Design of a Demonstration of Coordinated Housing, Health and Long-Term Care Services and Supports for Low-Income Older Adults. V. Policy and Practice Questions


The demonstration is intended to answer the following policy and practice questions:

  1. Can independent affordable senior housing (largely subsidized congregate apartment buildings) serve as an effective platform for meeting the health and long-term care services and support needs of low-income older residents (62+) as well as some proportion of similar individuals who live in the surrounding community?

  2. What housing with services models result in the best outcomes?

  3. Do targeting specific groups of residents maximize the chances that the above outcomes will be achieved?

  4. What capacity, infrastructure and resources must be present in housing providers and their partners, and in the communities in which sites are located to maximize the demonstrations success?

  5. To what extent can demonstration sites rely on existing federal and state data sources to identify potential demonstration sites and participants? What is the role of the government in making data available?

  6. What rules promulgated by HUD, local housing authorities and finance agencies, and sponsors and owners (fair housing rules, restrictions on services coordinator roles and responsibilities; financing for services coordination, common space, and building/apartment accessibility features; allowing residents to have live-in help; etc.) are major barriers to implementing the proposed design and can they is accommodated? Some of these issues may be defined in the Housing Quality Standards (HQS), see: for the future, perhaps some of the accessibility features can be added to the HQS.

  7. What federal and state health and human service policies and/or regulations are impediments to demonstration implementation and how can they be overcome (e.g., state licensing requirements for congregate settings providing health services and or serving frail residents; federal privacy rules; barriers to integrating services for dual eligible; etc.).

  8. What other barriers to the demonstration must be addressed (e.g., insurance liability concerns/costs; local fire and safety ordinances). What types of properties do they impact and how can they be overcome.

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