Developing Affordable and Accessible Community-Based Housing for Vulnerable Adults Proceedings of a Workshop (2017) / Chapter Skim
Currently Skimming:
5 Models Connecting Affordable Housing and Services as a Platform for Health and Independence
5 Models Connecting Affordable Housing and Services as a Platform for Health and Independence
Pages 45-66
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 45... ...
program at Cathedral Square; and Rose Englert, a senior business leader of CareOregon's Community Health Innovation Program -- then described their specific programs. Following the presentations, Craig Ravesloot, a research professor of psychology and the director of research and training at the Center on Disability in Rural Communities at the University of Montana, led a moderated discussion with the panelists and then opened up the discussion to the workshop participants.
|
From page 46... ...
More data linking better health outcomes with supportive housing could induce 1 For more information, see http://www.cbpp.org (accessed March 8, 2017)
|
From page 47... ...
There is a range of types of housing models, Bailey said. There are housing services models that span single-site settings and provide onsite services as well as scattered-sites settings that aim to deliver services in homes distributed throughout the community.
|
From page 48... ...
Department of Housing and Urban Development Lisa Sloane Senior Policy Advisor Technical Assistance Collaborative Katina Washington of HUD began this joint presentation by explaining that HUD originally provided both capital and operating assistance to nonprofit organizations to construct or rehabilitate housing for individuals with disabilities. However, with declining appropriations and 2 For more information, see http://www.successacademies.org (accessed March 15, 2017)
|
From page 49... ...
ashington said the agency encourages states to work with their W local housing authorities to use existing public housing as additional housing for people with disabilities, or to use the Housing Choice Voucher program or other state-level affordable housing programs. 7 Frank Melville Supportive Housing Investment Act of 2010, Public Law 111-374, 111th Cong.
|
From page 50... ...
An executive management council, consisting of the LDH deputy secretary, LDH program office assistant secretaries, the state Medicaid director, the LDH permanent supportive housing director, and the LHC housing authority administrator, meets at least once each quarter to assist with program implementation, management, and monitoring. TAC has aided in Louisiana's development of its PRA program by encouraging the program to map how it plans to get an individual from housing application to tenancy (see Box 5-1)
|
From page 51... ...
2. Client submits application to Louisiana Department of Health Permanent Supportive Housing office.
|
From page 52... ...
In addition, she said, CAPABLE is focused equally on health and housing, as opposed to being a housing program that might address health issues, or a health program that includes consideration of housing issues. To provide an example of a typical individual participating in CAPABLE, Szanton told the story of Mrs.
|
From page 53... ...
. The ABLE study employed a combination of occupational and physical therapy sessions and home modifications to improve the ability of older adults to engage in instrumental activities of daily living (IADLs)
|
From page 54... ...
showed that CAPABLE cut in half the number of ADL difficulties that participants experienced. Almost 75 percent of the participants, all of whom received Medicaid support, improved on measures of ADL limitations, and 65 percent improved on IADL limitations, such as managing medications, getting groceries into their home, and doing laundry (see Figure 5-2)
|
From page 55... ...
Figure 5-3 MODELS CONNECTING AFFORDABLE HOUSING AND SERVICES 55 100% 9.8% 12.8% 90% 15.4% 80% 22.2% 70% 60% 50% 40% 74.8% 65.0% 30% 20% 10% 0% ADL limitations IADL limitations Improved Stayed the same Worsened FIGURE 5-2 Changes from baseline to follow up in activities of daily living limi tations and instrumental activities of daily living limitations among participants in the CAPABLE study. NOTES: ADL = activity of daily living; IADL = instrumental activity of daily living.
|
From page 56... ...
SUPPORT AND SERVICES AT HOME Molly Dugan Statewide Director, Support And Services at Home Cathedral Square SASH uses affordable housing as a platform for realizing population health, said Molly Dugan of Cathedral Square. She commented that while the program's partners -- home health agencies, mental health agencies,
|
From page 57... ...
It is doing the hard work of explaining what we are all trying to do together and all agreeing to a certain set of rules." Partnership requires information sharing, and all SASH participants sign consent forms to allow for readily sharing information among the program partners. Participants in SASH are assigned to a "panel" of clients served by one care coordinator, one wellness nurse, and a team of community providers that together build relationships that support being healthy at home, Dugan explained.
|
From page 58... ...
With the information the nurse and Diana gathered, the SASH team created a healthy living plan for Larry, which included health coaching, regular check-ins with Diana to help with his generalized anxiety disorder, and attendance at a local diabetes class. The Area Agency on Aging designated a staff person to accompany him to sporting events and help him cook meals, and the home health agency made sure Larry was eligible to receive some personal care and housekeeping services.
|
From page 59... ...
PROMISING MODELS IN OREGON Rose Englert Senior Business Leader, Community Health Innovation Program CareOregon CareOregon is a nonprofit health plan and health services organization, Rose Englert said, and the Community Health Innovation Program is what she called CareOregon's social determinants team. CareOregon has some 230,000 low-income members, which is large by Oregon standards.
|
From page 60... ...
"It is amazing what you can learn with a home visit," Englert said. The organization also has a Go Mobile team that provides enrollment assistance for individuals in the community who need help finding care, figuring out whether they have insurance, or whether they are eligible for care as a veteran.
|
From page 61... ...
"We had to take a lot of time in meeting with [existing community] providers ahead of time and trying to get on the same page about what were the gaps that remained even though some of these organizations had been at this difficult work for 30 to 40 years." Through a series of "delicate conversations," she said she was able to convince the existing community-based providers that SASH could add value, such as with the trusting relationship that the SASH staff build with SASH participants.
|
From page 62... ...
In terms of payment Englert said a barrier arises when programs restrict how funds can be spent. Oregon is fortunate, she said, because its Medicaid waiver enables organizations like CareOregon to spend money on what it calls flex or health-related services, although some policy changes would make it easier to get more payment models involved.
|
From page 63... ...
Vermont has six designated regional housing organizations that have the leadership to disseminate the SASH model statewide, and this core group has been implementing it since 2011. "If you have champions, you are better off because then you have that sustainability," said Dugan.
|
From page 64... ...
Four cities in Michigan have received funds from the Hillman Foundation and ichigan Medicaid to deploy CAPABLE in those ities. Michigan M c Medicaid has pledged to make CAPABLE available to all 15,000 Medicaid beneficiaries in the state if the 4 cities can show that the program delays nursing home admissions by an average of 1 day.
|
From page 65... ...
Winston Wong of Kaiser Permanente asked the panelists if there is a way to empower the people whom these programs affect so that they can advocate for themselves, rather than only having service providers tout the benefits of these programs. "I think this is an equity question with regard to empowering the individuals in communities to say this is not a question of trying to convince someone but about seizing their right for integration into society," Wong said.
|
From page 66... ...
"I have to say that not all social justice groups are following this, and it is a shame," Baldwin said. Bailey remarked that the Center on Budget and Policy Priorities has been known for its long papers filled with charts and graphs.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.