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• 1. [Article] Home Forward’s Aging in Place Initiative: Planning for Current and Future Residents

  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 ...

  Citation × Citation Citation Abstract Copy Title: Home Forward’s Aging in Place Initiative: Planning for Current and Future Residents Author: Carder, Paula C., Weinstein, Jenny, Kohon, Jacklyn Nicole Year: 2012 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 about how to respond to the aging of both current residents and the local community. The population of older persons has and will continue to increase in Multnomah County, and Oregon. While many older persons enjoy relative economic stability, a sizeable number are very poor and face housing instability and declining health. According to the 2010 U.S. Census, the poverty rate among county residents age 65 and older is 10.9%, higher than the national average of 9%. A recent study of Multnomah County adults with incomes at or below 200% of poverty level found that 44% of those who had moved in the prior five years had done so to reduce housing costs. Title: Home Forward’s Aging in Place Initiative: Planning for Current and Future Residents Author: Carder, Paula C., Weinstein, Jenny, Kohon, Jacklyn Nicole Year: 2012 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 about how to respond to the aging of both current residents and the local community. The population of older persons has and will continue to increase in Multnomah County, and Oregon. While many older persons enjoy relative economic stability, a sizeable number are very poor and face housing instability and declining health. According to the 2010 U.S. Census, the poverty rate among county residents age 65 and older is 10.9%, higher than the national average of 9%. A recent study of Multnomah County adults with incomes at or below 200% of poverty level found that 44% of those who had moved in the prior five years had done so to reduce housing costs. Close

• 2. [Article] Characteristics of Medicaid Clients in Assisted Living, Residential Care, Memory Care, and Adult Foster Homes 2013-2014

  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 ...

  Citation × Citation Citation Abstract Copy Title: Characteristics of Medicaid Clients in Assisted Living, Residential Care, Memory Care, and Adult Foster Homes 2013-2014 Author: Carder, Paula C., Kohon, Jacklyn Nicole, Elliott, Sheryl DeJoy, West, Maximilian, Zimam, Amanuel, Neal, Margaret B. Year: 2014 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 use, and demographic characteristics; provide a baseline for future reports. In addition, this information about Medicaid clients can be compared to the recently completed summary of assisted living facilities (ALF), residential care facilities (RCF), memory care communities (MCC), and adult foster homes (AFH) completed by Portland State University’s Institute on Aging. All three CBC reports and a report recently completed by Oregon State University on nursing facilities in Oregon, provide an important overview of community-based and long-term care settings in Oregon that can be used by policymakers, providers, and consumers. Title: Characteristics of Medicaid Clients in Assisted Living, Residential Care, Memory Care, and Adult Foster Homes 2013-2014 Author: Carder, Paula C., Kohon, Jacklyn Nicole, Elliott, Sheryl DeJoy, West, Maximilian, Zimam, Amanuel, Neal, Margaret B. Year: 2014 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 use, and demographic characteristics; provide a baseline for future reports. In addition, this information about Medicaid clients can be compared to the recently completed summary of assisted living facilities (ALF), residential care facilities (RCF), memory care communities (MCC), and adult foster homes (AFH) completed by Portland State University’s Institute on Aging. All three CBC reports and a report recently completed by Oregon State University on nursing facilities in Oregon, provide an important overview of community-based and long-term care settings in Oregon that can be used by policymakers, providers, and consumers. Close

• 3. [Article] Resident and Home Characteristics Report 2014: Adult Foster Homes

  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 ...

  Citation × Citation Citation Abstract Copy Title: Resident and Home Characteristics Report 2014: Adult Foster Homes Author: Carder, Paula C., Elliott, Sheryl DeJoy, Limburg, Aubrey, Kohon, Jacklyn Nicole, Zimam, Amanuel, West, Maximilian, Neal, Margaret B. Year: 2014 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; describe AFH provider characteristics (e.g., number of years as a provider, professional training); describe adult foster homes (e.g., occupancy, monthly charges, staffing); and provide a baseline for future surveys. In addition, this information about AFHs can be compared to the recently completed summary of assisted living, residential care, and memory care facilities completed by Portland State University’s Institute on Aging. Both surveys, along with a report that summarizes characteristics of Medicaid clients based on data provided by DHS and a report recently completed by Oregon State University on nursing facilities in Oregon, provide an important overview of community-based care settings in Oregon that can be used by policymakers, providers, and consumers. Title: Resident and Home Characteristics Report 2014: Adult Foster Homes Author: Carder, Paula C., Elliott, Sheryl DeJoy, Limburg, Aubrey, Kohon, Jacklyn Nicole, Zimam, Amanuel, West, Maximilian, Neal, Margaret B. Year: 2014 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; describe AFH provider characteristics (e.g., number of years as a provider, professional training); describe adult foster homes (e.g., occupancy, monthly charges, staffing); and provide a baseline for future surveys. In addition, this information about AFHs can be compared to the recently completed summary of assisted living, residential care, and memory care facilities completed by Portland State University’s Institute on Aging. Both surveys, along with a report that summarizes characteristics of Medicaid clients based on data provided by DHS and a report recently completed by Oregon State University on nursing facilities in Oregon, provide an important overview of community-based care settings in Oregon that can be used by policymakers, providers, and consumers. Close

• 4. [Article] The Health and Housing Specialist: An Emerging Job Classification to Support Aging in Place in Subsidized Housing

  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 ...

