“We Can Do Better Together”
Partnerships for Low-Income Health, Housing,
and Social Support Services:
Livable Communities for All Ages
Fellowship Project Conducted in Partnership with:
Department of Health & Human Services,
Administration for Community Living,
Health Resources and Services Administration, and
Department of Housing and Urban Development
Lori Simon-Rusinowitz, MPH, PhD
2014-15 Health and Aging Policy Fellow
University of Maryland School of Public Health
September 10, 2015
Health, Housing, and Social Support Services
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Project Mentors and Planning Team Members:
• HHS Administration for Community Living:
Bob Hornyak, Elena Fazio, Lan Marshall
• HHS Health Resources and Services Administration:
Suma Nair, Jacqueline Rodrigue, Kent Forde, Shafa Al-Showk
• Department of Housing and Urban Development
Jennifer Ho, Ron Ashford, Leigh van Rij
Health, Housing, and Social Support Services
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Agenda
•
•
•
•
Background Information
Project Goals and Approach
Webinar Description
Comprehensive Agenda to Encourage more Successful
Partnerships
• References
Health, Housing, and Social Support Services
3
Why Increased Interest in
“Livable Communities” Now?
• U.S. Trends in Aging
 Demographic and economic imperatives.
 Increased recognition about the importance of and demands
on family caregivers, the backbone of our long-term services
and supports (LTSS) system.
Health, Housing, and Social Support Services
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U.S. Trends in Aging
• In 2013 there were 44.7 million Americans age 65 and older
representing 14.1% of the U.S. population. By 2040, the number of
older Americans is expected to grow to 82.3 million or about 21.7%
of the U.S. population (Administration on Aging, 2014).
• An estimated 70% of people who turn 65 will require long-term
services and supports (LTSS) in their lives (e.g., personal care,
medication management, care coordination, household tasks,
transportation, etc.) (DHHS 2015).
•
•
Source: www.census.gov/population/www/projections/summarytables.html
Source: http://longtermcare.gov/the-basics/who-needs-care/
Health, Housing, and Social Support Services
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U.S. Trends in Aging
• In 2013, about 40 million family caregivers in the U.S. provided an
estimated 37 billion hours of care to an adult with limitations in daily
activities. The estimated economic value of their unpaid contributions was
approximately $470 billion in 2013, up from an estimated $450 billion in
2009 (Reinhard et al. 2015).
• Older adults prefer to receive LTSS in their own home and community, as
opposed to institutional settings (e.g., nursing homes).
– 88% prefer to remain in their current residence for as long as possible
(Keenan 2010)
– 92% prefer to remain in their local community for as long as possible
(Keenan 2010)
•
•
Source: http://assets.aarp.org/rgcenter/general/home-community-services-10.pdf
Source: http://www.aarp.org/content/dam/aarp/ppi/2015/valuing-the-invaluable-2015-update-new.pdf
Health, Housing, and Social Support Services
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What is a “Livable Community”?
• Multiple terms:
 Housing Plus Services, Livable Community, Livable
Communities for All Ages, Communities for a Lifetime,
Age-Friendly Community, Dementia Friendly Community
 World Health Organization (WHO, 2007) framework for a
broad set of services that supports people aging in their
own community rather than an institutional setting.
Health, Housing, and Social Support Services
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World Health Organization Framework (WHO, 2007)
Transportation
Outdoor
Spaces &
Buildings
Community
Support &
Health Services
Housing
Age-friendly
city
Communication
& Information
Social
Participation
Respect &
Social Inclusion
Civic
Participation &
Employment
World Health Organization (Ed.). (2007). Global age-friendly cities: A guide. World Health Organization. Retrieved from http://whqlibdoc.who.int/publications/2007/9789241547307_eng.pdf?ua=1
Health, Housing, and Social Support Services
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Why Increased Interest in “Livable Communities” Now?
Health Care Reform is Changing the Policy Landscape
• Affordable Care Act policies and incentives (i.e. value-based payment
and population health) are changing health care providers’ priorities
and behavior.
• To achieve the “triple aim” of better care for individuals, better care for
populations, and lower per capita costs, providers need to keep people
healthy and out of hospitals (IHI, 2015).
• Health care providers can benefit from partnerships with affordable
housing and social support programs to help meet these goals
(LeadingAge, 2014).
•
•
Institute for Healthcare Improvement (IHI). IHI Triple Aim Initiative. http://www.ihi.org/engage/initiatives/tripleaim/pages/default.aspx . Accessed August 29, 2015.
LeadingAge Center for Housing Plus Services (2014) Housing and Health Care : Partners in Healthy Aging. http://www.leadingage.org/housinghealth/ Accessed August
29, 2015.
Health, Housing, and Social Support Services
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Benefits of Affordable Housing, Social Support,
and Health Care Partnerships
• Health care and affordable housing partnerships can offer residents:
– easy access to health care services and programs (important for
high service users),
– health education programs and follow up care in a cost-effective
setting,
– health care providers who have an improved understanding of
social factors effecting health conditions,
– a service coordinator who knows residents and can follow up
when needed.
•
LeadingAge Center for Housing Plus Services (2014) Housing and Health Care : Partners in Healthy Aging.
http://www.leadingage.org/housinghealth/ Accessed August 29, 2015.
Health, Housing, and Social Support Services
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Partnerships for Low-Income Health, Housing, and Social
Support Services Can Increase Access to Health Care
• Housing Plus Services can help address the following health
care challenges:
-

