LeadingAge Magazine · January-February 2017 • Volume 07 • Number 01

Affordable Housing Plus Services: an Answer to Many Questions

January 26, 2017 | by Dianne Molvig

Affordable senior housing plus services is a model with a promising future. Here is a look at how it can answer many challenges.

A basic value in a humane society is that everyone deserves a decent place to live. For older adults, it’s not just a matter of having a roof over their heads. They also may need support to enable them to continue living under the roof of their choice. Many seniors, however, can’t afford to pay for the help they require to remain independent.

“The lower your income, the fewer your choices,” says Linda Couch, vice president of housing policy and priorities for LeadingAge. “If we truly want a world in which seniors have a voice and choice in getting a decent place to live, then we need to create a robust affordable-housing-plus-services system.”

Here’s a look at how this model can help meet some key challenges facing older adults and our country as a whole.


Challenge: How can we best provide health services to low-income, older adults while also slowing the rapid growth in health care costs?

When older adults’ health issues are neglected, serious consequences follow: repeated emergency room visits, serial hospital admissions, high health care costs, deteriorating health and, often too soon, an end to being able to live independently.

Supportive services can avert those outcomes by “maintaining low-income individuals’ health and quality of life and allowing them to stay in their community, which all older adults want to do. The public payer system also benefits,” says Alisha Sanders, managing director of LeadingAge’s Center for Housing Plus Services.

Research to document the benefits of affordable housing plus services is still in its early stages, Sanders says, largely because there’s no central place to access data. “We’re fortunate we’re getting to the point where HUD (Housing and Urban Development) and HHS (Health and Human Services) are interested in sharing that data,” she says.

Food distribution.
A weekly food distribution at a Givens Communities housing community. The organization’s new Givens Gerber Park will
feature apartments for low-income residents and for modest income people who often have trouble finding housing. (Photo
courtesy of Givens Communities.)


Many LeadingAge members have witnessed the benefits of supportive services, including Givens Communities in Asheville, NC, which has had service coordinators in some of its communities for years, says Teresa Stephens, affordable communities director.

As a result, “One benefit we’ve noticed,” she says, “is that our residents spend less than 6 months, if any time at all, in skilled care at the end of their lives.”

Now, Givens is using the housing-plus-services model in a new, 3-phase senior housing community, Givens Gerber Park. When completed, it will have 180 apartments for low-income individuals and 82 apartments for modest-income people who, Stephens notes, often fall through the cracks in their search for affordable housing. Phase 2 will include a café and an on-site health clinic available to all residents.

The key pieces of this project, Givens points out, are 2 service coordinators and a community nurse. They’ll perform multiple tasks: making sure residents understand their medications, that the shower chair has arrived before a resident comes home from the hospital, that people with diabetes are eating right … and much more.

“We believe doing those simple things—these essential things—will mean improved health for our residents and lower costs in the health care system,” Stephens says. “This is an affordable way to keep people safe and healthy in their homes.”


Challenge: How can we reduce homelessness among senior citizens?

Homeless shelters can be intimidating environments for anyone. “If you’re older and frail and lack survival skills, those places can be shocking,” says Mark Hinderlie, president/CEO of Hearth in Boston and the co-chair of the National Leadership Initiative to End Elder Homelessness, in which LeadingAge is a partner with Hearth, Shelter Partnership and the Corporation for Supportive Housing.

Health problems can lead to homelessness, and homelessness often results in poor health and premature aging. In the homeless population, the “older adult” description extends to people as young as 50, Hinderlie explains, because “of the rapid acceleration of the aging process. That’s a key piece of the problem.”

According to the Centers for Disease Control and Prevention, homeless persons have a mortality rate 4 to 9 times higher than those who have housing. Many homeless people don’t live to 65.

The elderly homeless population is predicted to rise 33% from 2010 to 2020 and will more than double by 2050, Hinderlie points out. Several factors are contributing to this growth: the burgeoning aging population, the widening economic gap in this country and insufficient public funding for affordable housing.

Also, the War on Drugs is producing a large population of seniors released from prison after long sentences “who have no traction in the job market or the housing market,” Hinderlie says.

