDERFUL, WONDERFUL RESEARCH OUT THERE, INFORMATION OUT THERE, ABOUT AGING AND LET'S START LOOKING AT AGING FROM A PROACTIVE STANCE ALSO. YOU ALL ARE DOING WONDERFUL, WONDERFUL THINGS FROM A REACTIVE STANCE TO DEAL WITH CHRONIC CONDITIONS AFTER THEY HAPPEN, BUT THERE'S ONLY ABOUT 30% OF HOW WE AGE IS DUE TO OUR GENES. 70% IS OUR LIFESTYLE. >> ANYBODY WANT TO COMMENT ON THAT OR SHOULD WE JUST MOVE TO THE NEXT -- >> A QUICK POINT, WHICH IS A PD&R ASSIGNMENT COULD BE TO LOOK AT WHAT THEY'RE DOING IN OTHER PARTS OF THE WORLD AS WELL BECAUSE OTHER PARTS OF THE WORLD ARE AHEAD OF US WITH RESPECT TO THE AGE CURVE. I THINK JAPAN IS SEVEN OR AILTHS YEARS OLDER THAN -- EIGHT YEARS OLDER THAN WE ARE IN AVERAGE OR LONGEVITY AND THEY HAVE ALL KINDS OF THINGS GOING. JAPAN, SCANDINAVIA, THESE ARE COUNTRIES THAT ARE OLDER AND THEIR SOCIAL SYSTEMS ARE GEARED AND THEY HAVE CAPITAL TO SPEND, SO THEY ARE ON KIOSKS AND ALL KINDS OF THINGS THAT THEY'RE DOING THAT WE OUGHT TO LEARN FROM. SO AN INTERNATIONAL CUT AT THIS TO FIND BEST PRACTICES AND CIRCULATE THEM IN A WORTHWHILE ENDEAVOR. >> AND THE WORLD'S HEALTH ORGANIZATION IS WORKING ON THAT AND LOOKING AT LIVEABLE COMMUNITIES AND HOW VILLAGES CAN FIT IN IN SO MANY OTHER COUNTRIES ARE EVEN LOOKING AT WHAT WE'RE DOING WITH VILLAGES, NORCs, ETCETERA. >> BACK TO THE THIRD MICROPHONE. >> JOHN NELSON WITH WALL STREET WITHOUT WALLS. WE'VE BEEN MOSTLY INVOLVED IN COMMUNITY DEVELOPMENT FINANCE, BUT FIND OURSELVES INTERESTED IN AGING IN PLACE FINANCE. ONE THING THAT PD&R AND HUD MIGHT LOOK AT IS HOW TO CREATE STANDARDIZED DOCUMENTATION PERFORMANCE DATA SO WE CAN TAKE LAND SALE CONTRACTS OR OTHER WAYS OF LERCHINGING A PERSON'S -- LEVERAGING A PERSON'S EQUITY IN A HOME, NOT A REVERSE MORTGAGE, TO HELP THEM AGE IN PLACE AND DELAY GOING INTO A SENIOR FACILITY, SO A GUARANTY, A PIPELINE FOR INFORMATION AND DATA SO THAT WE CAN GET THE SCALE TO EITHER SECURITIZATION OR GUARANTIES THAT IMPACTED INVESTORS MIGHT BE ABLE TO GET BEHIND. >> SHALL WE JUST KEEP GOING? >> GREAT STUFF. >> GOOD POINT. >> INTERESTING. >> LET'S BRING IT BACK UP TO THE FRONT. >> JOHN DOYLE, I'M A COMMERCIALS A A PRAISER IN NEW YORK. I'VE BEEN APPRAISING SECTION 8 HOUSING FOR 20 YEARS AND I CAN TELL YOU THEY LOOK MORE LIKE AN ASSISTED LIVING FACILITY TODAY, YET THE RENT SUBSIDY IS FOR A GENERIC APARTMENT BUILDING, AND YET THEY'RE DELAYING THE TRANSITION TO SKILLED NURSING, SO HUD IS