Community Housing Network Collaborates with Health Care Entities to Better Serve Aging Population

Pilot Program for Older Adults in Oakland County Aims to Break Down Silos, Increase Health and Housing Outcomes

Older adults are at the center of our nation’s housing affordability and homelessness crisis as our nation’s population is increasing in age at historic rates and income inequality continues to grow, especially for non-White older adults.

Right here at home in Oakland County, approximately 34,870 older adults surveyed in 2019 by the Area Agency on Aging 1-B, identified that housing is the biggest unmet need facing their community.

Last year, agencies reported serving more than 230 adults 55 and older who were experiencing homelessness, according to the Alliance for Housing.

Around the same time, the Michigan Coalition Against Homelessness (MCAH) and its partners convened and conducted a landscape assessment of current Oakland County services and resources geared toward older persons at risk of or experiencing homelessness.

Their key findings have forced a rethinking of our systems for providing services and support for the aging population.

This includes addressing the need for accessible and affordable housing, assuring coordinated health care and attention to social determinants of health, augmenting medical and support services in the home, and supporting the desire of many older adults to avoid institutional care, particularly nursing homes.

After all, research demonstrates that stable affordable housing can improve health outcomes at any time by freeing up needed dollars to pay for food and health care expenditures. Rent burdened older adults are paying excessive amounts of their income for housing and are left with insufficient resources for their essential needs.

Why Are Older Adults Experiencing Homelessness?

It’s difficult to pinpoint the exact reason for the rise in the older homeless population, which is composed largely of younger baby boomers. Some would say mass incarceration policies and weak social safety nets are to blame.

This lack of safety nets may be attributed to network impoverishment, which many low-income families experience. It’s not just the individual who is living in poverty, but many others in their familial and social circles are too.

Due to discrimination and higher rates of poverty, Black and Latinx older renters are more likely than older White renters to have insufficient income and few assets as they enter retirement. Decades of disinvestment in affordable housing at the federal level and rising rental costs in communities across the nation have also led to a diminishing supply of affordable housing for older adult renters.

Insufficient affordable housing has been a point of contention since the 1980s. 

Eric Tars, legal director at the National Homelessness Law Center, told PBS in March 2023 that this is “an injury, a chronic illness” that began when the nation’s affordable housing supply began to shrink during the Reagan era.

Tars called out former President Ronald Reagan and Congress who at that point cut the affordable housing budget by more than half, and every subsequent Congress that never made up the gap, which hasn’t been made up at the state or local level either.

A report, “Addressing Homelessness Among Older Adults” prepared in October 2023 by the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services, revealed that among the unhoused population who are 50 and older, about half had been homeless at some point before they were 50, while the other half were homeless for the first time.

The report points to the latter group that typically had worked their whole lives hovering around the poverty level, but always with housing. A combination of a few life changes forced them from their homes. These events included losing a job, getting sick, a spouse or partner getting sick, separation from a partner, or the death of a partner or parent.

And for those who first become homeless after 50, the report shows that life expectancies can be even worse than the already early death rate for the general older homeless population.

Add to that, the federal government’s Supplemental Security Income, or SSI, is said to be insufficient for many people and difficult to qualify for. It also has not increased commensurate with inflation, even with cost-of-living increases.

Whatever the cause, this increase in homelessness in the older adult community isn’t the result of individual bad choices people are making, which is a common assumption.

Actualizing Better Care and Support for Older Adults

After a pause brought on by the COVID pandemic, CHN in partnership with MCAH, has reconnected with stakeholders to share our vision of what care looks like for all older adults with medical and functional support needs.

We can begin addressing the lack of care coordination between housing and healthcare systems over the next two years through a pilot program funded by the Michigan Health Endowment Fund’s Healthy Aging Grant.

Phase one of this inclusive pilot program involves outreach to Oakland County partners in healthcare, senior services and homeless response systems to foster intentional relationships that will ensure public health efforts for older adults are aligned.

CHN has a team of individuals responsible for connecting with healthcare providers and health plan services, as well as older adults and caregivers, to prevent and end homelessness, increase awareness and education regarding housing services among healthcare providers, and assist older adults in accessing safer housing facilities.

Our Housing Navigators use person-centered planning processes and trauma-informed interventions when working with older adults. Educating health and housing providers about solutions to shared barriers across systems is a priority.

The goal is to assess the needs and wants of the individual, then connect them to local available and applicable resources. This includes non-housing resources such as transportation, legal assistance, caretaking and chore assistance, mental health services, food, clothing and hygiene items. CHN is also able to connect individuals with financial wellness resources through our Housing Counseling, Rent Right and Financial Education Programs, and other community partner programs and resources.

But CHN will not just be helping older adults who are at risk of or are experiencing homelessness. The organization is helping health care providers, too, by meeting with and training staff to better help their patients by learning more about the housing system and how it works. We will provide them with access to subsidized housing and Housing Choice Voucher information and lists, educating them about the benefits of using our Housing Resource Center, and encouraging them to refer individuals to CHN who are ages 55 and older, are medically involved, and are experiencing housing instability. 

This pilot program will give CHN the opportunity to collaborate with HOPE Recuperative Care Center in Pontiac, for example, where older adults who were hospitalized recently are staying because they did not have a home to be discharged to. CHN will step in and help these individuals create housing goals based on their options and connect them with the resources they need to meet those goals.

Through this program, CHN and its partner agencies will create a new standard of care for older adults in the region.

“Addressing the homeless needs of our aging population is going to be one of the most pressing issues our community will be facing in the next five to 10 years,” said Kirsten Elliott, President at CHN. “This pilot will help and it’s only one part of the solution. We are going to need an overhaul of the social safety net to ensure that our older adults have secure and integrated affordable housing long term.”