Supportive Services

Background

Many federal housing developments that accommodate older adults have expanded their mission by providing supportive services. The Department of Housing and Urban Development has funded thousands of service coordinators in housing developments for older adults, enabling many residents to age in place longer and more successfully.

However, many developments face financial, space-related and other barriers to offering services such as congregate meals and help with chores and personal care. Many do not generate enough operating revenue to provide adequate common services because of the “fair-market rent” guidelines. Making it easier for subsidized housing communities to provide additional services to their residents would help create an efficient network of support for residents with low incomes.

In recent years, new models that facilitate service delivery in housing are making it easier for people to age in place in a connected way. Some examples include:

  • Naturally Occurring Retirement Communities, communities that have a large portion of older residents that were not specifically planned or designed to for this age group;
  • Communities for a lifetime, efforts to make communities places where people of all ages, especially older adults, can live; and
  • The “Village” model, in which residents form a non-profit and pay dues to coordinate access to affordable services, such as transportation, health and wellness programs, home repairs, social activities, and educational opportunities.

Supportive Services: Policy

Housing with services

In this policy: FederalLocalState

State and local governments should encourage coordination of housing, health services, and other supports to facilitate access and efficiencies in service delivery.

The Department of Housing and Urban Development (HUD) should develop higher fair-market rent standards for assisted living residences and other forms of service-enriched housing.

HUD programs for the construction or conversion of residences for older adults should include a range of housing options, including service-enriched housing and housing located in communities with access to transit, mobility options, and other amenities.

HUD, the Federal Housing Administration (FHA), the Federal National Mortgage Association (Fannie Mae), the Federal Home Loan Mortgage Corporation (Freddie Mac), and state housing finance agencies should encourage innovative financial underwriting to incorporate the cost of services, service coordinators, and technology (including broadband) in housing development operating budgets (see Chapter 10, Utilities: Telecommunications, Energy and Other Services—Connecting Via Broadband for Successful Aging).

Enhancing HUD and Department of Health and Human Services (HHS) coordination

In this policy: Federal

HUD and HHS’s Administration for Community Living should better coordinate their efforts to facilitate client-based data collection and program development regarding residents’ service needs, facility retrofitting, development of supportive housing, and the cost-effectiveness of providing supportive housing that maximizes residents’ ability to age in place.

Increasing supportive services

In this policy: Federal

Federal housing policy should concentrate greater resources on frail older adults, particularly those who live alone, members of racial and ethnic groups that have experienced discrimination, people living in underserved rural and inner-city areas, and people with disabilities.

HUD and HHS should identify ways to enable housing providers to support resident services by taking into account savings to the health care system. Joint HUD-HHS regulations should make it easier to use existing funding streams.

Congress should establish a supportive-services grant program to replace the Congregate Housing Services Program and the Homeownership and Opportunity for People Everywhere for Elderly Independence program. Funded services should include access to necessary health and social services for residents aging in place.

Housing demonstration programs

In this policy: Federal

HUD and other federal agencies should use the results of demonstration programs to develop effective strategies to meet the service needs of older adults in subsidized housing.