The population of elderly in the United States is large and growing at a rapid pace. This growth can be ascribed to the aging of the Baby Boomers and to the advances and improvements in medicine and health care resulting in longer life spans. It is projected that by the year 2030, the older population (65 years or older) of the country will more than double to 70 million (U.S. Dept. of Health and Human Services, 2002). The importance of integrating services with housing to assist the low-income elderly is gaining recognition.

The National Low Income Housing Coalition (NLIHC) uses the umbrella term housing plus services to describe permanent housing that incorporates services into the operation of housing, with the services provided by people for whom service delivery, not property management, is their primary responsibility (Granruth & Smith, 2001). In order to give an accurate understanding of housing programs for the elderly, I must first explain the broader policies on housing and work my way down to more specific, local examples.

The linkage of housing with services is not particularly new in terms of social welfare programs. In 1657, almshouses were established to assist the elderly, disabled, and the poor who were seriously ill. Soon after, workhouses were set up to correct the perceived disobedient ways of the “unworthy poor”.

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In both institutions, residency and services were involuntary and often geared toward reducing the need for public financial support (Axinn & Levin, 1997). Although almshouses and workhouses were later disregarded, the belief in the relation of housing and services continued to survive. During the late 19th century, settlement houses grew to be the most prominent tool for providing needed services to local communities. Settlement houses, as opposed to almshouses, had positive environments where services were voluntary and directed at improving individual and community functioning (Lundblad, 1995). This integration of housing and services was recommended in the early 1900’s as a way to build strong communities. In the

United States, federal recognition of housing as a public policy concern originated with the New Deal. The National Housing Act of 1934 insured new mortgages, prompting the construction and ownership of homes. In 1937, the U.S. Housing Act established the federal role in the production and subsidation of rental housing for low-income people. The housing shortage that resulted prior to World War II led to the passage of the Housing Act of 1949 that aimed to achieve “…a decent home and suitable living environment for every American family” (U.S. Congress, Committee on Banking and Financial Services, 1999).

In the 1960’s the first federally coordinated effort to link housing and services came about with the creation of the Concentrated Services Demonstration program by the Housing and Home Finance Agency and the Department of Health Education and Welfare (predecessor organizations to the Departments of Housing and Urban Development and Health and Human Services, respectively) (Bratt & Keyes, 1997). A federal report was completed in 1971 to establish what progress had been made in meeting the national housing goal set in the 1949 legislation.

The findings additionally suggested that issues relating to housing policy and the environment had both physical and social dimensions. The report called for “more explicit attention to the environmental impact of housing programs” and a more active role on the part of the state and local governments “in relating community growth, development and services to the housing needs of citizens of all income levels” (Granruth, 2001). The U.S. Department of Housing and Urban Development’s (HUD) 1995 Reinvention Blueprint supported housing programs that would provide greater self-sufficiency for its residents and in 1998 major reforms to the public housing programs initiated these and other designs.

Housing plus programs generally offer, in varying degrees and levels of importance, the following services to residents: life skills/stabilization, crisis intervention, case management, service coordination, and the provision of specialized programs and enrichment, recreational, or educational activities (Cohen, 2004). Many also utilize a method of resident participation in the development and operation of programs, policies, and services. The fundamental differences are most often shaped by the needs of the residents or general target populations living there, the main goals or expected outcomes desired by the developer or owner of the housing, and the requirements of the funding sources for the housing itself, which are often targeted to a specific population of residents or to specific, desired outcomes (Granruth, 2001).

Most existing research is in regards to housing with service programs that seek permanent housing and economic stability as the primary goal. Generally, housing programs

linked with services have been found to be beneficial in improving the economic condition of

some program participants. Many researchers assume that the long-term gains may not occur within the first year or two, but may lead to positive impacts on future generations of current public housing residents. According to Shlay and Hopluka, participants in such programs demonstrated increased educational aspirations, higher self-esteem, and a greater sense of control over ones life.

