The evaluation of the Supportive Services Demonstration is a large, cluster-randomized controlled trial (cRCT) that tests the Integrated Wellness in Supportive Housing (IWISH) model, which leverages coordinated service delivery as a means to better address the interdependent health and supportive service needs among older residents in HUD-assisted properties. The key hypotheses guiding the demonstration are that the IWISH model will reduce unplanned hospitalizations and use of other types of acute care, increase the use of primary and nonacute care, and increase the length of stay in housing by reducing transitions to long-term care facilities.

The key components of the IWISH model include:

1. A full-time Resident Wellness Director (RWD) and part-time Wellness Nurse (WN);
2. A structured approach to resident engagement through person-centered interviews and health assessments;
3. Individual Healthy Aging Plans;
4. A Community Healthy Aging Plan;
5. Evidence-based programming and other activities to meet needs outlined in these plans;
6. Partnerships with healthcare providers; and
7. Enhanced service coordination to better meet the health and supportive service needs of residents.

The three-year demonstration is being implemented in 40 HUD-assisted multifamily properties in seven states which predominantly or exclusively serve households headed by people aged 62 and over. HUD contracted with Abt Associates and its partner L&M Consulting to support and document the implementation of the IWISH model and measure its impact on residents’ housing stability and healthcare utilization. The evaluation compares outcomes for residents living in 40 properties that implement the demonstration (the treatment group) to those of residents living in 84 similar properties that do not implement the demonstration (the control group).

The second report in a three-part series, Supporting Aging in Place through IWISH: Second Interim Report from the Evaluation of the Supportive Services Demonstration documents implementation over the entire demonstration period (October 2017–September 2020), including fidelity to the IWISH model and the experiences of staff, property owners, and residents. The third and final report, expected in late 2022, will show the potential impacts of the demonstration on participants’ housing stability and healthcare utilization.

Supportive Services Demonstration and Evaluation: Testing the Integrated Wellness in Supportive Housing (IWISH) Model