A large and rapidly expanding population of low-income older adults faces the dual challenges of finding affordable, safe housing that can accommodate changing needs as they grow older.
Millions of older adult renters and homeowners face excessive housing costs and/or live in housing with serious physical problems. As they age, an increasing proportion of these older adults experience multiple chronic illnesses. In many cases, deteriorating physical and cognitive functioning impede the ability of these older adults to live independently in the community.
The LeadingAge LTSS Center @UMass Boston is striving to address these challenges by serving as a national catalyst for the development, adoption, and support of innovative affordable housing solutions that enable older adults with low and modest incomes to age safely and successfully in their homes and communities.
We are continuing LeadingAge’s decade-long efforts to study the role that publicly subsidized congregate housing with services could play in meeting the growing need for health and long-term services and supports (LTSS) among low-income elders.
Our research initiatives in this area include 2 groundbreaking studies confirming that HUD-assisted residents were more likely to be dually eligible for Medicare and Medicaid; and that the presence of a service coordinator in HUD-assisted housing communities significantly decreased residents’ odds of having a hospital stay.
Read more about our work on housing plus services:
Check out our Housing Plus Services Toolkits for tips on developing housing-health partnerships, conducting resident assessments, working with medical house call programs, and starting intergenerational programs.
Toolkits:
Housing and Health Care Partnerships Toolkit
Assessing Resident Needs Toolkit
The John D. and Catherine T. MacArthur Foundation supported this multi-faceted research project to explore whether affordable senior housing can serve as an effective platform for helping to address the health and long-term care needs of older residents with low incomes. Researchers from LeadingAge and The Lewin Group assessed the association between onsite services and resident health care utilization and spending.
A key study finding: the presence of a service coordinator significantly decreased residents’ odds of having a hospital stay. Researchers also explored service availability in HUD-assisted senior housing, conducted interviews with state policy makers about the potential role of affordable senior housing plus services strategies, and created a collection of case studies describing how 3 affordable senior housing properties with housing plus services programs.
Status: Completed
Contact: Alisha Sanders, Robyn Stone
Read More:
Housing and Health Care: A Toolkit for Building Partnerships
Eliza Jennings Wellness Clinics in Affordable Senior Housing, Lakewood, OH: Case Study Snap Shot
Northgate II, Camden, NJ: Case Study Snap Shot
Blackstone Apartments, Boston, MA: Case Study Snap Shot
Why Housing Plus Services is a “Bright Spot” in Efforts to Support Dual Eligibles
For the first time, researchers from LeadingAge, Lewin Group, and The Moran Company were able to successfully link administrative data from the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Housing and Urban Development (HUD). The initial study created a dataset that linked HUD administrative data for all individuals receiving HUD assistance in 12 geographic areas with the individuals’ Medicare and Medicaid claims data. An analysis of the data confirmed that HUD-assisted residents in the study areas were more likely to be dually eligible for Medicare and Medicaid.
Status: Completed
Contact: Alisha Sanders
Read More:
Picture of Housing and Health: Medicare and Medicaid Use Among Older Adults in HUD-Assisted Housing
Study Documents Higher Health Costs Among HUD Assisted Seniors
How Good Data Can Help Low-Income Elderly Age in Community
The Lewin Group, LeadingAge LTSS Center @UMass Boston, and National Center for Healthy Housing were selected by the U.S. Department of Housing and Urban Development (HUD) to serve as the Implementation Team for a major randomized control trial testing a service-enriched housing model for low-income older adults.
Forty HUD-assisted senior housing properties will participate as intervention sites in the 3-year Supportive Services Demonstration for Elderly Households in HUD-Assisted Multifamily Housing.
In addition to designing the demonstration, the Implementation Team will provide ongoing training, technical assistance, and program oversight to the 40 intervention sites.
Status: Ongoing
Contact: Alisha Sanders, Robyn Stone
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CFAR Will Help Implement HUD’s Housing Plus Services Demonstration
The LeadingAge LTSS Center@UMass Boston is working in partnership with RTI International to evaluate the Support and Services at Home (SASH) intervention through the final years of its Medicare Multi-Payer Advanced Primary Care Practice (MAPCP) demonstration grant.
Through the SASH model, a housing-based wellness nurse and SASH care coordinator work in concert with social service agencies, community health providers, and nonprofit housing organizations to support older Vermont residents who choose to live independently at home.
The project is funded by the Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services. The evaluations have found that growth in annual Medicare expenditures was slower for some SASH participants.
Status: Ongoing
Contact: Alisha Sanders
Read More:
Journal Article Details SASH Evaluation Findings
Support and Services at Home (SASH) Evaluation: First Annual Report
Affordable Senior Housing Plus Services Program Slows Growth in Medicare Costs
Behind the Dollar Signs: What’s the SASH Value?