avoid unnecessary hospital re-admissions,
address medication complications,
manage chronic health,
conduct patient education and encourage patient engagement,
address social determinants of health,
address “super utilizers,” and
link older residents to social support services via local Aging &
Disability Resource Centers and Area Agencies on Aging
(e.g., case management, personal care, transportation,
homemaker services).
LeadingAge Center for Housing Plus Services (2014) Housing and Health Care : Partners in Healthy Aging. http://www.leadingage.org/housinghealth/
Accessed August 29, 2015.
Health, Housing, and Social Support Services
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Health and Housing Partnership:
Public Housing Primary Care Program
• HRSA operates Federally Qualified Health Centers (FQHC), the primary
care, safety net health system for low income, vulnerable populations.
• These health centers offer comprehensive primary care for all ages.
• HRSA funds approximately 80 Public Housing Primary Care Centers
that are either located in a public housing building or within one mile.
• This program serves about 22 million patients; however, only 7% are
over 65 years old (about 1.5 million patients).
• FQHC Opportunity: Health centers can expand their capacity to serve
the growing elderly population.
•
US HHS Heath Resources and Services Administration, Bureau of Primary Care, Public Housing and Primary Care Health Centers.
http://bphc.hrsa.gov/qualityimprovement/supportnetworks/specialpopulations/. Accessed August 29, 2015.
Health, Housing, and Social Support Services
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Social Service Community Partnerships:
“No Wrong Door” Approach to Services
• ACL Goal: A LTSS system that is consumer-driven and
cost-effective.
• Steps:
–
–
–
–
•
Outreach and coordination with referral community services
Person-centered counseling (focus on the person’s goals)
Streamline eligibility to public programs
State agency support: must include governor, Medicaid
agency, consumers, key stakeholders in service design and
oversight
Administration for Community Living (2015), Center for Integrated Programs, Office of Consumer Access and Self-Determination, Aging & Disability Resources
Centers, Program, No Wrong Door System, http://www.acl.gov/Programs/CIP/OCASD/ADRC/index.aspx. Accessed August 29, 2015.
Health, Housing, and Social Support Services
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“No Wrong Door” System Organizations
14
Health, Housing, and Social Support Services
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Why Focus on Interagency Partnerships?
•
A Government Accountability Office Report (May 2015), entitled, Older Adults. Federal
Strategy Needed to Help Ensure Efficient and Effective Delivery of Home and CommunityBased Services (HCBS), calls for the Administration for Community Living to lead
collaborations between:
– Departments of Housing and Urban Development,
– Transportation,
– and Agriculture,
– as well as the Centers for Medicare and Medicaid Services,
to meet the growing needs of elders for social support services.
•
With limited resources and growing needs, partnerships can leverage existing programs to
better serve this population.
•
This report focused on non-medical services; it did not address primary care offered by
FQHCs. However, social support services are essential to the successful outcomes of
primary health services.
•
Federal interagency partnerships require time and attention. Each agency has its own
priorities, and culture. Successful partnerships bridge these differences.
Health, Housing, and Social Support Services
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Agenda
•
•
•
•
Background Information
Project Goals and Approach
Webinar Description
Comprehensive Agenda to Encourage More Successful
Partnerships
• References
Health, Housing, and Social Support Services
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Project Goals: Obtain Maximum Program Benefits
for Consumers via Interagency Partnerships,
Encourage More Partnerships
Social Support
Services
Housing
Services
Health, Housing, and Social Support Services
Health
Services
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Project Approach
• Identify existing health, housing, and social support
partnerships, and program characteristics that make them
successful or create barriers to success.
• Highlight exemplary programs in a webinar designed to teach
us about successful partnerships. Invite policymakers,
providers, researchers, and others.
• Identify ways to share lessons from the “early innovators” with
the wider health, housing, and social support communities.
• Develop a comprehensive agenda to encourage more
successful partnerships.
Health, Housing, and Social Support Services
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Key Project Steps
• Propose project to leaders in each agency, and obtain their
support.
• Agency leaders identify interagency team members.
• Review literature and conduct background discussions with