Evaluations completed by HUD on their housing and services programs support finding

that the programs reach the intended target group and show a positive impact on residents, most

often seen through improved well-being. Community building, increasing the capacity of a community, or fostering community pride are all documented as positive outcomes of housing

and services programs (Cohen ; Phillips, 1997). According to Tull, “a housing environment can provide a base for moving people out of poverty if the housing is enriched with services that provide crisis intervention, resources to identify resident needs, and referrals to connect residents with services in the community”(1998).

In Luzerne County, the Commission on Economic Opportunity (CEO) helps families with children and senior citizens to acquire and sustain adequate housing. Together, with the Housing Development Corporation of Northeast PA, they offer numerous services. These include housing related counseling services, assistance with rent and security deposits, mortgage foreclosure mitigation and reverse mortgage counseling assistance, landlord/tenant negotiation, emergency housing, loan and grant program applications and budget counseling.

Additionally, CEO also manages Washington Square Apartments located in Wilkes-Barre, PA. This facility is an income-based, senior-only apartment building that falls under the HUD Section 236 and Section 8 Rental Assistance Project. Eligible residents must have a household gross income (AGI) that is below 80% of the area median income for Section 236, or below 50% for Section 8. All other eligibility requirements are the same for both sections. Income, assets and allowances are verified prior to move-in and annually thereafter. Rent is calculated by the manager on site and is based on the greatest of 30% of household AGI or basic rent. It is the resident’s responsibility to inform the manager of any income increases over $200 per month, as rent will be recalculated. This is one example of what is available for low-income, independent seniors in our area.

Although there are housing services available to the aging the population the demand is far greater than the availability. My 86 year-old godmother happens to live in an income-based senior apartment complex and although she is grateful to have a place to live, she struggles with the transition on a daily basis. She had lived in the house she grew up in and was, understandably, reluctant to let it go. When she finally moved into her apartment my family was delighted; she would no longer be alone in a huge house that she physically and financially could not maintain. It seemed everyone was happy about this except for my godmother. She feels like she lost her independence. If she wants to hang a picture on her wall it has to be authorized first. They do inspections all the time to be sure she is keeping her space clean and clutter-free.

More often than not she is told she has to be home at a certain hour because of an inspection or meeting, and then she wastes her whole day waiting because they are never on time. Recently she received a notice saying that they would be coming to repaint the apartment and that it is her responsibility to move all the furniture. She is frantic because her piano will be out of tune once it is moved which means she will have to pay to have it tuned again. According to the notice, the painters will be there “sometime in May”. How is someone supposed to plan for this without an exact date? It also stated that painting is done every 3 years. To me this seems a bit excessive. I find it hard to believe that every apartment needs to be re-painted every 3 years!

I think this is a perfect example of why services need to be intertwined. By providing services with housing we are working to attain a long-term goal, whereas in the past each individual problem was treated independently of the other. The social work profession has emphasized that housing and social services are interrelated and critical in helping troubled, aged and/or low-income communities.


Axinn, J. & Levin, H. (1997) Social Welfare: A History of the American Response to Need. New

York: Longman

Bratt, R.G. & Keyes, L.C. (1998) Challenges Confronting non-profit Housing Organizations’

Self-Sufficiency Programs. Housing Policy Debate

Cohen, C.S. ; Phillips, M.H. (1997) Building Community: Principles for Social Work Practice

in Housing Settings. Social Work, Feb. (5) 471-481

Cohen, C.S., Mulroy, E., Tull, T., White, C., Crowley Housing Plus Services: Supporting

Vulnerable Families in Permanent Housing. Child Welfare September (5) p.529

Gans, H.J. (1995) The War Against the Poor: The Underclass and Poverty Policy. New York:

Basic Books

Granruth, L.B. ; Smith, C.H. (2001) Low Income Housing and Services Programs: Towards a

New Perspective. Washington, D.C. National Low Income Housing Coalition

Lundblad, K.S. (1995) Jane Adams and Social Reform: A Role Model for the 1990’s. Social

Work, 40 (5), p. 661-669

Tull, T. (Ed.) (1998) Service Enriched Housing: Models and Methodologies (2nd ed.) Los

Angeles: Beyond Shelter


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