Older adults who have been homeless, perhaps for many years, need both housing and supportive services to navigate the journey back from homelessness, Hinderlie says. Hearth does outreach at area shelters to help people find affordable housing. It also operates 188 units of affordable housing at 7 sites for formerly homeless older adults. Nurses, social workers, personal care workers and service coordinators provide supportive services.

A new 54-unit project in the pipeline will serve both formerly homeless people and some who are on the brink of falling into homelessness. “That’s because,” Hinderlie says, “the best way to end homelessness is to prevent it.”


Challenge: How can we better serve military veterans?

As of January 1, 2016, 40,000 military veterans were homeless, according to HUD’s annual Point-in-Time estimate. That number reflected a 47% decrease since 2010, thanks largely to the Obama administration’s Opening Doors initiative aiming to end veteran homelessness.

Still, there’s much left to do, and one Texas LeadingAge member is among those creating a solution. “We know that we have lots of veterans in our area who are homeless or near homeless,” says Lee Ann Hubanks, president of Plano Community Home. “We also have a lot of senior veterans who are living in poor housing.”

Plano Community Home has a 31-year history in providing affordable housing plus services for low-income older adults. Now it’s in the process of adding a new project, called Pettijohn Memorial Housing, which will provide homes to veterans age 62 and older.

CSI residents
At CSI Support & Development Services co-ops, members (residents) are the
decision-making body. Each member gets one vote, and resident
councils and their officers are elected from among the members.
Members make all the major operating decisions and write the annual
budget. (Photo courtesy of CSI.)

The new housing project, still in planning stages, will include 92 apartments and a 20,000-square-foot multipurpose building where various local agencies will provide services. The building will include office space for participating agencies, plus rooms for classes, meetings, peer-group counseling and more. Plans are for a local veterans’ clinic to provide basic health care on site as well as health-related classes. Training is under way to prepare Plano Community Home staff to work specifically with veterans.

Not only will the building’s supportive services be accessible to Pettijohn Memorial Housing residents, but also to any area veteran. Hubanks is pursuing a grant to be able to offer transportation for veterans from off-campus.

Creating housing is an important element of this endeavor. “But the success of this will be getting people re-acclimated if they have been homeless or near homeless,” Hubanks says. “We will build a network of support to help veterans reestablish themselves in society.”


Challenge: How can seniors remain independent and have an active role in their communities?

As Three Dog Night sang in their 1968 hit, “one is the loneliest number.” Many older adults know that well. They live alone, isolated, and experience a daily diet of loneliness. Numerous studies have documented the resulting physical and mental deterioration. Especially vulnerable are low-income seniors.

Quality senior housing organizations strive to do all they can to help their residents feel connected and involved in their community. That objective is built right into the structure of CSI Support & Development Services, based in Warren, MI, which operates as an affordable senior housing cooperative with 6,057 apartments in 58 buildings in California, Maryland, Massachusetts and Michigan.

CSI resident meeting
CSI’s co-op model, very unusual in senior housing, maximizes democratic control and transparency for members. Engagement
is baked into the model. (Photo courtesy of CSI.)


CSI is now in the process of bringing supportive services and service coordinators into all of its co-ops. The resident-involvement element, however, has been there since the beginning in 1965.

“We have very much a collaborative partnership between staff and residents, whom we call members,” says Nancy Evans, general manager. “The members work within the management of their own co-op.” She notes that non-co-ops, too, could use this model.

On each floor in each building, members meet to discuss issues and elect a floor representative who serves on the co-op’s council. All members may attend general co-op meetings and council meetings, and they elect the board of directors, to which Evans reports.

To help run the day-to-day life of the co-op, members volunteer to serve on any of several committees: entertainment, maintenance, décor, grounds, exercise and others. Thus, members are active, engaged and in control. “They have a real sense of self-worth,” Evans says, “because they make the decisions.”

Time and again she hears members say they feel part of a family living in the co-op. “Something else I hear routinely,” Evans adds, “is ‘I thought I came here to die, for the end of my life. But instead I have a new life. Moving here saved my life because now I’m part of something.’”

Dianne Molvig is a writer who lives in Madison, WI.