Social and Behavioral Sciences Commons^™

Housing With Services, Paula C. Carder

Institute on Aging Publications

This report describes findings of an evaluation of the Housing with Services project in Portland, OR.

This evaluation was designed to assess the implementation process and impacts of a novel program of coordinated health and social services on behalf of over 1,400 residents of 11 affordable housing properties in Portland, Oregon. Affordable housing for older adults and persons with disabilities provides an important financial subsidy for persons with low incomes. To qualify for the affordable housing described in this report, individuals must have incomes of no more than $15,450 for a single person. In the U.S., over one million older …

Oregon Community-Based Care Survey 2016: Adult Foster Homes, Paula C. Carder, Jacklyn Nicole Kohon, Aubrey Limburg, Amanuel Zimam, Megan Rushkin, Margaret B. Neal

Institute on Aging Publications

This report describes adult foster homes in Oregon. An adult foster home (AFH) is a type of licensed community-based care (CBC) setting that provides residential, personal care, and health-related services, primarily to older adults. The study collected information from adult foster homes to achieve the following four main goals.

1. Describe adult foster home characteristics, including staffing types and levels, policies, and monthly charges and fees
2. Describe current residents’ health and social characteristics
3. Compare current results to prior Oregon surveys and to national studies of similar setting types to identify changes and possible trends
4. Compare setting types for differences that might …

Oregon Community-Based Care Survey: Assisted Living, Residential Care, And Memory Care, Paula C. Carder, Jacklyn Nicole Kohon, Aubrey Limburg, Amanuel Zimam, Megan Rushkin, Margaret B. Neal

Institute on Aging Publications

This report, prepared by the Institute on Aging (IOA) at Portland State University (PSU) in collaboration with the Oregon Department of Human Services, describes community-based care (CBC) settings that provide residential, personal care, and health-related services, primarily to older adults. The study collected information from assisted living, residential care, and memory care communities to achieve the following four main goals.

1. Describe assisted living, residential care, and memory care community characteristics, including staffing types and levels, policies, and monthly charges and fees
2. Describe current residents’ health and social characteristics
3. Compare current results to prior Oregon surveys and to national studies of …

Differential Health And Social Needs Of Older Adults Waitlisted For Public Housing Or Housing Choice Vouchers, Paula C. Carder, Gretchen Luhr, Jacklyn Nicole Kohon

Institute on Aging Publications

Affordable housing is an important form of income security for low-income older persons. This article describes characteristics of older persons waitlisted for either public housing or a housing choice voucher (HCV) (previously Section 8) in Portland, Oregon. 358 persons (32% response rate) completed a mailed survey with questions about demographics, health and housing status, food insecurity, and preference for housing with services. Findings indicate that many waitlisted older persons experienced homelessness or housing instability, poor health, high hospital use, and food insecurity. Public housing applicants were significantly more likely to report lower incomes, homelessness, and food insecurity than HCV applicants. …

The Case For Age-Friendly Communities, Margaret Neal, Alan Kenneth Delatorre

Institute on Aging Publications

The report was funded by Grantmakers In Aging, an organization dedicated to promoting and strengthening grantmaking for an aging society. The movement toward age-friendly communities is growing, with the key impetus being population aging. Beyond what individuals themselves can do to age optimally, the movement to create communities that are age friendly focuses on how the economic, physical, and social environments can be improved to address not only the needs but also maximize the assets of an aging population, for the benefit of all.

Building A State For All Ages: Tapping The Potential Of Older Oregonians, Stephen Percy, Judith A. Ramaley, John Tapogna, Margaret B. Neal, Jay Bloom, Alexandra Reece

Institute on Aging Publications

This report explores how the aging population—including native Oregonians and senior adults moving to the state—represent an asset to Oregon. Aging in America has often been viewed from a perspective of deficit and decline. We wholeheartedly challenge this perspective. This report identifies how older adults can play vital roles in the workforce, entrepreneurship and innovation, and supporting community revitalization through volunteering of time and talent.

Consumer Satisfaction With Aging & Disability Resource Connection Of Oregon: Round 4, Diana White, Sheryl Dejoy Elliott

Institute on Aging Publications

The report describes the fourth round of consumer satisfaction surveys that were conducted with people who had been in contact with the Information & Referral/Assistance (I&R/A) Call Center or received Options Counseling (OC) services of Aging and Disabilities Resource Connection (ADRC) of Oregon. Data for this survey were collected in November 2014. This Executive Report summarizes and presents data on overall satisfaction, conclusions, and recommendations for the ADRC program.