health, housing, and social support stakeholders to inform
the webinar.
• Identify successful partnerships to highlight.
• Identify appropriate webinar audience members.
• Conduct webinar with audience polling questions.
• Develop a comprehensive agenda with recommendations.
Health, Housing, and Social Support Services
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National Initiatives Indicate Growing Interest in
Livable Communities
• AARP Livability Index (2015)
• National Association of Area Agencies on Aging
(2015). “Making Your Community Livable for All
Ages”
• Grantmakers in Aging: Improving America for All
Ages (2013)
• AARP’s network of age-friendly communities (2012)
• LeadingAge “Housing Plus Services” Center, Learning
Collaborative (2012)
Health, Housing, and Social Support Services
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National Initiatives Indicate Growing Interest in
Livable Communities
• National Center for Health in Public Housing: 2015 national
symposium includes a plenary session and workshops on healthy
aging in public housing.
• Association of State and Territorial Health Officers, 2015 Annual
Meeting showcases effective healthy aging programs, Association
has a position statement on healthy aging in community settings.
• Altarum Institute (2015) “MediCaring Communities,” financing
model for community support services.
• US HHS Assistant Secretary for Planning and Evaluation (2014a),
evaluation of Support And Services at Home (SASH), a Vermont
statewide housing, health, and social support program.
Health, Housing, and Social Support Services
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Current Literature Indicates Growing Interest in
Livable Communities
• Public Policy and Aging Report (2015). Making a home in the city:
The age-friendly community movement.
• The Gerontologist (2015): Toward the 2015 White House Conference on
Aging: Creating an aging policy vision for the decade ahead, addresses
“age-friendly communities.”
• LeadingAge (2014): Combined HUD and Medicare database documents
higher health costs among HUD-assisted elders.
• Generations (2013-14): issue on “age-friendly communities.”
• Journal of Aging and Social Policy (2014), two-volume issue on
“age-friendly communities.”
Health, Housing, and Social Support Services
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Agenda
•
•
•
•
Background Information
Project Goals and Approach
Webinar Description
Comprehensive Agenda to Encourage More Successful
Partnerships
• References
Health, Housing, and Social Support Services
23
Webinar Description
•
•
•
•
Webinar Overview and Introductions
We Need to Learn From You: Audience Polling Question
What Does Research Tell Us About “Housing Plus Services”?
Learning from Partnerships in Vermont, California, and
Hawaii
• We Need to Learn From You: Audience Polling Questions
• Audience Discussion
Health, Housing, and Social Support Services
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Webinar Audience Members
• Planning team members invited key stakeholders from
their own health, housing, and social service networks.
• We aimed for 50 key stakeholders.
• Over 100 people registered for the seminar, and included
people from:
- eight federal agencies or offices,
- national associations/technical assistance providers.
- direct service providers,
- foundations, and
- researchers.
Health, Housing, and Social Support Services
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Bob Hornyak
Director, Office of Performance and Evaluation
and
Lori Gerhard
Director, Office of Integrated Programs
HHS ACL
Health, Housing, and Social Support Services
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Suma Nair
Director of the Office of Quality Improvement
Health Resources and Services Administration’s
Bureau of Primary Health Care
Health, Housing, and Social Support Services
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Jennifer Ho
Senior Advisor on Housing and Services
U.S. Department of Housing and Urban Development
Health, Housing, and Social Support Services
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Robyn Stone
Executive Director, Center for Applied Research,
LeadingAge
Health, Housing, and Social Support Services
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Building the Evidence Base
for Affordable Senior
Housing + Services
Robyn I. Stone, DrPH
Executive Director, Center for Applied Research, LeadingAge
July 29, 2015
Health, Housing, and Social Support Services
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“A Picture of Housing & Health”
 Researchers compared Medicare and Medicaid cost
and utilization for HUD-assisted Medicare beneficiaries
and unassisted beneficiaries in the community.
 They found that HUD residents:
– included a much larger percentage of people who are
dually eligible for Medicare and Medicaid than people who
do not receive HUD assistance, and
– have more serious health conditions, use more Medicare
and Medicaid services, and have greater health care costs
than those outside of HUD assisted programs.

