Health departments and senior housing communities should really get to know each other better.
A recent study posted on the Center for Disease Control and Prevention (CDC) website highlighted a falls-prevention initiative piloted in affordable senior housing communities by the health department in Salt Lake County, UT.
You don’t often see the words “health department” and “senior housing” together, so I was intrigued.
The partnership made perfect sense. The county health department was looking for better ways to target its falls-prevention programs to older adults who needed them the most. After mapping emergency medical services (EMS) calls for falls and fall-related injuries among older adults over several years, the department found that certain census tracts had a high count or rate of falls. And, it turns out, senior housing communities within these tracts had high concentrations of falls-related calls.
Armed with this data, the health department decided to offer falls-prevention programs, including Stepping On, and traditional and group-based versions of Otago, to residents of a housing community that had the highest incidence of reported falls. The pilot was later expanded to include other housing communities in Salt Lake County.
Through the intervention, an emergency medical technician met with individual housing residents in their apartments, performed a safety check, and asked if the residents might be interested in participating in a falls-prevention program. Residents who expressed an interest received a follow-up call from the health department to register them for a program.
2 LESSONS FROM UTAH
The Salt Lake County initiative offers 2 important lessons. The first is about the benefits that can accrue when housing communities partner with health departments. In this case, the first housing community where the initiative was implemented had the highest number of program participants and experienced a significant decrease in falls-related EMS calls.
I think it’s fair to conclude that, without the health department’s intervention, these positive outcomes may have been out of reach for housing community residents, putting their safety at great risk, and resulting in high, and avoidable, health care costs.
The second lesson is just as important: programs sponsored by health departments and other service providers won’t succeed simply by offering the right services in senior housing communities. They also need help from housing-based staff to ensure that residents actually use those services.
In the building experiencing the significant decrease in falls-related EMS calls, the service coordinator provided assistance by educating and onboarding residents to get them to participate in falls-prevention programs. This didn’t happen in the other buildings, which just delivered fliers to residents’ apartments and posted them in common areas. The outcomes in these other buildings were not as good.
These differing outcomes tell me that having a concentration of older adults in one location like a senior housing community, in and of itself, may not be enough for programs to succeed. That concentration has to be combined with the active collaboration of a service coordinator or another staff member who recognizes the benefit of the program and helps residents understand the value of both the program and their engagement in it.
A LESSON FROM FLORIDA
A third lesson, this one from Florida, is also important. Because health departments have so much to offer to older adults, senior housing communities should really get to know them better. And because senior housing and other aging services providers also have resources that can help support the delivery of public health services, public health departments should get to know them.
LeadingAge Florida Executive Director Steve Baumer and Janet Stringfellow, president and CEO of Volunteers of American of Florida, learned this lesson recently when they spoke to members of a learning collaborative established by the Florida Department of Health and Trust for American’s Health, a public health policy, research, and advocacy organization. The collaborative, supported by The John A. Hartford Foundation, helps county health departments identify areas in which they can support, complement, or enhance aging services.
Steve and Janet educated the collaborative about the work of LeadingAge Florida members, particularly its affordable housing members. That education was critically important, Steve quickly learned. To his surprise, virtually none of the people in the room knew anything about LeadingAge Florida, its members, or what they do. Steve told the health department officials about the vast array of aging resources in their communities, many offered by LeadingAge Florida members.
Steve also talked about opportunities for LeadingAge Florida and county health departments to collaborate on advancing their shared public policy goals. For example, the health department staff weren’t well-versed on the state’s affordable housing trust fund; in particular, they didn’t know that a portion of the fund was designated for seniors, or that the legislature’s constant sweeping of funds contributed to homelessness among Florida residents. This is a concern for both groups. Together, the health departments and LeadingAge Florida members could offer a powerful unified voice to help preserve affordable housing funding.
Steve connected this to another common area of concern for both groups—pressure on the Medicaid budget. An adequate supply of affordable housing, connected with public health and other services, is a way to support frail older adults in the community and prevent or delay use of more expensive Medicaid services.
Steve has already connected some learning collaborative members with LeadingAge Florida members that could offer program advice or share resources. He’s eager to learn more about public health entities, their needs, and resources, and to pass that information on to LeadingAge Florida members so they can take advantage of potential opportunities for collaboration.
A FINAL LESSON FOR US ALL
Steve and Janet clearly made a great start in forging important ties between LeadingAge Florida members and their county health departments. But Steve’s not ready to rest on his laurels. He shared his most important lesson at the very end of our conversation.
“We clearly have much communicating to do,” he told me.
We would all do well to take that final lesson to heart.
Alisha Sanders is director of housing and services policy research in the Washington, DC office of the LeadingAge LTSS Center @UMass Boston. Her work focuses on identifying, evaluating, and advancing strategies and policies that link affordable housing settings with health and supportive services.