Evaluating Your Age-Friendly Community Program: A Step-By-Step Guide, Margaret B. Neal, Iris Wernher

Institute on Aging Publications

This guidebook was developed to help you document and evaluate your community’s progress in becoming more age friendly. Although this task may sound intimidating, with a small dose of courage and by understanding a few key terms, the building blocks of evaluation can come alive and help guide your work.

Housing With Services: Year 1 Evaluation, October 2014, Paula C. Carder

Institute on Aging Publications

This report describes the initial findings of an on-going evaluation of the Housing with Services project based in Portland, OR. Housing with Services was supported, in part, with funding from Oregon’s State Innovation Model (SIM) project grant from the Center for Medicare and Medicaid Innovations to Cedar Sinai Park.

Housing with Services, LLC is a collaborative model of supportive services delivered or made available to low-income residents of affordable housing. The SIM grant helped to establish the project and funded the evaluation of the program implementation and resident- and system-level outcomes.

The collaborative model includes partnerships between health plans, coordinated …

Enhancing Equity For An Aging Region, Alan Delatorre, Lee Girard, Bobby Weinstock, Richard Lycan

Institute on Aging Publications

Presentations on "Aging and Equity in the Region" from the Institute on Aging - Drs. Alan DeLaTorre and Richard Lycan - with community partners Bobby Weinstock (NW Pilot Project) and Lee Girard (Multnomah County Aging and Disability Services).

Collaborative Treatment Of Late-Life Depression In Primary Care (Germanimpact): Study Protocol Of A Cluster-Randomized Controlled Trial, Iris Wernher, Frederike Bjerregaard, Iris Tinsel, Christiane Bleich, Sigrid Boczor, Thomas Kloppe, Martin Scherer, Martin Härter, Wilhelm Niebling, Hans-Helmut König, Michael Hüll

Institute on Aging Publications

Background: Depression is not a normal side effect of aging, however it is one of the most prevalent mental health issues in later life, imposing a tremendous burden on patients, their families, and the healthcare system. We describe the experimental implementation of a collaborative, stepped-care model for the treatment of late-life depression (GermanIMPACT trial) in the German primary care context. GermanIMPACT was developed as an adaptation of a successful and widely used American model. The aim of the study is to evaluate the model’s applicability to the German primary care setting and its cost-effectiveness.

Methods/Design: The study will be conducted …

Senior Mental Health Specialist Investment, Diana L. White, Linda Dreyer, Julie Reynolds, Alice Updike Scannell, Serena Worthington

Institute on Aging Publications

Participants: Thirty-five informants were interviewed or completed a survey for this report. They represented the Budget Note Workgroup and others identified by workgroup members. Informants represented aging services, mental health, advocacy, and other sectors such as long-term care, quality improvement, and health/medical care. Both those with a statewide focus and those with a local agency or community focus participated, including people from rural areas of the state.

The Problem: According to informants, mental health needs of older adults are not being met because:

• Systems are fragmented. The organizations that could address these needs work in silos with different funding priorities, …

Forcasting Senior Populations, Richard Lycan

Institute on Aging Publications

This project seeks to: Improve population forecasts for senior populations; Increase awareness of issues related to forecasting senior populations; Provide support to corecasters

Consumer Satisfaction With Aging & Disability Resource Connection: Round 3, Diana White, Serena Worthington

Institute on Aging Publications

This report describes the third round of consumer satisfaction surveys conducted with users of Aging and Disabilities Resource Connections (ADRC) of Oregon. The telephone survey was conducted between October 18 and November 2, 2013 and focused on three of the core ADRC functions: 1) information, referral, and awareness; 2) options counseling (OC); and 3) streamlined eligibility determination for public programs. The ADRC Advisory Committee had previously established benchmarks to be used in determining success for many aspects of the program described in this report.

Aging And Equity In The Greater Portland Metropolitan Region, Alan Kenneth Delatorre, Margaret B. Neal

Institute on Aging Publications

Aging and Equity in the Greater Portland Metropolitan Region discusses the opportunities and needs created by the increase in older adults in the region. The 65 and older population is expected to more than double over the next two decades, to over half a million people. Planning for the inevitable and unprecedented aging of our population provides an opportunity to improve our environments while becoming a leader in the push to create sustainable, equitable, and age-friendly communities.

