America is in the throes of an affordable housing crisis. Many Americans are considered severely rent-burdened, as they spend more than 50 percent of their earnings on housing.

For people with disabilities and the elderly, there is a triple whammy—prices are soaring, their incomes are not keeping pace, and only a fraction of housing is built to accommodate those with limited mobility.

U.S. Department of Labor statistics consistently prove that people with disabilities are by far the most under-employed, unemployed, and impoverished of all marginalized groups. About one in four people in the U.S. have a disability. By 2030, one in five Americans will be older than 65. This means tens of millions of people cannot afford safe, quality, convenient housing that meets their needs.

Further compounding the catastrophic situation, surveys of housing stock show less than five percent of it is move-in ready accessible to people with disabilities. Less than one percent of housing is wheelchair accessible and virtually all of that is in multifamily housing. Accessible housing features a zero-step entrance, accessible restroom, wider doors, lowered counters and sinks in the kitchen/bath, and other features to accommodate reduced mobility due to aging or disability.

Senator Bob Casey, Democratic chair of the Senate Special Committee on Aging, held a hearing this summer to sound the alarm over the lack of affordable, accessible housing.

“Stable, high-quality housing is an essential human need and the foundation of community well-being,” Casey said in an interview via email. “But for millions of Americans, adequate housing is more of an aspiration than a reality. In particular, far too many older adults and people with disabilities cannot afford accessible housing. That’s why I introduced the Visitable Inclusive Tax Credit for Accessible Living (VITAL) Act, which would ensure that we are increasing the amount of accessible housing available for people with disabilities and older adults to meet their needs. Investments in accessible housing are central to guaranteeing better outcomes in health and satisfaction for older adults and people with disabilities.”

The Low-Income Housing Tax Credit (LIHTC) is a federal program providing tax credits to developers who build new housing for low-income renters. The VITAL Act would increase funding for the LIHTC program to increase the number of accessible homes.

The key measure of VITAL is it would require that states construct at least 20 percent of their LIHTC units as accessible and/or walkable and rollable. The act has been endorsed by a host of disability advocacy organizations, including The Kelsey.

The Kelsey is a disability-forward housing developer in the San Francisco-San Jose area. In less than two years, it has secured the co-development of 227 inclusive, affordable homes in one of the nation’s most challenging housing markets.

“Part of solution to this housing crisis is to go beyond looking at number of units, so we’re looking at the type of housing. It is critical to build integrated housing—disabled people are not isolated or segregated,” said Allie Cannington, The Kelsey’s senior project manager, organizing & advocacy. “We emphasize creating housing for people who need supportive services in their homes and communities. We do this with our own developments and through the policy changes we push for.”

Cannington noted that The Kelsey advocates for more use of LIHTC and more tax credit projects to be move-in ready for people with disabilities. The nonprofit also has collaborated with architecture firms to create a free, online guide to Housing Design Standards for Accessibility and Inclusion.

“Low Income Housing Tax Credits is one of biggest drivers of affordable housing. At the federal level, we need more tax credits to fund affordable housing. And we need to make sure the end unit is affordable and adaptable (to serve people with disabilities,” said Cannington, who uses a wheelchair for mobility. “We need state and local government to invest in developer subsidies and vouchers for residents. We need to make affordable, accessible housing the norm across the country.”

The Kelsey Ayer Station is a fully inclusive mixed-ability, mixed-income housing community located in a transit-oriented neighborhood blocks north of downtown San Jose. The 115 apartment homes come with inclusion concierges that will connect residents to the community and support services.

“There is a dangerous assumption that making disability-forward housing comes with an exorbitant cost. We work in one of the most expensive markets in the nation and found if your are have good partners, you can deliver at a cost on par with (not accessible) market-rate housing. Kelsey Ayer Station is on par with San Jose Costs.”

Cannington noted that The Kelsey Civic Center, a 112-unit, amenity-rich, urban co-living community across from San Francisco City Hall, is coming in at 14 percent less than the city average cost of residential construction.

She suggests that states, when they are scoring applications for LIHTC, should give a high rank to submissions that include accessibility for people with disabilities. That, matched with city incentives, would increase the amount of accessible housing—changing the present reality that 95 percent of all housing excludes people with disabilities, with 99 percent off limits to wheelchair users.

“People with disabilities are the largest minority in America—well more than 60 million and the number is growing. “It makes sense for the public and private sector to respond to this,” Cannington said.

“A 2020 study by the North Carolina Housing Finance Agency found that for every dollar spent on home repair (to make it more accessible for aging and disability), there were $19 in Medicare savings,” she added, emphasizing that investing in affordable, accessible housing is not just the right thing to do for human beings, but also a huge return on investment.

Rodney Harrell, vice president, family, home and community for AARP, knows there is a huge market for affordable, accessible housing.

“Think of it not pure wheelchair access but making our housework for us at all ages. Design for all abilities makes our housing stock more valuable,” he said, noting that accessibility features do not limit re-sale or re-rent to people with disabilities. “I laugh when I watch HGTV and see housing with a zero threshold  shower with a fold down bench in the home of a young family. They might be doing it for design reasons. But over time, they will need these features.”

Harrell said there is a huge economic benefit to building housing and neighborhoods that are accessible to all. He said if a person can no longer use the stairs at their house or apartment building, they stay home and become socially isolated.

He cited AARP research that found the impact on the health of socially isolated older adults is an estimated $6.7 billion in additional Medicare spending annually. That impact didn’t consider the same negative impact on the health of people with disabilities who are not elderly.

Clearly, cities that use tax credits and other incentives on affordable/accessible housing–can potentially erase hundreds of billions in Medicare and Medicaid spending.

In February, The New York City Council approved a law aimed at creating more accessible housing. It requires housing developers receiving city funds for new rental developments with over 41 units to incorporate universal design features–such as wheelchair access especially in the bath and kitchen plus adjustable countertops.

The goal of the law is to make all units fully accessible to any occupant no matter their age, or disability. The law is intended to create accessible housing, so elderly and disabled  New Yorkers are not dependent on pleading with landlords to make adaptations on a case-by-case basis.

Kleo J. King, who served as general counsel to the New York City Mayor’s Office for People with Disabilities, is the Senior Director of Accessibility Operations & Counsel for the United Spinal Association – a national nonprofit that is based in Queens. She said Universal Design is not only essential, but it also adds value to housing.

“Universal Design and aging in place principles should be added to all new construction and rehabilitation residential projects which would increase the ability for people to stay in place as they age or acquire a disability.  Providing removable base cabinets in kitchens and bathroom, blocking for grab bars around the toilet and shower, widening doorways, and minimizing level changes in a unit allow for easier and less expensive modification if they are needed,” she said.

Steve Wright is a writer, planner, educator, and keynote speaker who has lectured on the ADA and public policy at the American Planning Association National Conference and at the International Making Cities Livable conference in Paris. He created a groundbreaking universal design course for architects and planners and blogs daily on the inclusive city at Urban Travel, Sustainability & Accessibility. He also tweets on disability issues at @stevewright64.