HOMELESSNESS PREVENTION SERIES: Spotlight on Older Adults

Read the other spotlights and the federal Homelessness Prevention Framework at usich.gov/prevention .

According to HUD's 2024 Point In Time Count, ~20% of people (n=146,150) experiencing homelessness in America were 55 or older, with many experiencing homelessness for the first time in their lives. For those who've spent their whole lives stably housed, later-life homelessness typically is precipitated by a traumatic event. The death of a spouse, divorce, job loss, eviction, or the onset of health issues which then cause a housing crisis.

Older adults are also more likely to spend over half their income on housing and live on a fixed budget based on government programs like Social Security. Meaning they are unable to keep up as costs spike. Once homeless, people over 55 tend to stay homeless, with nearly half (46%) living 'unsheltered' in places not meant for human habitation. Homeless shelters and housing lack the capacity to help elderly individuals with daily activities. Many also lack accommodations for people with mobility issues, such as wheelchair ramps, first-floor rooms, and lower-bunk beds.

In response to what has been called a 'gray wave' of elder homelessness, communities across America are recognizing the lack of services for this population and want to expand their capacity to provide for the unique needs of older people without a home. What follows are several 'spotlights' developed by USICH through a Request For Information (RFI) process in partnership with the highlighted communities, hoping it will prove insightful for other communities facing similar issues.

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In Arizona, the Foundation for Senior Living (FSL) stands out as one of the state's largest nonprofit affordable housing developers, helping Arizonans age since 1974. FSL owns and operates 25 apartment complexes across the state, embedding support services and eviction prevention. They place community health workers (CHWs) in housing communities to address the interconnected needs of residents. The goal: create a holistic solution to homelessness prevention by integrating services such as:

Healthcare navigation: assistance enrolling in Medicaid, scheduling doctor's appointments, and avoiding medical scams;
Health monitoring: Through the use of in-unit devices, provide daily check-ins on metrics like blood pressure, blood sugar, temperature, and more to notify primary care as needed;
Food security: running the onsite food pantry and delivering meals door to door;
Transportation assistance: schedule grocery store visits and group outings;
Socialization: bring resources to the local community room (Zumba classes, healthy cooking demonstrations, insurance presentations, potlucks, and more)

Addressing social determinants of health can have a significant impact when it empowers residents like Rafael and Martina. A medical supply company scammed them before seeking guidance from their onsite CHW, who resolved the issue, thereby helping them maintain independence and dignity in their later years.

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Across all of California's 58 counties, the Home Safe program has expanded the scope of housing-related programs for older people at risk of homelessness for years. The goal is to prevent homelessness through financial assistance and case management, along with landlord engagement and home improvement using $200 million in state funds run through each county's adult protective services (APS) agency, which investigates cases involving elder abuse, neglect, exploitation, and cases of older people who cannot meet their own needs—all of which are a significant risk factor for homelessness. In Los Angeles County and San Diego County, APS tailored the program to the specific needs of their communities and the resources available to meet them. Follow the link to learn more about how it works.

L.A. County's Home Safe Program can help ensure immediate access to supportive services provided by the local Area Agencies on Aging (AAA), quickly addressing housing and health needs to prevent homelessness, while investigations of abuse occur. When APS receives a referral, the county's system initiates both the APS investigation and involvement of the Home Safe team, which assesses and works to strengthen housing stability and prevent homelessness through voluntary services, including: 

Financial assistance for housing expenses, such as rental assistance, application fees, and security deposits
Up to six months of housing-related intensive case management
Eviction prevention 
Landlord mediation and incentives
Home modifications that facilitate mobility
Deep cleaning to maintain safe housing

San Diego County's Home Safe Program has a similar structure but focuses more on case management and housing support. San Diego County also has the Shallow Rental Subsidy Program, which offers $500 a month for up to 18 months to low-income older adults who need financial assistance to remain in their homes. Participants are also provided case management to connect them with additional resources and social support. This intervention is supported by the fact that 70% of Californians who have experienced homelessness believe that a monthly subsidy of $300-$500 would have prevented their homelessness.

Federal guidance

All In: The Federal Strategic Plan to Prevent and End Homelessness cites the following strategies, among others, that USICH and federal agencies are using to prevent older adults from experiencing housing instability and homelessness, including:

Increase access to home- and community-based services and housing that is affordable, accessible, and integrated.
Identify measures and metrics to ensure that we are using all available data to inform action and implementation and that it includes key populations and marginalized groups, including older adults and people with disabilities. 
Expand availability and supply of accessible and integrated housing opportunities that meet the needs of older adults and people with disabilities, and encourage partnerships between housing providers, aging and disability services, and health care.
Provide guidance and technical assistance to states and local governments on service improvement and the provision of housing-related supports for older adults and people with disabilities— especially those in rural communities, people transitioning out of institutions and into integrated community-based housing, and people at risk of institutionalization. 
Strengthen coordination between Continuums of Care, AAAs, Centers for Independent Living, Aging and Disability Resource Centers/No Wrong Door Systems, housing, Social Security, health care, AmeriCorps Seniors volunteers, and homeless service providers.
Promote flexible funding to cover the first or last deposit for renters with reliable sources of income, such as Supplemental Security Income, which provides little to no discretionary spending.
As part of the White House Housing Supply Action Plan, the Department of Housing and Urban Development (HUD) announced $115 million in grants to support the development and preservation of supportive housing for an estimated 1,100 units for low-income seniors through the Section 202 Supportive Housing for the Elderly Program. 
HUD and the Department of Health and Human Services (HHS) launched the Housing and Services Partnership Accelerator to help selected states with approved Medicaid waivers address the health and housing needs of older adults and other people at risk of homelessness with complex medical needs.
HHS agencies published reports on "A Strategic Framework for a National Plan on Aging" and "Addressing Homelessness Among Older Adults."
USICH published an op-ed to increase public awareness about the rise in and risks of homelessness among older adults.

Conclusion

We must reverse the rise in homelessness among older people. This work will continue until every American—for every year of their life—has a safe and affordable place to call home. Like air, water, and food, housing is a basic need, and we must meet this population's housing needs before they become increasingly reliant on social safety nets that may not holistically meet those needs.

USICH wants to hear from you! Do you have best practices for effective and innovative ways to prevent homelessness? Click to share them with USICH.

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