Support and Services at Home (SASH) Evaluation: Second Annual Report
SASH Continues to Slow Growth in Medicare Expenditures
4-Year Evaluation Shows SASH Continues to Slow Medicare Growth
The Gordon and Betty Moore Foundation is supporting this 1-year project to explore financing mechanisms that can support the development and implementation of housing plus services models. For more than a decade, LeadingAge has been studying the role that publicly subsidized congregate housing with services could play in meeting the growing need for health and long-term services and supports (LTSS) among elders with low incomes. The LTSS Center is now exploring mechanisms that could be used to finance programs that integrate housing and health care.
Status: Ongoing
Contact: Alisha Sanders, Robyn Stone
Read More:
Taking Steps Toward Financing Housing Plus Services
LTSS Center Will Study Financing Options for Housing Plus Services
When Can I Stop Chasing My Own Tail?
Report Explores Financing Options for Housing Plus Services Models
Exploring Financing Options for Services in Affordable Senior Housing Communities: Full Report
Exploring Financing Options for Services in Affordable Senior Housing Communities: Research Snapshot
The LeadingAge LTSS Center @UMass Boston worked with Generations United to explore the characteristics and benefits of intergenerational programming in senior housing properties.
In their final report, researchers documented the number and characteristics of housing-based intergenerational programs; the benefits of and barriers to implementing these programs; and promising practices that can foster the replication of successful intergenerational work in senior housing. The Retirement Research Foundation funded the study.
Status: Completed
Contact: Taryn Patterson
Read More:
Exploring Intergenerational Programming in Senior Housing
Can Housing-Based Programming Bridge the Generational Divide?
New Report Explores Intergenerational Programming in Senior Housing
Intergenerational Programming in Senior Housing: From Promise to Practice: Full Report
Research Snapshot: Intergenerational Programming in Senior Housing
This grant from the Retirement Research Foundation is helping the LeadingAge LTSS Center @UMass Boston and Generations United continue their work to foster a broader culture of intergenerational interaction and exchange that, over time, could become normalized in the housing setting.
Researchers will use the findings from the first phase of the “From Promise to Practice” project to develop, test, and disseminate a toolkit that housing communities can use to plan, develop, implement, evaluate, and sustain intergenerational programs.
The new project is also designed to build the capacity of national affordable housing providers to plan and implement high-quality intergenerational programs that positively impact older adults and members of younger generations.
Status: Ongoing
Contact: Taryn Patterson
Read More:
New Grant: Creating and Sustaining an Intergenerational Culture in Senior Housing
Hebrew SeniorLife, a LeadingAge member in Boston, obtained grant funding to create a replicable, scalable, and sustainable model of housing with support services to enable older adults to live independently for as long as possible.
The LeadingAge LTSS Center @UMass Boston will evaluate the model’s impact on utilization of services, including hospitalization and emergency room use. Researchers will measure resident satisfaction and quality of life, execution of the intervention, and return on investment.
Status: Ongoing
Contact: Marc Cohen
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First Impressions Make a Difference in Service-Enriched Housing
The LeadingAge LTSS Center @UMass Boston is working with several partners in Massachusetts to design a new study that will assess the impact of housing plus services programs on residents living in some of the state’s affordable senior housing properties.
Partners in the project include Jewish Community Housing for the Elderly, a LeadingAge member in Brighton, MA, and Commonwealth Medicine, the policy and research arm of the University of Massachusetts School of Medicine.
Status: Ongoing
Contact: Alisha Sanders
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LeadingAge and its Massachusetts Partners Design Housing Plus Services Study
The LeadingAge LTSS Center @UMass Boston worked with the U.S. Department of Housing and Urban Development, Ginnie Mae, and the government of Japan to explore strategies that could help older adults remain in their homes and communities for longer.
The international research team developed case studies describing innovative programs that explore promising approaches to financing housing for older adults, identifying connections between health and housing, seeking public-private partnerships, creating healthy and accessible communities, and developing viable policies in a constrained budget environment.
Status: Completed
Contact: Natasha Bryant, Robyn Stone
Read More:
In 2017, LeadingAge established the Robert Wood Johnson Foundation (RWJF) Award for Health Equity, which honors individuals using systems changes to address health disparities and work toward achieving health equity within their communities.
The LeadingAge LTSS Center @UMass Boston helped LeadingAge develop the nomination criteria and selection process, and continues to lend its guidance to the awards program, which is supported by a 6-year grant from RWJF.
Status: Ongoing
Contact: Alisha Sanders
Read More:
New LeadingAge Grant Will Fund Annual Award for Health Equity
How Wellness Coaching is Advancing Health Equity in Colorado
Bringing Service Coordination Home in Rural Ohio
Other Areas of Work
WORKFORCE
Exploring strategies for strengthening the LTSS workforce
NURSING HOMES
Identifying evidence-based practices to enhance nursing home quality
FINANCING
Finding new approaches to financing long-term services and supports
AGING & HEALTH
Building a robust evidence base for healthy aging
CONSUMER ENGAGEMENT
Engaging older adults in our work, and encouraging other LTSS organizations to do the same
HOUSING PLUS SERVICES
Assessing the role of housing plus services models in affordable senior housing communities