The U.S. Department of Housing and Urban Development (HUD)âs Office of Policy Research and Development is undertaking an evaluation of the Supportive Services Demonstration (demonstration, or SSD). SSD is designed to test the impact of housing-based supportive services on the healthcare utilization and housing stability of low-income adults aged 62 and over. The demonstration offers grant funding to HUD-assisted multifamily property owners to implement the Integrated Wellness in Supportive Housing (IWISH) model over the demonstration period. The IWISH model features a full-time on-site Resident Wellness Director with a part-time Wellness Nurse at each property funded to implement IWISH. The Resident Wellness Director and Wellness Nurse work together to implement a formal strategy for coordinating services to help residents meet their long-term care needs and successfully age in place.
HUD designed the SSD as a cluster-randomized controlled trial to allow rigorous measurement of impacts. HUD published a Notice of Funding Availability (NOFA) in January 2016 for the demonstration, received more than 700 responses, and applied screening and ranking criteria described in the NOFA to identify 185 properties across seven states as eligible for random assignment. HUD assigned properties to three groups: a treatment group that received grant funding to hire the Resident Wellness Director and Wellness Nurse and implement the demonstration; an active control group that did not receive funding for implementation but received an incentive for participating in the evaluation; and a passive control group that received neither an implementation grant nor an incentive.
The final demonstration sample is 124 HUD-assisted properties: 40 in the treatment group (also known as IWISH properties), 40 in the active control group, and 44 in the passive control group. All properties serve households headed by people aged 62 or over, either predominantly or exclusively. The properties are in the following states: California, Illinois, Maryland, Massachusetts, Michigan, New Jersey, and South Carolina. Each state has treatment, active control, and passive control properties.
The demonstration formally began October 1, 2017. The 40 properties in the treatment group implemented IWISH for an initial three-year demonstration period between October 2017 and September 2020. The Continuing Appropriations Act, 2021 and Other Extensions Act and the Consolidated Appropriations Act, 2021 provided additional funds and authorization to extend the demonstration for an additional two years (2021 â 2023).
To determine the impact of IWISH on healthcare utilization and housing stability, the evaluation will compare outcomes for residents at treatment properties, where IWISH is implemented, to the outcomes of residents at the active and passive control properties, which represent âbusiness as usualâ for HUD multifamily elderly-designated properties.
The evaluation is being conducted in two parts. The research team has been conducting an evaluation of the initial three years of the demonstration, from October 2017-September 2020. This first phase of the evaluation is taking place from October 2017 to 2022. During the second phase of the evaluation, the research team will continue to evaluate the demonstration through September 2026. The second part of the evaluation focuses on the two-year extension period of the demonstration as well as the transition period between the two grant-funded demonstration periods. The evaluation of the two-year SSD extension period is taking place from October 2021 through September 2026.
The evaluation has a qualitative componentâthe process studyâdesigned to learn how treatment group properties implemented the IWISH model and how property staff and residents responded to it, and a quantitative componentâthe impact studyâdesigned to measure the effect of the intervention on key outcomes related to residentsâ use of healthcare services and housing stability.
This is the third process study package submitted for OMB approval. The first submission, approved November 02, 2018 (OMB Control number 2528-0321), covered the baseline data collection for the study, which ended in March 2020. The second submission, approved August 07, 2020 (OMB Control number 2528-0321), covered IWISH staff interviews and interviews with property owners conducted in summer 2020.
This third submission requests approval for an additional round of interviews with IWISH staff and property owners, as well as owners of properties in the control group. It also seeks approval for interviews with residents of IWISH properties, which is a new data collection activity. All data collection activities in this request are planned for 2023.
The purpose of the data collection activities in this request is to collect data from multiple perspectives about the continued implementation of the demonstration, the strengths and weakness of the model, and how resident wellness activities compare across treatment and control properties. This information is necessary to complete the demonstrationâs process study by providing input from key stakeholders near the end of the demonstrationâs two-year extension period.
Data are collected under Title 12, U.S.C. Sec. 1701Z-1 and 2.
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
OMB 83c-IWISH.docx
30-Day Notice Supportive Services Demonstration.pdf
Resident Interviews conducted via on demand interpretation