Stone, R., (2015). Building the evidence base for affordable senior housing + services. Presented during the webinar, entitled Partnerships for Health, Housing, and
Social Support Services: Livable Communities for All Ages, July 29.
Health, Housing, and Social Support Services
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How Housing and Services Matter
 Two data sources help illustrate outcomes:
– Researchers surveyed 2,017 HUD properties in the
HUD/Medicare-Medicaid data set, and reviewed
services available and health outcomes.
– They also studied three “housing plus services”
programs:
• Vermont: Support And Services at Home (SASH)
• Pittsburgh, PA: Staying at Home Program
• Harrisburg, PA: Presbyterian Senior Living &
PinnacleHealth Partnership
Health, Housing, and Social Support Services
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How Housing and Services Matter
 Sample Findings Indicate Positive Outcomes:
 HUD/CMS Survey: The availability of HUD building services were
associated with several positive resident health outcomes.
 Support And Services at Home (SASH): Early findings over two years
indicated that growth in annual total Medicare expenditures was
$1,756 - $2,197 lower for SASH participants in well-established
panels than for two comparison groups.
 Staying at Home: Participants were less likely to visit the ER, have
unscheduled hospital stays, report negative health conditions, and
move to a nursing home.
 Presbyterian Senior Living & PinnacleHealth: Over a two-year
period, partnership participants had fewer ER visits and inpatient
visits.
Health, Housing, and Social Support Services
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Molly Dugan
Director
Support And Services at Home (SASH), Vermont
Health, Housing, and Social Support Services
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The Intersection of Health & Housing
• SASH – Statewide, part of
Vermont’s Health Care
Reform Initiative
• Housing as a platform for
health care
• 65 partner agencies part of
SASH Collaboratives
• Available in all types of HUD
housing
Health, Housing, and Social Support Services
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The SASH Model Focuses on
Three Components of Care Management
• Conducts wellness assessment
• Convenes SASH team
• Understands participants needs and preferences
• Coordinates individual/community healthy living plans
Care
Coordination
• Develops healthy living plan
• Coaches SASH Participants
• Provides reminders and in person check ins
• Organizes presentations and evidence based programs
Self
Management
• Coordinates with discharge staff, family and neighbors
• Personal visit to review discharge instructions
• Helps ensure a safe home transition
Transitional
Care
Health, Housing, and Social Support Services
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Primary Challenges
•
•
•
•
•
•
Sustainable funding source
Lack of administrative funding
Keeping housing at the “table.”
Information sharing – IT systems, HIPAA
Capacity for mental/behavioral health services
Multiple funding sources=multiple
applications, reports, outcomes, etc.
Health, Housing, and Social Support Services
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Success Drivers
• Housing sector included in statewide health care
reform discussions/initiative
• Population-based approach with focus on social
determinants of health
• Medicare Demonstration funds allow flexible spending
to match need – capitated model
• SASH designed with participants not for them
• Real-time data and ability to regularly share outcomes
• Statewide platform to build upon
Health, Housing, and Social Support Services
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Marty Lynch
CEO
and
Brenda Goldstein
Psychosocial Services Director
LifeLong Medical Care, California
Health, Housing, and Social Support Services
 Services located in Oakland, Berkeley, West Contra
Costa County
 48,000 patients served annually
 12 Primary Care Clinics, Urgent Care, Adult Day
Health, Supportive Housing, School-Based Clinics,
Dental
 Special history with elders and care for complex
adult populations including disabled and homeless
Health, Housing, and Social Support Services
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
City/County Government
 Behavioral Health
 Housing Departments
 Public Health






