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In your experience, what are some good examples of health and housing working together in ways that have promoted positive outcomes for seniors? What has made these programs successful? View the full forum.

By Bill Kelly

Most of my experience with constructive partnerships of housing and health care providers has grown out of my work with Stewards of Affordable Housing for the Future (SAHF) members.

SAHF’s eleven non-profit members provide affordable rental apartments for 116,000 households—seniors, low-income families, and persons with disabilities. With support from the Kresge and Annie E. Casey Foundations, SAHF is tracking life outcomes of residents across the fields of health and wellness, income and assets, children and education, housing stability, and community engagement and developing ways of assisting residents to improve those outcomes.

With respect to health and wellness for seniors, SAHF members are engaged in a series of ongoing demonstrations around the country and are in discussions with health plans in four states with clusters of member properties, looking to form strategic partnerships.

Some members are partnering with hospitals and health systems through Community Benefit Programs. For example, Mary Washington Hospital in Richmond, Virginia supports a part-time nurse at an NHT/Enterprise property, primarily serving uninsured older adults not covered by Medicaid and not yet eligible for Medicare. The nurse reduces doctor and ER visits by helping residents understand their own health and how to navigate the health system.

In the Sacramento area, Mercy Housing is a host site for the Chronic Disease Self-Management Program sponsored by Dignity Health. Mercy and Dignity Health predict a savings of about $590 per participant who completes the program, primarily due to reduced emergency room visits and hospitalizations.

Massachusetts General Hospital, through its Senior HealthWISE program, holds Weekly Wellness Centers at three Boston properties, including a property run by Preservation of Affordable Housing. The centers provide a variety of health, behavioral and social services, as well as referrals to community collaborators for a wide range of supportive services.

National Church Residences and Mercy Housing have improved quality of life and achieved costs savings by providing housing with supportive services that allows seniors to move into affordable housing from higher levels of care or the street. In the case of Mercy Housing, over a seven-year study period, the cost savings from moving 11 formerly homeless seniors out of a skilled nursing facility and into Mission Creek Apartments more than covered the additional health care costs of providing or arranging for supportive services to 39 formerly homeless seniors who also moved into the senior building. Of course, the benefits of enabling people to lead better lives are incalculable.

What are some of the patterns here? First, affordable housing providers are well-positioned to work with low-income residents to help them address the social determinants of health beyond safe shelter. Staff know the residents, are trusted by them and can assist them directly as well as link them to outside services. Second, the cost structures of housing organizations are radically different from and lower than that of the clinical health care world, opening the prospect for better health and wellness with a better experience and at a lower per capita cost—all in line with the goals of the Affordable Care Act (ACA). Third, the forms of partnership, the roles of each party, the nature of data sharing, and the economic arrangements vary widely based in part on how the ACA is administered in the various states.

Bill Kelly is a strategic advisor for Stewards of Affordable Housing for the Future (SAHF).


Welcome to the BPC Health and Housing Expert Forum. Each month contributors from different parts of the health and housing sectors will be invited to respond to a discussion topic. Have a question you’d like us to consider? Please leave it in the comments.

Any views expressed on this forum do not necessarily represent the views of the Health and Housing Task Force, its co-chairs, or the Bipartisan Policy Center.