  Citation × Citation Citation Abstract Copy Title: The Health and Housing Specialist: An Emerging Job Classification to Support Aging in Place in Subsidized Housing Author: Carder, Paula C., Weinstein, Jenny, Kohon, Jacklyn Nicole Year: 2012 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, health monitoring, adult day health, and home care. Such efforts are intended to deliver health related services that allow older adults to remain in their apartment for as long as possible while also reducing their use of hospital emergency departments or nursing facility placement. However, because housing providers have not traditionally hired or contracted with health and social services workers, neither the specific job tasks, nor the qualities of workers, have been studied. This report describes the findings from a study designed to identify the characteristics of subsidized housing employees who work primarily with older residents. The study took place during 2011- 2012 and included interviews with housing providers, health and social services professionals who have clients in subsidized housing, current residents, and resident service coordinators who work in subsidized housing. A systematic job analysis, including a national survey with 87 service coordinators from 23 states, was conducted in order to identify the specific job tasks and the knowledge, skills, and abilities required of subsidized housing employees whose job would entail supporting aging in place for older residents. Based on this study, it is clear that significant numbers of older residents of subsidized housing have a variety of unmet needs that place them at risk of eviction, hospitalization, and premature nursing home admissions. Four broad categories of supports identified by study participants include information and referral, health, social and personal care services, case management and care coordination, and building-specific supports. While most residents are independent and want to remain so, many need assistance on a short-term basis, such as during an acute illness or after a hospitalization. Others need on-going supports such as personal care, medication management, and health monitoring. Currently, few housing providers have a means of assessing or monitoring the health status or needs of residents. Most study participants believed that a designated staff person who could assess and monitor resident health would be beneficial, though some cautioned against creating an institutional environment or forcing services onto residents who do not want such assistance. Title: The Health and Housing Specialist: An Emerging Job Classification to Support Aging in Place in Subsidized Housing Author: Carder, Paula C., Weinstein, Jenny, Kohon, Jacklyn Nicole Year: 2012 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, health monitoring, adult day health, and home care. Such efforts are intended to deliver health related services that allow older adults to remain in their apartment for as long as possible while also reducing their use of hospital emergency departments or nursing facility placement. However, because housing providers have not traditionally hired or contracted with health and social services workers, neither the specific job tasks, nor the qualities of workers, have been studied. This report describes the findings from a study designed to identify the characteristics of subsidized housing employees who work primarily with older residents. The study took place during 2011- 2012 and included interviews with housing providers, health and social services professionals who have clients in subsidized housing, current residents, and resident service coordinators who work in subsidized housing. A systematic job analysis, including a national survey with 87 service coordinators from 23 states, was conducted in order to identify the specific job tasks and the knowledge, skills, and abilities required of subsidized housing employees whose job would entail supporting aging in place for older residents. Based on this study, it is clear that significant numbers of older residents of subsidized housing have a variety of unmet needs that place them at risk of eviction, hospitalization, and premature nursing home admissions. Four broad categories of supports identified by study participants include information and referral, health, social and personal care services, case management and care coordination, and building-specific supports. While most residents are independent and want to remain so, many need assistance on a short-term basis, such as during an acute illness or after a hospitalization. Others need on-going supports such as personal care, medication management, and health monitoring. Currently, few housing providers have a means of assessing or monitoring the health status or needs of residents. Most study participants believed that a designated staff person who could assess and monitor resident health would be beneficial, though some cautioned against creating an institutional environment or forcing services onto residents who do not want such assistance. Close

• 5. [Article] Resident and Community Characteristics Report 2014: Assisted Living, Residential Care, Memory Care

  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 ...

  Citation × Citation Citation Abstract Copy Title: Resident and Community Characteristics Report 2014: Assisted Living, Residential Care, Memory Care Author: Carder, Paula C., Kohon, Jacklyn Nicole, Limburg, Aubrey, West, Maximilian, Zimam, Amanuel, Neal, Kenneth Gordon Year: 2014 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 services. Residents of MCCs required the most assistance with ADLs and use of health services, which is similar to 2008. The percent of residents who used hospice services increased from 2008 by 2%. The percent of residents who visited the hospital or an emergency department increased from 10% in 2008 to 28% in 2014. The percent of residents using Medicaid increased from 2008 by 10%. Title: Resident and Community Characteristics Report 2014: Assisted Living, Residential Care, Memory Care Author: Carder, Paula C., Kohon, Jacklyn Nicole, Limburg, Aubrey, West, Maximilian, Zimam, Amanuel, Neal, Kenneth Gordon Year: 2014 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 services. Residents of MCCs required the most assistance with ADLs and use of health services, which is similar to 2008. The percent of residents who used hospice services increased from 2008 by 2%. The percent of residents who visited the hospital or an emergency department increased from 10% in 2008 to 28% in 2014. The percent of residents using Medicaid increased from 2008 by 10%. Close

• 6. [Article] Oregon Community-Based Care Survey: Assisted Living, Residential Care, and Memory Care

  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 ...

