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For individuals experiencing housing insecurity—and other hardships associated with poverty, such as low rates of health literacy, food insecurity, lack of transportation, and restricted access to quality health care—an HIV diagnosis exacerbates an already burdened quality of life. These larger structural barriers may inhibit HIV+ participants from feeling able to change individual-level behaviors which may complicate their HIV status. One counseling intervention that addresses obstacles to change is Motivational Interviewing (MI). MI is a collaborative, client centered approach that fosters communication between a service provider and their recipient with the goal of identifying and resolving the change goals identified during the counseling session. Studies on healthcare outcomes for chronically ill individuals who received MI interventions indicate that, when followed properly, MI can effect long-term, positive behavior changes. This paper defines MI, explores it's applications among HIV+ participants, describes an MI fidelity monitoring tool, and situates MI relevance while acknowledging the influence of social determinants of health.
Sanford Institute of Philanthropy at John F. Kennedy University;
With the rapid acceleration of the COVID-19 pandemic in March 2020, it was imperative to understand the immediate impact on local nonprofits in the East Bay and the communities they serve. The East Bay's diversity is one of its strengths. However, the COVID-19 pandemic threatens residents who have built community, but not wealth, for generations. It also threatens to further erode a strained and fragmented nonprofit ecosystem. Maintaining a healthy and viable nonprofit community is essential to create a Bay Area in which all can participate, prosper, and reach their full potential.
Health Neighborhood, a pilot project within Heartland Alliance Health (HAH), intended to create a population-based approach of improving integrated care among people with experiences of homelessness, who were housed in permanent supportive housing (PSH). The program was built on through intensive partnerships between HAH and five Permanent Supportive Housing (PSH) providers: Chicago House, North Side Housing and Supportive Services, Deborah's Place, Housing Opportunities for Women, and Heartland Human Care Services (HHCS). The program was implemented from 2016 – 2019, and served 46 participants.
The home environment plays a critical role in adults' ability to stay in their homes and communities as they age, commonly referred to as aging in place. Yet the majority of older adults' homes lack supportive features. Home modification is the process of making changes to a home to increase independence, safety, and health. Often combined with related repairs, home modification and repair (HMR) can be minor, such as adding grab bars and removing tripping hazards, or major, such as installing roll-in showers and ramps. Although HMRs can support people as their needs change and even preclude moves to institutional settings, numerous barriers challenge the ability of older adults and caregivers to access them.In response, the Administration for Community Living (ACL) funded the University of Southern California (USC) Leonard Davis School of Gerontology to implement the project, "Promoting Aging in Place by Enhancing Access to Home Modifications." Its goal is to address the barriers to home modification access and service delivery by increasing the availability and awareness of home modification at the national, state, and local levels. A key activity of this project was to develop a knowledge base of state HMR activities and programs for older adults and persons with disabilities with a focus on the State Units on Aging (SUAs). These agencies develop and implement state plans and support services for older persons, adults with physical disabilities and their families. SUAs administer funds, including those provided through the Older Americans Act (OAA), to support HMR services through local Area Agencies on Aging (AAAs) and other state and local entities (e.g., OAA Title VI organizations that serve older Native Americans). SUAs can play a significant role in HMR by including it in state plans, providing designated funding, raising awareness, and coordinating with other state agencies such as housing, disability, and health.In October 2019, USC and its ACL project partner ADvancing States administered an online survey of directors of the 56 SUAs (which ADvancing States represents). The 10-question closed and open-ended survey sought to ascertain SUA activities, challenges, and opportunities in HMR. With extensive follow-up through February 2020, 50 SUAs completed the survey (an 89% response rate).This report summarizes the survey results, giving a bird's eye view of SUA roles in HMR and shining a light on examples of SUA HMR activities. Its purpose is to encourage greater involvement and coordination in HMR service delivery among agencies with a stake in assuring older Americans' ability to age in place.Click "Download" to access this resource.Tags: Older Americans Act, Area Agencies on Aging, State Units on Aging, Home-and Community-Based Services
This toolkit was developed by Generations United and the Leading Age LTSS Center @UMass Boston with funding from the RRF Foundation for Aging (formerly the Retirement Research Foundation). It was designed specifically to help senior housing organizations plan and implement high-quality intergenerational programs that will benefit residents and young people in their communities. While designed with senior housing organizations in mind, a range of organizations interested in planning and implementing intergenerational programs and activities will also find the toolkit useful. There are many ways to take an intergenerational approach to programming. The materials contained in the toolkit can help you begin developing your program and/or give you tips on deepening or expanding your intergenerational work.