Hospitals
Managed Care Plans
Center for Independent Living
Health Care for the Homeless
Housing Developers
Community Based Organizations
Health, Housing, and Social Support Services
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
California has decentralized health care
delivery systems – delegated from state
to local managed care plans

Housing availability and cost

Fee for service billing and unaligned
financial incentives
Health, Housing, and Social Support Services
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
Funding case management by non-licensed
providers

Fragmented & diagnosis driven funding

Blended funding = multiple
reporting/documentation requirements

Productivity concerns – longer appointments needed for
complex populations which include family members, support teams etc.

Need to demonstrate cost savings
Health, Housing, and Social Support Services
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
Unlinked, multiple IT systems creates challenges
 Identifying target populations
 Tracking patient utilization
 Assessing outcomes across the system of care

Staff recruitment/retention

Aging homeless population – needs exceed access
to in home services or appropriate institutional
based care
Health, Housing, and Social Support Services
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
Medicaid eligibility expansion

Improved coverage of mental health services

Integration of primary/behavioral health care

Managed care plans focus on high cost members

Recognition of impact of social determinants of
health (especially housing)

Increased need for medical respite care given
focus on reducing hospitalizations
Health, Housing, and Social Support Services
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Merlita Compton
Director, Elder Services
And
Laura Taylor
Grant Writer
Kokua Kalihi Valley, Hawaii
Health, Housing, and Social Support Services
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Addressing the social determinants
of health among the multi-ethnic
elders of Kalihi.
July 29, 2015
Merlita Compton
Laura Taylor
Health, Housing, and Social Support Services
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Patient Demographics, 2014
8%
10.5% of KKV’s patients are 65 or older
1%
0-100% of
poverty level
35%
91%
30%
101-200% of
poverty level
over 200% of
poverty level
25%
20%
15%
17%
5%
18%
10%
Medicaid/Quest
Private Insurance
5%
0%
Uninsured
60%
Medicare
30% of KKV’s patients live in public housing
Health, Housing, and Social Support Services
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Elder Care Program History
# of clients
734
800
600
400
200
0
12
24
45
80
1999
2001
2002
2003
Elder
Services
Established
with Case
Management
Health
Maintenance,
Senior
Volunteers
Caregiver
Support &
Transportation
Health, Housing, and Social Support Services
120
2005
539
571
2011
2013
226
2007
MD, BH,
nutrition ed,
eligibility
services
Dental
&
CDSMP
2014
Personal
Care,
Gardening
MD
clinic
expands
49
Key Partnerships
Hawaii Department of Health,
Executive Office on Aging
Honolulu C&C, Elderly Affairs
Division (Area Agency on Aging)
Public Housing
communities
University of Hawai‘i
Law School
School of Medicine
Dept of Public
Health… eval
School of Nursing
Office of Public
Health Studies
Health, Housing, and Social Support Services
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KKV Elder Care Goals
Assist Kalihi’s kupuna to maintain:
Highest level of physical/mental
abilities
Highest quality of life
Save medical costs
Prevent or delay institutionalization
Reduce premature death
Improve quality of life
Reduce the risk of falling
Improve health
Promote mental well-being
Delay onset of disability
Empower elders to live independently
and remain in their community
Health, Housing, and Social Support Services
Nana Perpetua Amian, 101 years old
51
Funding partnerships, challenges in a
changing landscape
City
22%
Private
12%
66%
KKV
Elder Care Funding Sources
