Overview

HUD’s Supportive Services Demonstration is a large, cluster randomized-controlled trial that leverages HUD-assisted properties as a platform for the coordination and delivery of services to better address the interdependent health and supportive service needs of its older residents. The demonstration tests the Integrated Wellness in Supportive Housing (IWISH) model, which funds a full-time Resident Wellness Director and a part-time Wellness Nurse to work in HUD-assisted housing developments that either predominantly or exclusively serve households headed by people aged 62 or over. The Resident Wellness Director and Wellness Nurse proactively engage with residents and implement a formal strategy for coordinating services to help meet residents’ needs. The team:

• Performs person-centered interviews and health and wellness assessments;
• Develops Individual and Community Healthy Aging Plans;
• Assists residents with implementing their plans and accessing needed services and resources;
• Formally and informally engages with community partners; and
• Has access to supplemental supportive services funds to support health and wellness needs of residents.

The 3-year demonstration is being implemented in HUD-assisted multifamily properties in California, Illinois, Maryland, Massachusetts, Michigan, New Jersey, and South Carolina. HUD contracted with Abt Associates and its partner L&M Consulting to document the implementation of the IWISH model over the 3-year demonstration period and to measure the impact of IWISH on residents’ housing stability and healthcare utilization. The evaluation compares outcomes for residents living in 40 properties that implement IWISH (the “treatment” group) with outcomes for residents living in 84 similar properties that do not implement IWISH (the “control” groups).

The evaluation consists of both a process study and impact study. The process study assesses fidelity to the IWISH model and successes and challenges to implementation, and answers questions related to resident health, well-being, and housing. The impact study will use HUD administrative data linked with Medicare and state Medicaid claims data to assess the impact of IWISH on healthcare utilization. The key hypotheses guiding the demonstration are that the IWISH program will reduce unplanned hospitalizations and use of other types of acute care, increase the use of primary and nonacute care, and increase the length of stay in housing by reducing transitions to long-term care facilities.