Right Care, Right Place, Right Time: An Effective model for Integrating Senior Care and Housing

The average age of Bostonians is getting higher by the year, and so are the costs of housing and healthcare. According to the 2014 Aging in Boston report, even seniors with incomes well above the poverty line face a financial burden due to the high cost of living in the area. More often than not, seniors in supportive housing are struggling to pay for basic necessities such as prescriptions, health related co-pays, and nutritious foods—and such financial difficulties often contribute to declining health outcomes. Many disabilities affecting Boston seniors cause ambulatory and sensory difficulties, which greatly affect an older adult’s ability to live independently outside an institution.

Hebrew SeniorLife’s Right Care, Right Place, Right Time: Effectively Integrating Senior Care and Housing (R3) initiative, the winning entry of the 2017 Better Government Competition, is a comprehensive solution to two major issues for seniors in Greater Boston: independent housing and healthcare. Right Care, Right Place, Right Time uses a highly coordinated approach to prevent and respond to wellness issues of older adults in supportive housing, keeping seniors healthy and living in their community as long as possible and thereby decreasing costs to individuals and Medicaid.

The program has successfully integrated advanced wellness teams into two senior housing sites in Brookline and Randolph/Milton as a pilot. Wellness teams, which include nurses and care management staff, serve as a link between housing and healthcare. They educate housing staff to better meet resident’s needs, help with medication adherence, and create lines of communication between housing and medical providers, among other critical services. The R3 project also has a significant community outreach component in order to inform residents about the services available to them through the program.

The model of Right Care, Right Place, Right Time is largely inspired by two other care coordination programs: Vermont’s Support and Services at Home (SASH), which serves residents at an affordable senior housing property and older adults in the surrounding community, and CareOregon Housing with Services, which delivers services from health, aging, and social service providers to 11 senior living properties. Both programs were successful at reducing emergency trips to the hospital by nearly 20 percent. With the lessons learned through SASH, CareOregon, and the existing R3 pilot programs in Brookline and Randolph/Milton, Hebrew SeniorLife has designed R3 to fully anticipate the needs of the Boston senior community.

Because the R3 project can reduce rates of emergency trips and placement into nursing facilities as demonstrated by similar programs elsewhere, it has the potential to dramatically cut spending on avoidable ailments and falls. At one of the current R3 pilot locations that houses 560 residents, medical expense savings totaled an estimated $600,000 in one year.

Issues with wellness and housing can compound each other and prevent older adults from experiencing the quality of life they deserve. The Right Care, Right Place, Right Time initiative has created a replicable system of integrated healthcare and affordable senior housing that serves as a valuable model for other entities working on senior housing to meet this goal.