Health, Housing, and Social Support Services
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Agenda
•
•
•
•
Background Information
Project Goals and Approach
Webinar Description
Comprehensive Agenda to Encourage More Successful
Partnerships
• References
Health, Housing, and Social Support Services
53
Comprehensive Agenda: Process
• Establish an ongoing interagency workgroup that leaders from each
agency can support with adequate time and resources.
• Include Department of Transportation and CMS team members as
transportation and financing are key components of livable communities
for all ages.
• Develop intentional steps to create an interagency workgroup. Each
agency needs to understand each others’ mission, priorities, and culture.
• Build on existing knowledge – research, evidence-based interventions,
best practices, and discussions with key stakeholders.
Health, Housing, and Social Support Services
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Comprehensive Agenda: Content
• Address workforce issues, including shortages among direct
care workers, geriatricians, and other providers.
• Work with the newly funded HRSA Geriatrics Workforce
Enhancement Program (GWEP) to address workforce issues
(e.g., develop guidelines to expand FQHCs’ capacity to serve
elders and adults with disabilities).
• Develop guidelines to address issues such as:
– hiring and retaining geriatricians and other geriatric
providers,
– training for primary care providers who see elders and
adults with disabilities,
– developing approaches to address multiple chronic
conditions, and
– providing adequate time for complex consumers.
Health, Housing, and Social Support Services
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Comprehensive Agenda: Content (continued)
• Address the need for oral health services, physical therapy, occupational
therapy, and other services that support the chronic care needs of elders and
adults with disabilities.
• Incorporate technology that can help support consumers, direct care workers,
and family caregivers. Technology would need to include financing and training.
• Build on quality indicators/benchmarks for each service area (health, housing,
social support services), and benchmarks for integrated services (e.g., continuity
of services, communication among providers, level of consumer-direction
infused into services).
• Facilitate states’ efforts to offer individual budget community-based service
programs if they choose to do so. This evidence-based consumer-directed
option offers maximum flexibility to consumers and their families in purchasing
services and hiring direct care workers.
Health, Housing, and Social Support Services
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Comprehensive Agenda: Research
• Develop an ongoing literature review from health, housing, and social
support partnerships (including seminal work informing current
literature). Update the literature review regularly to include evolving
literature.
• Identify gaps in knowledge related to a low-income, diverse older
populations and adults with disabilities.
• Develop a research agenda, including suggested questions to address in a
demonstration and evaluation of evidence-based “housing plus services”
programs (e.g., implementation with diverse populations and in diverse
geographic areas).
• Develop and test messages designed to encourage partnerships among
health, housing, and social support services (e.g., we can do better by
working together; the outcome is worth the effort).
Health, Housing, and Social Support Services
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Comprehensive Agenda: Policy and Implementation
Challenges
• Lack of targeted, sustainable funding for health, housing, and social
support partnerships (e.g., funding for administrative functions).
• Need for streamlined funding sources to address duplication from
multiple funders (e.g., multiple applications and reports).