SUBSIDIZING HEALTH AND HUMAN SERVICES AND THE SECTION 8 LANDLORDS ARE PROVIDING A LEVEL OF CARE THAT SHOULD BE COMMENSURATE WITH THAT. THEY SHOULD BE RECEIVING A RENT SUBSIDY MORE AKIN TO THAT. >> GOOD POINT. >> INTERESTING. >> WE'LL THROW IT TO THE BACK MIC. THIS IS LIKE YOUR SHOPPING LANES. YES, IN THE BACK. >> THANK YOU VERY MUCH. DAVID WITH BUILDING TECHNOLOGY, INC., IN SILVER SPRING, MARYLAND. MR. SECRETARY, YOU MENTIONED UTILITY COSTS AS ONE OF THE FOUR ISSUES IN YOUR PRESENTATION. >> RIGHT. >> AND MS. WILLIS, YOU MENTIONED WEATHERIZATION AS ONE OF THE AREAS OF TECHNICAL SUPPORT. MY QUESTION IS, WHAT CAN WE DO TO TARGET -- TO FOCUS THE ISSUES OF WEATHERIZATION ON THE SPECIFIC NEEDS OF THE AGERS IN PLACE? THAT IS, ENERGY EFFICIENCY IN THE HOME IS A FUNG OF THE ASSETS -- A FUNCTION OF THE ASSET, WHICH IS THE HOME, BUT IT'S ALSO A FUNCTION OF THE HUMAN BEHAVIOR AND THE HUMAN BEHAVIOR OF THE AGERS IN PLACE MAY HAVE SOME SPECIAL DIMENSIONS TO IT THAT ARE NOT CURRENTLY CONSIDERED BY ENERGY AUDITS. WHAT CAN WE DO? >> IT STRIKES ME THAT WHAT WE OUGHT TO DO IS WITHIN THE CONTEXT OF THE WEATHERIZATION PROGRAM, LOOK AT IT THROUGH THE LENS OF AGING IN PLACE SO THAT IT MAY BE SOME PHYSICAL CHANGES THAT ARE JUST ONE NOTCH BEYOND THE EXISTING WEATHERIZATION PACKAGE, OR AS YOU SAY, BEHAVIORAL SUGGESTIONS, BUT THE WEATHERIZATION PROGRAM, I THINK, HAS GREAT POTENTIAL TO BE EXPANDED ONE NOTCH BEYOND PURE WEATHERIZATION TO REAL ASSISTANCE TOO, TO MAKE A HOUSE AGE-APPROPRIATE. >> AND I WOULD COMPLEMENT THAT IN THAT MANY VILLAGES OFFER AND WORK WITH THEIR LOCAL UTILITIES AND PROVIDE ENERGY ASSESSMENTS IN PEOPLE'S HOMES, AND THEY DO THAT WITH PROGRAMS AND THEN INDIVIDUALLY IN PEOPLE'S HOMES SO THAT ENERGY EFFICIENCY IS SOMETHING THAT HELPS PEOPLE STAY IN THEIR HOMES, BUT FINANCIALLY ARE ALSO SAFE IN THEIR HOMES. >> WE ALSO HAVE LOCAL OFFICIALS LIKE FIRE DEPARTMENTS THAT GO TO HOMES TO CHECK THEM FOR FIRE SAFETY. SO COLLABORATION AT THE LOCAL LEVEL TO JUST CHECK ON HOME FOR ITS AGE-APPROPRIATENESS MIGHT MAKE A LOT OF SENSE AS A PARTNERSHIP. >> THANK YOU. >> WE'LL BRING IT UP TO THE FRONT MIC. >> HI, GOOD AFTERNOON. THANK YOU FOR THIS GREAT PROGRAM. MY NAME IS DIANA COHO, I'M WITH THE FEDERAL COMMUNICATION COMMISSION, CONSUMER AFFAIRS AND OUTREACH DIVISION AND ONE OF MY CONSTITUENCIES IS SENIORS AS WELL AS OTHER GROUPS TOUCHED ON TODAY. I'M TRYING TO FORMULATE A TRAIN OF THOUGHT