Joint Center for Housing Studies of Harvard University;
As the overall population ages, the number of very low-income older adult households that qualify for HUD housing assistance is rising rapidly. Older adults tend to stay in subsidized housing longer than younger families. As a result, older adults make up a growing share of HUD-subsidized renter households. In the last ten years alone, the share of older adults in HUD-subsidized housing has risen five percentage points, and older adult households now make up over a third of all subsidized renters. In this paper, we examine whether the subsidized housing stock is suitable for aging in place. We ask: What physical challenges do older subsidized renters face? What difficulties do they experience with their housing environment? And, are subsidized units more equipped with accessibility features than units without rent assistance?To answer these questions, we used the 2011 American Housing Survey, the last vintage of this survey to include detailed questions about housing accessibility and household mobility difficulties. We constructed a comparison group of eligible, unsubsidized renters making up to 30 percent of area median income. We used chi-square statistics, logistic regression modeling, and propensity score matching to identify differences in housing accessibility and mobility difficulties between subsidized and unsubsidized, eligible older adults. We also compare households receiving project-based subsidies to those receiving tenant-based vouchers.The findings confirm that older subsidized renters have many vulnerabilities, but rental housing assistance provides more livable housing in terms of accessibility than private-market rentals. We also find that renters receiving project-based rental assistance typically have more accessibility features than those receiving tenant-based assistance, but the differences are not statistically significant. Ultimately, our results highlight the benefit of subsidized housing but also point to unmet needs. Livable and wheelchair accessible units are lacking for older, extremely low-income renters, whether they receive a subsidy or not. While many units are potentially modifiable, only a small share have basic accessibility features that make them currently livable for older adults.Click "Download" to access this resource.
ABT Associates, Inc.;
As the economic crisis precipitated by the COVID-19 pandemic has unfolded in 2020, nonprofit institutions have stepped up to provide shelter for the homeless, food for the hungry, and health care for those in need. Afinancially strong nonprofit organization that can provide this support through economic downturns does not happen by itself, however. It takes planning, investment, skill and hard work. As funders, policymakers, and practitioners consider how to foster financially strong nonprofit institutions that can help with the current and future crises, it is worth reflecting on the effectiveness of past efforts to support the growth of nonprofit institutions.In the early 2000s, the John D. and Catherine T. MacArthur Foundation (MacArthur) launched one such effort. MacArthur sought to support the growth and sustainability of a group of nonprofit affordable housing developers through program-related investments (PRIs) that provided long-term flexible equity-like capital. This report summarizes the results of Abt Associates' evaluation of this initiative. Among other conclusions, Abt found that these investments played an important role in helping the developers survive and even thrive during the last major economic upheaval, the Great Recession. The flexible financing provided by the PRIs helped the nonprofit developers achieve larger scale, improve financial and staff capacity, and react creatively to changes in economic and social conditions.
ABT Associates, Inc.;
As the economic crisis precipitated by the COVID-19 pandemic has unfolded in 2020, nonprofit institutions have stepped up to provide shelter for the homeless, food for the hungry, and health care for those in need. A financially strong nonprofit organization that can provide this support through economic downturns does not happen by itself, however. It takes planning, investment, skill and hard work. As funders, policymakers, and practitioners consider how to foster financially strong nonprofit institutions that can help with the current and future crises, it is worth reflecting on the effectiveness of past efforts to support the growth of nonprofit institutions.In the early 2000s, the John D. and Catherine T. MacArthur Foundation (MacArthur) launched an effort to support the growth and sustainability of a group of nonprofit affordable housing developers through program-related investments (PRIs) that provided long-term flexible equity-like capital. This brief summarizes the results of Abt Associates' evaluation of this initiative. Among other findings, Abt found that these investments played an important role in helping the developers survive and even thrive during the last major economic upheaval, the Great Recession. The flexible financing provided by the PRIs helped the nonprofit developers achieve larger scale, improve financial and staff capacity, and react creatively to changes in economic and social conditions.
This report highlights findings from a subset of those interviewed during the Minnesota Homeless Study in 2018: U.S. military Veterans experiencing homelessness.
The Minnesota Homeless Study, conducted every three years by Wilder Research, is a point-in-time study aimed at better understanding homelessness in Minnesota. The study is the most comprehensive source of descriptive information about homeless adults, youth, and children in the state, and is intended to equip readers with the data needed to improve housing programs and policies, address systemic problems, and ultimately eliminate homelessness in Minnesota.This summary provides a snapshot of the numbers of people who were homeless in Minnesota in 2018 and findings from face-to-face interviews conducted on October 25, 2018, with 4,181 adults experiencing homelessness throughout Minnesota.
Committee for Greater LA;
The ongoing homelessness crisis in Los Angeles has elevated calls for a better governance structure to address this devastating issue. Los Angeles combines an already fragmented system of general governance with a fragmented governance approach to homelessness. Any new governance structure must be customized around these distinctly Los Angeles features.We often assume the problems in homelessness governance can be solved with more leadership, more data, restructured government institutions, more coordination, more city-county collaboration, and more money. This independent report commissioned by the Committee for Greater LA challenges these assumptions.
This report examines the service model of Wilder's Customized Living program, describes similar models of care currently operating in Minnesota, assesses the costs and benefits of these programs, and describes challenges providers face in executing this model. It includes an annotated bibliography of relevant literature.