Resident And Home Characteristics Report 2014: Adult Foster Homes, Paula C. Carder, Sheryl Dejoy Elliott, Aubrey Limburg, Jacklyn Nicole Kohon, Amanuel Zimam, Maximilian West, Margaret B. Neal

Institute on Aging Publications

In collaboration with the Aging and People with Disabilities program of Oregon’s Department of Human Services (DHS), Portland State University’s Institute on Aging conducted this research study of adult foster homes (AFH) throughout the state of Oregon. The Oregon legislature appropriated funds for DHS to collect information from these community-based care providers that will allow DHS, providers, and the public to better understand resident characteristics and adult foster home services.

This report summarizes findings from the first state-wide survey of licensed adult foster homes in Oregon. The survey goals were to:

• describe resident health-related needs, service use, and demographic characteristics; …

Resident And Community Characteristics Report 2014: Assisted Living, Residential Care, Memory Care, Paula C. Carder, Jacklyn Nicole Kohon, Aubrey Limburg, Maximilian West, Amanuel Zimam, Kenneth Gordon Neal

Institute on Aging Publications

This report provides an overview of community-based care settings in Oregon. The results presented here are derived from surveys completed by 243 facilities serving 9,485 residents. Key changes between the 2008 OOHPR survey and 2014 include:

• Compared to 2008, the number of facilities increased by 13%, with the largest growth in MCCs (41%).
• The proportion of for-profit facilities and facilities managed by a third party increased from 2008 by 8%.
• The acuity level of residents increased on most measures compared to 2008.
• Compared to 2008, residents across all three community types required more assistance with ADLs and used more health …

Medication Management Services Offered In U.S. Residential Care Communities, Lisa L. Dwyer, Paula C. Carder, Lauren D. Harris-Kojetin

Institute on Aging Publications

Using data from the 2010 National Survey of Residential Care Facilities, this study estimated the percentage of U.S. residential care communities (RCCs) offering selected medication management services (MMS) and examined differences in prevalence by community characteristics. The most common services were central storage for medications and cueing residents, while the least common were administering injections and intravenous medications. Medication reminders, helping residents take medications, and administering drops/topical ointments and injections varied by RCC characteristics. Characteristics most commonly associated with these differences are size, purposefully built status, nursing hours, and availability of a physician or pharmacist to review medication appropriateness. Understanding …

Characteristics Of Medicaid Clients In Assisted Living, Residential Care, Memory Care, And Adult Foster Homes 2013-2014, Paula C. Carder, Jacklyn Nicole Kohon, Sheryl Dejoy Elliott, Maximilian West, Amanuel Zimam, Margaret B. Neal

Institute on Aging Publications

In collaboration with the Aging and People with Disabilities (APD) program of Oregon’s Department of Human Services (DHS), Portland State University’s Institute on Aging generated this report of Medicaid clients living in community-based care (CBC) settings in the state of Oregon. The Oregon legislature appropriated funds for DHS to collect information about these community-based care providers which will allow DHS, providers, and the public to better understand characteristics of Medicaid clients living in different CBC settings.

This report is based on an analysis of Medicaid data provided by DHS. The study goals were to:

• describe Medicaid clients’ health-related needs, service …

Action Plan For An Age-Friendly Portland, The Age-Friendly Portland Advisory Council

Institute on Aging Publications

The goal of this Action Plan is to enhance Portland, Oregon’s age friendliness. As defined by the World Health Organization (WHO), an "age friendly" city:

• has structures and services that are accessible and inclusive of older people with varying needs and capacities
• emphasizes enablement rather than disablement, and
• is friendly for people of all ages and abilities

The action steps that comprise this plan are intended to move Portland toward future development and activities that foster not only physical environments but also social and service environments that meet these criteria, making Portland a community for all ages.

Consumer Satisfaction With Aging & Disability Resource Connection (Adrc) Services: Round 2, Diana L. White, Sheryl Elliott

Institute on Aging Publications

Aging and Disabilities Resource Centers (ADRC) are a program of the Administration for Community Living (ACL), the Centers for Medicare and Medicaid (CMS), and the Veterans Health Administration. They serve as a single entry point into the long-term services and supports systems for older adults and those with disabilities. The goal is to provide a coordinated system of information and access to those seeking long-term services and support, thereby minimizing confusion, enhancing individual choice, and supporting informed decision-making.