BECAUSE I HAVE A LOT OF DIFFERENT QUESTIONS, BUT A BIG ISSUE THAT THE FCC LOOKS AT IN TERMS OF CONSUMERS AND SENIORS IN PARTICULAR, I'VE BEEN TRYING TO MARRY UP THE ISSUES WITH AGING IN PLACE. I HAVE A PLANNING BACK BROWNED IN A PREFERS LIFE, SO WHEN I HEAR AGING IN PLACE AND I HEAR WEATHERIZATION, I START TO THINK OF SOMETHING A LITTLE BIT BROADER, SORT OF LIKE AN AGING IN PLACE AUDIT OR CHECKLIST OR SOMETHING, AND THAT BROADBAND AND HAVING ACCESS TO BE ABLE TO COMMUNICATE WITH PEOPLE OUTSIDE THE HOME IS SOMETHING THAT HAS SEVERAL COMPONENTS TO IT. ONE OF THEM IS YOU HAVE TO GET SIGNAL. THAT'S LIKE A PHYSICAL HARD WIRE OR SOME TYPE OF THING IN THE COMMUNITY, IN THE BUILDING, IN THE UNIT, WHATEVER LIKE THAT. THEN THERE IS RELEVANCY. A LOT OF OLDER PEOPLE DON'T WANT TO GET ON THE INTERNET BECAUSE THEY DON'T SEE HOW IT'S RELEVANT, SO WE DO OUTREACH WITH THAT. THEY'RE ALSO WORRIED WITH THE COST, THE BILLS. IT IS A UTILITY THAT'S EXPENSIVE, BUT WITH HEALTH AND SOME OF THE THINGS ABOUT MONITORING WHILE YOU'RE IN YOUR HOME, THE MENTAL HEALTH TREATMENTS, THERE'S ALL KINDS OF STUFF LIKE THAT. >> SECURITY. >> SECURITY AS WELL AS RECORDS MANAGEMENT, AND THE ISOLATION, YOU KNOW, WITH THE SOCIAL NETWORKING, SEEING YOUR GRANDKIDS ON FACEBOOK AND THAT KIND OF STUFF. I'M TRYING NOT TO GO ON AND ON TOO MUCH, BUT WHAT I'M LOOKING FOR IS LINKAGES AND PARTNERSHIPS WITH THIS IDEA OF COMMUNICATION, BROADBAND, AGING IN PLACE AND HOW WE CAN MAYBE LOOK AT THAT. THANK YOU. >> I THINK YOU'VE SAID IT. [ LAUGHTER ] >> WOW. >> THANK YOU SO MUCH. LET'S SEND IT TO THE BACK. >> MY NAME IS LYDIA, I AM FROM PD&R AND I'M GLAD TO MEET ALISHA IN PERSON. I MET HER IN THE EMAIL BECAUSE I PARTICIPATED IN THE DATA PROCESSING FOR HER PROJECT, BUT MY QUESTION IS FOR THE VILLAGE-TO-VILLAGE NETWORK. WHAT IS THE ROLE OF THE PUBLIC SCHOOL IN THIS VILLAGE-TO-VILLAGE NETWORK? SEE, WHEN YOU'RE TALKING ABOUT WELLNESS AND LONELINESS OF PEOPLE, THE CHILDREN, IT'S A JOY TO OLDER POPULATION AND IT'S A GOOD WAY ALSO FOR KEEPING THEM UP ALIVE AND JUMPING AROUND. SO IN YOUR -- IN THIS DEMONSTRATIONS OR IN THESE CASES, WHAT IS THE ROLE OF PUBLIC EDUCATION? THERE'S A PUBLIC SCHOOL IN EVERY FOOT OF THE COMMUNITY IN THIS COUNTRY. >> ABSOLUTELY, GREAT QUESTION. MANY OF THE VILLAGES HAVE RELATIONSHIPS WITH SCHOOLS, ALL OF THE -- USUALLY MIDDLE SCHOOLS, HIGH SCHOOLS AND COLLEGES, FOR THOSE PEOPLE TO BE VOLUNTEERS, DO LEAF