• Data sharing barriers due to privacy concerns/HIPAA and
information technology incompatibilities.
• Barriers to funding diverse types of case managers, including those
who may be competent but unlicensed.
Health, Housing, and Social Support Services
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References
•
•
•
•
•
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•
•
•
•
•
•
•
•
AARP (2015) Livability Index. http://livabilityindex.aarp.org/ Accessed August 29, 2015.
AARP (2012). AARP’s network of age-friendly communities. Washington, DC. Retrieved on August 20, 2012 from
http://www.aarpinternational.org/File%20Library/Resources/AARPNetworkofAgeFriendlyCommunitiesBooklet.pdf
Administration for Community Living (2015), Center for Integrated Programs, Office of Consumer Access and Self-Determination,
Aging & Disability Resources Centers, Program, No Wrong Door System,
http://www.acl.gov/Programs/CIP/OCASD/ADRC/index.aspx. Accessed August 29, 2015.
Administration on Aging (2014). A Profile of Older Americans. http://www.aoa.acl.gov/Aging_Statistics/Profile/index.aspx
Accessed August 29, 2015.
Castle, N., & Resnick, N. (2014). Service-enriched housing: The staying at home program. Journal of Applied Gerontology,
0733464814540049.
Altarum Institute (2015) Center for Elder Care and Advanced Illness. MediCaring communities. A call to action: Making it safe to
grow old. http://altarum.org/sites/default/files/uploaded-related-files/MedicaringCommunities_042815.pdf
Accessed August 29, 2015.
Association of State and Territorial Health Officers, Health aging and public health position statement. http://www.astho.org/Policyand-Position-Statements/Healthy-Aging-and-Public-Health-Position-Statement/
Ellenbecker, C. H., Byrne, K., O’Brien, E., and Rogosta, C. (2002). Nursing Clinics in Elder Housing: Providing Access and Improving
Health Care Outcomes. Journal of Community Health Nursing, 19: 7–15.
Generations, Vol. 37, No. 4. Winter 2013–2014. Aging in Community.
Golant, S. M., Pynoos, J., Cicero, C., Lawler, K., Berger, C., & Blechman, A. D. (2012). Livable and Sustainable Communities.
Public Policy and Aging Report, 19(1).
Golant, S. M., Parsons, P., & Boling, P. A. (2010). Assessing the quality of care found in affordable clustered housing-care
arrangements: Key to informing public policy. Cityscape, 5-28.
Grantmakers in Aging (2013). Age-friendly communities. The movement to create great places to grow up and grow old in America.
Retrieved on April 12, 2014 from http://www.giaging.org/documents/130402_GIA_AFC_Primer.pdf
Institute for Healthcare Improvement (IHI). IHI Triple Aim Initiative.
http://www.ihi.org/engage/initiatives/tripleaim/pages/default.aspx . Accessed August 29, 2015.
Journal of Aging & Social Policy (2014). Special Issue: Age-friendly cities and communities around the world. Vol. 26, Issue 1-2.
Health, Housing, and Social Support Services
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References
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•
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•
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•
•
•
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•
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Keenan, T. A. Home and community preferences of the 45+ population. (Washington, D.C.: AARP, 2010), 4. Available at:
http://assets.aarp.org/rgcenter/general/home-community-services-10.pdf
LeadingAge Center for Housing Plus Services (2014). Study documents higher health costs among HUD-assisted seniors.
http://www.leadingage.org/Study_Documents_Higher_Health_Costs_Among_HUD_Assisted_Seniors.aspx
Accessed August 29, 2015.
LeadingAge Center for Housing Plus Services (2014) Housing and Health Care : Partners in Healthy Aging.
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For additional information about today’s
webinar, please contact:
Lori Simon-Rusinowitz
email: lasr@umd.edu
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