Supportive Services Demonstration and Evaluation: Testing the Integrated Wellness in Supportive Housing (IWISH) Model
 

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. A process study will assess fidelity to the IWISH model, successes and challenges to implementation, and answer 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.

Research Design

The Supportive Services Demonstration is a rigorous, cluster-randomized controlled trial testing 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 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) to assess whether IWISH reduces unplanned hospitalizations and use of other types of acute care, increases the use of primary and nonacute care, and increases the length of stay in housing by reducing transitions to long-term care facilities.

Download the Impact Study Research Design

Reports Published By HUD


First Interim Report

The First Interim Report documents the baseline characteristics of the residents of the demonstration properties and describes the first 18 months of the implementation of IWISH.

Download the First Interim Report


Second Interim Report

The Second Interim Report will contain a comprehensive analysis of IWISH implementation using data from interviews with staff from the IWISH and control properties, focus groups with residents, and further analysis of data collected on program participants.


Comprehensive Report

The Comprehensive Report will provide a quantitative analysis of the impact of IWISH on residents’ healthcare utilization and housing stability by comparing the treatment and control groups along four primary outcomes:

  • Unplanned hospitalizations and use of other acute care;
  • Use of primary care and other nonacute health care;
  • Length of stay in HUD multifamily housing, including frequency of exits from housing; and
  • Transitions to long-term care facilities.

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