BLOWING, VISIT PEOPLE, AND THEN ON THE OTHER SIDE, WE ACTUALLY EMBARKED IN THE BEACON HILL VILLAGE, THEY HAVE RELATIONSHIP WITH A NONPROFIT CALLED GENERATIONS, INC., AND WE HAVE VOLUNTEERS WHO ARE BEACON HILL VILLAGE MEMBERS WHO GO INTO ELEMENTARY SCHOOLS AND HELP WITH TUTORING AND THOSE RELATIONSHIPS. MOUNT LEBANON VILLAGE IN PITTSBURGH, THEY ACTUALLY HAVE AN INTERGENERATIONAL GAMES PROGRAM. EVERY -- I THINK ONCE A YEAR, AND THAT ARE PEOPLE OF ALL AGES WHO LITERALLY HAVE KIND OF A SENIOR OLYMPICS, IF YOU WILL, BUT AN INTERGENERATIONAL. INTERGENERATIONAL PROGRAMS ARE VERY IMPORTANT IN WORKING WITH THE SCHOOLS. NEWTON, MASSACHUSETTS, THEY HAVE A PROGRAM WITH THE HIGH SCHOOL IN THE AUTO MECHANICS THAT MEMBERS OF THE VILLAGE CAN BRING THEIR CAR THERE AND LEARN HOW TO CHANGE THEIR OIL, ETCETERA, OR WILL HAVE IT DONE FOR THEM. SO THERE ARE LOTS OF WAYS THAT WE ARE WORKING WITH SCHOOLS AND IT COULD PROBABLY EVEN BE MORE EXPANDED. >> ONE SCHOOL-RELATED ACTIVITY THAT I'VE HEARD ABOUT IN SEVERAL PLACES IS THE USE OF THE LIBRARY IN THE PUBLIC SCHOOLS WHERE SENIORS EITHER STAFF THEM OR STAFF THEM AFTER HOURS SO THEY CAN BE USED BY SENIORS. THE SCHOOL LIBRARY FOR SENIOR-RELATED, BOOK-RELATED ACTIVITY IN THE PUBLIC SCHOOLS. >> YOU KNOW, THE ONLY DIFFICULT THING ABOUT MODERATING THIS PANEL TODAY IS THAT I HAVE TO ANNOUNCE THAT OUR TIME HAS COME TO AN END. I KNOW THERE ARE OTHERS WITH COMMENTS AND I WANT TO BE MINDFUL WITH TIME. I'M SORRY, I HATE TO BE DOING THIS PART OF THE THING. I WANT TO INVITE JEAN UP TO TAKE US HOME. >> WELL, WHAT AN ENLIGHTENING AND RICH CONVERSATION. I REALLY DON'T WANT THE CONVERSATION TO END, SO I HOPE THAT WE CAN CONTINUE TO HAVE THIS DIALOGUE EVEN AFTER THE UPS DATE. I WANT TO THANK ALL OF OUR SPEAKERS TODAY. KEVIN, JENNIFER, SECRETARY CISNEROS, ALISHA, JUDY AND JAMES, FOR THEIR OUTSTANDING JOB TODAY AND REALLY SHARING THEIR RESEARCH AND THEIR EXPERIENCES AND THEIR WORK WITH ALL OF US. NOW, AS A PREVIEW FOR OUR NEXT QUARTERLY UPDATE, FOR OUR NEXT EVIDENCE MARPT ISSUE, WE'RE GOING -- MATTERS ISSUE, WE'RE GOING TO BE FOCUSING ON THE TOPIC OF VACANCY, BOTH VACANT PROPERTIES IN THE COMMERCIAL AND RESIDENTIAL SECTOR, ADDRESSING THE CHALLENGES ASSOCIATED WITH ABANDONMENT AS WELL AS THE OPPORTUNITIES FOR REUSING THESE LANDS. SO I HOPE THAT YOU CAN JOIN US AGAIN IN APRIL AND THANK YOU VERY MUCH FOR YOUR ATTENDANCE AND PARTICIPATION TODAY. SEE YOU SOON. [ APPLAUSE ]