[EQ] Public Housing and Supportive Services for the Frail Elderly

Public Housing and Supportive Services for the Frail Elderly:
A Guide for Housing Authorities and Their Collaborators

Co-published by the Milbank Memorial Fund and the Council of Large Public
Housing Authorities
September 2006

Available online at:
http://www.milbank.org/reports/0609publichousing/0609publichousing.html

".This report translates into practical advice the experience of public
housing authorities in creating housing with supportive health
and social services for elders. It summarizes the experience of employees of
these authorities and their collaborators in state and local
public and nonprofit service agencies...

".The elderly resident population is changing radically, bringing new
challenges to public housing providers. These residents are not only poorer
than the general senior population, they are also older, disproportionately
minority and female, and more likely to be alone....

"..A significant portion of public housing for the elderly is rapidly
becoming physically and functionally obsolete. Most developments are simply
not equipped to meet the residential and supportive service needs of their
increasingly frail and diverse residents. Without these services, the only
alternative can be moving people into costly, isolated institutions. People
can be devastated by unnecessary institutionalization, and services
provided in nursing homes are also far more costly than those offered in
other settings.

This report offers an overview of supportive housing for housing authorities
who are adopting new approaches in order to meet the needs of their
elderly tenants.

. The first section of the report describes three case studies of
successful developments planned by housing authorities to address the
 needs of their rapidly aging populations.

. The second section, "Developing Supportive Services in Public
Housing: Getting Started," offers advice on gauging local need and
designing and evaluating projects. This section outlines in detail the
benefits and disadvantages of different program designs, such
as working with service providers or offering services internally;
concentrating supportive services in one development or dispersing
 them over several sites; offering "a la carte" services or service
packages; and making meal programs mandatory or optional.

. The third section, "Service Delivery," summarizes the different
types of supportive services that may be provided at a public housing site.
Services can range from the relatively less-intensive care management model,
which typically includes counseling and service referrals
 to residents, to the very intensive Program of All Inclusive Care for the
Elderly (PACE), which typically offers an adult day care center
supplemented by in-home and referral services.

. The fourth section, "Regulatory Requirements," helps housing
authorities navigate state and federal regulations for assisted living
facilities.

. The final section, "Funding Assisted Living," lists different
funding sources available for public housing assisted living developments.

Table of Contents
Foreword
Glossary
Executive Summary
Case Studies

Developing Supportive Services in Public Housing: Getting Started

Assessing Residents' Needs and Infrastructure

Advantages and Disadvantages of Alternative Project Designs

Collaboration between Housing Authorities and Service Providers

Service Delivery
Care Management
Housing with Services/Congregate Care
Assisted Living
Program of All Inclusive Care for the Elderly (PACE)

Regulatory Requirements
Regulations for Assisted Living
Conflicts between Tenants' Preferences and Regulations

Funding Assisted Living
Medicaid Funding
Mixed-Income Assisted Living
Additional Capital Funding Sources
Obstacles

Appendix A: Specific Issues to Be Addressed during Project Design
Appendix B: Information Sources
References

* * * *
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Received on Mon Oct 2 13:02:56 2006