  Citation × Citation Citation Abstract Copy Title: Oregon Community-Based Care Survey: Assisted Living, Residential Care, and Memory Care Author: Carder, Paula C., Kohon, Jacklyn Nicole, Limburg, Aubrey, Zimam, Amanuel, Rushkin, Megan, Neal, Margaret B. Year: 2016 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. Describe assisted living, residential care, and memory care community characteristics, including staffing types and levels, policies, and monthly charges and fees Describe current residents’ health and social characteristics Compare current results to prior Oregon surveys and to national studies of similar setting types to identify changes and possible trends Compare setting types for differences that might affect access, quality, or costs The study findings are intended to provide information that state agency staff, legislators, community-based care providers, and consumers might use to guide their decisions. Providing state-level information was one of the goals of Oregon’s LTC 3.0 planning process (Oregon Department of Human Services, n.d.). In addition, as possible, comparisons are made to national surveys of residential care and assisted living conducted by the National Center for Health Statistics. Because of state variation in licensure categories, the national surveys combine residential and assisted living settings and use the term residential care to describe both. It should also be noted that regulatory standards and the types of residents that can be served in AL and RC settings vary by state, as well. Title: Oregon Community-Based Care Survey: Assisted Living, Residential Care, and Memory Care Author: Carder, Paula C., Kohon, Jacklyn Nicole, Limburg, Aubrey, Zimam, Amanuel, Rushkin, Megan, Neal, Margaret B. Year: 2016 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. Describe assisted living, residential care, and memory care community characteristics, including staffing types and levels, policies, and monthly charges and fees Describe current residents’ health and social characteristics Compare current results to prior Oregon surveys and to national studies of similar setting types to identify changes and possible trends Compare setting types for differences that might affect access, quality, or costs The study findings are intended to provide information that state agency staff, legislators, community-based care providers, and consumers might use to guide their decisions. Providing state-level information was one of the goals of Oregon’s LTC 3.0 planning process (Oregon Department of Human Services, n.d.). In addition, as possible, comparisons are made to national surveys of residential care and assisted living conducted by the National Center for Health Statistics. Because of state variation in licensure categories, the national surveys combine residential and assisted living settings and use the term residential care to describe both. It should also be noted that regulatory standards and the types of residents that can be served in AL and RC settings vary by state, as well. Close

• 7. [Article] Differential Health and Social Needs of Older Adults Waitlisted for Public Housing or Housing Choice Vouchers

  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 ...

  Citation × Citation Citation Abstract Copy Title: Differential Health and Social Needs of Older Adults Waitlisted for Public Housing or Housing Choice Vouchers Author: Carder, Paula C., Luhr, Gretchen, Kohon, Jacklyn Nicole Year: 2016 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. We conclude with policy implications for housing and health agencies that serve low-income older persons. Title: Differential Health and Social Needs of Older Adults Waitlisted for Public Housing or Housing Choice Vouchers Author: Carder, Paula C., Luhr, Gretchen, Kohon, Jacklyn Nicole Year: 2016 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. We conclude with policy implications for housing and health agencies that serve low-income older persons. Close

• 8. [Article] Oregon Community-Based Care Survey 2016: Adult Foster Homes

  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, ...

  Citation × Citation Citation Abstract Copy Title: Oregon Community-Based Care Survey 2016: Adult Foster Homes Author: Carder, Paula C., Kohon, Jacklyn Nicole, Limburg, Aubrey, Zimam, Amanuel, Rushkin, Megan, Neal, Margaret B. Year: 2016 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. Describe adult foster home characteristics, including staffing types and levels, policies, and monthly charges and fees Describe current residents’ health and social characteristics Compare current results to prior Oregon surveys and to national studies of similar setting types to identify changes and possible trends Compare setting types for differences that might affect access, quality, or costs The study findings are intended to provide information that state agency staff, legislators, community-based care providers, and consumers may use to guide their decisions. Providing state-level information was one of the goals of Oregon’s LTC 3.0 planning process. Title: Oregon Community-Based Care Survey 2016: Adult Foster Homes Author: Carder, Paula C., Kohon, Jacklyn Nicole, Limburg, Aubrey, Zimam, Amanuel, Rushkin, Megan, Neal, Margaret B. Year: 2016 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. Describe adult foster home characteristics, including staffing types and levels, policies, and monthly charges and fees Describe current residents’ health and social characteristics Compare current results to prior Oregon surveys and to national studies of similar setting types to identify changes and possible trends Compare setting types for differences that might affect access, quality, or costs The study findings are intended to provide information that state agency staff, legislators, community-based care providers, and consumers may use to guide their decisions. Providing state-level information was one of the goals of Oregon’s LTC 3.0 planning process. Close