Forward

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 Council of Large Public Housing Authorities (CLPHA) and the Milbank Memorial Fund collaborated to write and publish the report. CLPHA is a national nonprofit organization that works to preserve and improve public and affordable housing through advocacy, research, policy analysis, and public education. The Fund is an endowed operating foundation that has worked since 1905 to improve health by helping decision makers in the public and private sectors acquire and use the best available evidence to inform policy for health care and population health.

Public housing is the ideal laboratory in which to find ways to allow seniors to age in place. Elderly households represent 31 percent of the nation’s approximately 1.1 million public housing households. Of the seniors in public housing, 16 percent are over the age of eighty-two.

This report will be of benefit to people both inside and outside of public housing. According to persuasive research, approximately half the population born between 1946 and 1964 is at risk of having incomes that will not meet their needs as they grow older. These Americans will have difficulty paying out-of-pocket costs for health and long-term care as well as meeting their minimum need for food, housing, and essential transportation. Moreover, most American seniors, like those in public housing, prefer to live in their own homes as long as possible, even as they become progressively, though intermittently, frailer as a result of the convergence of biological aging and chronic disease. Creating and maintaining more housing with supportive services will be needed to meet these demands. It will require more public funds, but at the same time will reduce demand for Medicaid financing for health and long-term care.

Work on the report began in 2000, after Daniel J. Wuenschel, then Executive Director of the Cambridge Housing Authority, participated in a meeting of decision makers about affordable assisted living convened by the American Association of Homes and Services for the Aging and the Fund. At his invitation, Dan Fox, the President of the Fund, visited housing that had been renovated for seniors by the Authority. The housing also provides residents with health and social services through collaboration with public and nonprofit agencies.

Wuenschel suggested to his colleagues in CLPHA that they join the Fund in preparing a guide to developing and managing senior public housing with supportive services. CLPHA and the Fund organized work groups on housing renovation, licensing requirements and issues of choice and safety, and planning and programs of health and human services. Msgr. Charles Fahey and Charles Palmer, program officers of the Fund, wrote several drafts of the guide and revised them following review by members of the work groups and the steering committee.

Members of the steering committee and the work groups are listed in the Acknowledgments along with staff of CLPHA and the Institute for Social and Economic Development who assisted in the project. Because the guide is grounded in their first-hand experience, we recommend it to anyone interested in providing housing and supportive services for low-income seniors.

Daniel M. Fox President
Milbank Memorial Fund

Sunia Zaterman
Executive Director
Council of Large Public Housing Authorities