Summary
The HUD Supportive Services Demonstration (SSD), also referred to as Integrated Wellness in Supportive Housing (IWISH), leverages HUD’s properties as a platform for the coordination and delivery of services to better address the interdependent health and supportive service needs of its older residents. The demonstration is testing a model of housing and supportive services with the potential to delay or avoid nursing home care for low-income elderly residents in HUD-assisted housing. The demonstration aims to promote aging in place and improve housing stability, wellbeing, health outcomes, and reduce unnecessary or avoidable healthcare utilization associated with high healthcare costs.
The SSD model funds a full-time Resident Wellness Director (RWD) and part-time Wellness Nurse (WN) to work in HUD-assisted housing developments that either predominantly or exclusively serve households headed by people aged 62 or over. The RWD and WN implement a formal strategy for coordinating services to help meet residents’ needs: The team will assess and identify resident needs; develop Individual Healthy Aging Plans (IHAP); assist residents with implementing these plans and accessing needed services and resources; motivate and encourage residents to adopt beneficial behavior changes and follow-through with appointments and other activities; develop property-level programming based on identified resident needs and interests; engage with community partners, formally and informally, to assist individuals and bring services and resources to the property; engage the property management team and maintenance staff in protecting the privacy of residents and promoting their well-being; and work collaboratively to coordinate services and supports based on individual resident needs.
The 3-year demonstration is being implemented in HUD-assisted multifamily properties in California, Illinois, Maryland, Massachusetts, Michigan, New Jersey, and South Carolina.
HUD has designed a rigorous evaluation to accompany the demonstration, with the major goal of producing reliable, credible, quantitative evidence for Congress and stakeholders about the impact of IWISH on costly healthcare utilization and transitions to nursing home care. Eligible HUD-assisted properties that applied for the demonstration were randomly assigned to a treatment group that received grant funding to hire a RWD and WN and implement the SSD model and a control group that will continue business as usual.
The evaluation consists of a process study and impact evaluation. The process study will assess fidelity to the IWISH model, successes and challenges to implementation, and answer important questions related to resident health, well-being, and housing. The impact evaluation will use HUD administrative data and Medicare and Medicaid claims data to quantitatively assess the impact of IWISH on healthcare utilization by comparing those participating in IWISH and those in the control group.
Key facts
Main target group: Vulnerable older people (e.g. at risk or victims of abuse, living alone, poor etc.)
Sector(s): Health, Housing, Information and communication, Social protection, Urban development
Desired outcome for older people:
Be mobile
- Ageing in place
- Healthy behaviours (e.g. physical activity)
- Inequities
- Inclusion
- Participation