Home Forward’S Aging In Place Initiative: Planning For Current And Future Residents, Paula C. Carder, Jenny Weinstein, Jacklyn Nicole Kohon

Institute on Aging Publications

This report was prepared on behalf of the Aging in Place Initiative of Home Forward. The Initiative sought to gather information about older persons currently residing in Home Forward’s public housing properties, from persons age 55 and older on the waitlist for housing, and from older adults in the Portland area. While local data were unavailable at the time of this report, we know that nationally, more than one-third (37 percent) of the approximately 5 million households receiving housing assistance from HUD are headed by persons age 62 and older. With this in mind, Home Forward must make decisions now …

The Health And Housing Specialist: An Emerging Job Classification To Support Aging In Place In Subsidized Housing, Paula C. Carder, Jenny Weinstein, Jacklyn Nicole Kohon

Institute on Aging Publications

As the U.S. population ages, the availability of workers with a basic understanding of aging and health-related services has not kept pace. This is true in traditional health care organizations such as hospitals and primary care clinics as well as in long-term care settings and senior housing, including subsidized housing, the focus of this report. Nearly 1.8 million older persons receive some form of publicly-subsidized rental assistance. Some subsidized housing providers, including those that operate buildings designated for older persons, are developing new systems of service delivery that would either coordinate or provide health screenings, physical activity programs, nutrition programs, …

Lane Transit District Integrated Functional Transportation Assessment Project: Findings From A Case Study And Developmental Evaluation, Margaret B. Neal, Susan Eliot, Mark Person, Jost Lottes

Institute on Aging Publications

This report describes the results of a case study and developmental evaluation of Lane Transit District's innovative project to develop an integrated functional assessment for transportation services, referred to here simply as the Transportation Assessment Project (TAP).

The TAP is unique in that it is a collaborative effort between a public transit agency and local human service agencies to blend traditionally separate assessments for eligibility for transportation services. Specifically, in the TAP, Lane Transit District subcontracts with human services agencies to conduct personalized in-home assessments with individuals with special transportation needs and who are requesting paratransit rides. While in the …

State Experiences With Affordable Housing Plus Services: Report To Seniors And Persons With Disabilities, On The Move, Paula C. Carder, Erika Zoller

Institute on Aging Publications

Housing developers, providers, policy makers, and advocates, increasingly recognize that for some groups of individuals, access to affordable housing alone is "not enough." That is, some individuals require more than shelter. Examples include individuals who have chronic health conditions (e.g., HIV/AIDS), those with physical or cognitive limitations (e.g., persons with developmental disabilities, adults with physical disabilities), and those who have a combination of health conditions or who cannot thrive in traditional housing (e.g., persons who have been homeless, individuals with chronic mental illness). Increasingly, housing providers, social service agencies, advocates, states, and federal agencies have recognized the need to combine …

The Older Driver In Oregon: A Survey Of Driving Behavior And Cessation, Margaret B. Neal, Sharon Baggett, Kathleen A. Sullivan, Tyrae Mahan

Institute on Aging Publications

In a study of older adults and their travel patterns in Oregon, a statewide mail survey and telephone interviews were conducted with older drivers and older adults who had voluntarily chosen to stop driving. The purpose of the study was to determine: (1) the factors that influence driving cessation; (2) the physical and emotional barriers that delay driving cessation; (3) what opportunities exist for alternative transportation after driving cessation; (4) whether drivers make relocation decisions on the basis of driving cessation; (5) the warning signs that make a driver stop driving; and (6) whether a crisis situation generally forces a …

The World Health Organization Age-Friendly Cities Project In Portland, Oregon, Usa, Margaret B. Neal, Alan Kenneth Delatorre

Institute on Aging Publications

The older population is increasing in size in Portland, the state of Oregon, the United States, and the rest of the world. Our cities and regions are vital to the support of this demographic shift through the provision of quality built environments, services, and social, cultural, and civic engagement opportunities promote healthy and active aging.

Over the next 30 years, the Portland-Vancouver metropolitan area will see dramatic growth in the proportion of the population that is aged 65 and older. Although the total population will increase by 47 percent, the 65+ population will more than double, growing by over 137 …

Working Caregivers: Issues, Challenges, And Opportunities For The Aging Network, Margaret B. Neal, Donna Wagner

Institute on Aging Publications

This paper provides an overview of the issues associated with working caregivers. We will examine the social and demographic trends influencing the growth of this group, their characteristics and their contributions to elders, and the consequences of caregiving for caregivers and their work. Next, we will briefly describe the various employer-initiated programs currently in place to support working caregivers and the evolution of these programs, followed by federal and state governments’ response to working caregivers, to date. The remainder of the paper details the potential role of the aging network in better supporting working caregivers, including current best practices and …