Resident Services Coordination to Support Aging in Place in Affordable Housing for Persons with Alzheimer's Disease and Related Dementias

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PROJECT SUMMARY – PROJECT 2 One quarter of the 2.9 million older people living in government-subsidized affordable housing in the U.S. have claims-based evidence of ADRD. Resident services coordinators (RSCs) are staff assigned to subsidized housing who manage and provide access to necessary supportive services in the community, provide case management services, develop programs and assets that support wellness, and address social determinants that would otherwise undermine successful aging in place. While myriad state and federal policies mandate and/or incentivize affordable housing building upgrades that address hazardous building conditions, standard financial models for affordable housing make funding for RSCs extremely challenging and fewer than half of federally funded properties serving older persons currently have an RSC. This is counterintuitive since evidence suggests that RSCs are valuable assets to both residents and property owners, benefiting occupancy and rent collection and reducing evictions and maintenance costs. A HUD survey of property managers found that they strongly believe RSC’s improve residents’ quality of life, promote independent living, and prevent unnecessary institutionalization. Little is known about the influence of RSCs on the health and well-being of residents with ADRD. Using linked data from the AASC (American Association of Service Coordinators), HUD (U.S. Department of Housing and Urban Development), CMS (Centers for Medicare and Medicaid Services), and semi-structured interviews with purposively sampled RSCs, we will explore the effects of RSCs on utilization of services and outcomes for older residents with ADRD using a sequential mixed-methods explanatory design. Our specific aims are: Aim 1. Compare the effects of RSCs on disparities in use of health services for residents with and without ADRD; Aim 2. Evaluate the effects of RSCs on inequality in use of services promoting aging in place for residents with and without ADRD; and Aim 3. Further explore the barriers and facilitators (including implicit and explicit biases) to aging in place for residents with and without ADRD that are identified in the first two aims.