9 months ago

Annual Performance Plan 508

Annual Performance Plan 508

and Improved Outcomes

and Improved Outcomes Along the HIV Care Continuum emphasizes the intersection of housing and health care for those living with HIV in an effort to educate communities by demonstrating stable housing as key HIV prevention and care strategy within the framework of coordinated HIV services and care. Accelerating improvements in health outcomes for all individuals living with HIV is a national priority. Additionally, work led by the Department of Justice (DOJ) and HHS related to enforcement of and compliance with the Supreme Court’s Olmstead decision 80 reinforces the rights of individuals with disabilities to live, work, and receive services in the greater community in the most integrated setting appropriate to their needs. As a result of Olmstead, there is a significant need for affordable, integrated housing opportunities where individuals with disabilities are able to live and interact with individuals without disabilities. Achieving this goal requires an increase in the supply of integrated housing options so that individuals have meaningful choice in where they live. HUD also helps protect the health of residents of assisted multifamily and public housing from both direct and environmental (i.e., second-hand and third-hand) tobacco smoke exposure by encouraging owners of assisted housing and public housing agencies to issue and implement smoke free policies, and by providing outreach and technical support. As of September 2014, 571 public housing agencies, that is, 18 percent of public housing authorities, had implemented smoke-free policies, protecting residents in about 200,000 housing units. The Department will enhance those efforts to help reduce the extent of this public health problem among residents of its housing portfolio. STRATEGIES • Promote health and financial stability of vulnerable populations by improving access to and effective utilization of health care services. HUD will identify ways to better capture health insurance status of HUD-assisted households and partner with state Medicaid programs to promote more efficient connections to health insurance enrollment options and services. • Build evidence on effective models for coupling services with housing and modify existing and future programs to reflect best practices. • Improve performance management by enhancing HUD’s collection and analysis of data pertaining to health-related outcomes across HUD-assisted housing programs. Also improve HUD’s ability to integrate and/or conduct administrative data matches with other partner federal programs. • Seek to increase the percentage of HOPWA households receiving permanent supportive housing who are stably housed and who accessed or maintained access to care. The HIV Care Continuum Initiative provides a framework to identify points where individuals living with HIV are not connected to care and to seek ways to monitor and evaluate the effectiveness of interventions. • Assist with enforcement and implementation of the Supreme Court’s Olmstead decision, in collaboration with HHS, DOJ, and state agencies, through facilitating expansion of integrated housing opportunities for people with disabilities transitioning out of institutions/at risk of institutionalization, including people experiencing homelessness. • Increase the number of public housing agencies that have issued smoke-free policies. In accordance with recommendations by the Surgeon General, 81,82 and the systematic review by the Department of Health and Human Services-chartered Task Force on Community Preventive Services on the effectiveness of smoke-free policies, 83 the public health of residents of public housing, both smokers and non-smokers, is improved when the management issues and implements a smoke free 86 Retrospective: FY 2014-2015 Agency Priority Goal End Veterans Homelessness

policy. Research by the Centers for Disease Control and Prevention indicates that such policies in assisted housing are associated with cost savings. 84 HUD will expand its encouragement of such policies through notices, guidance, outreach, and technical support and will track the issuance and implementation of smoke-free policies by public housing agencies. LEADING THIS OBJECTIVE Jennifer Ho Senior Advisor on Housing and Services Office of the Secretary FY14 APR PROGRESS UPDATE HUD is working to meet the needs of the most vulnerable populations, including individuals experiencing chronic homelessness, individuals living with disabilities, and older adults, and ensure the healthiest environments for residents of Public Housing and other HUD-assisted properties. Through research and collaboration with HHS, we are promoting the impact of supportive housing on the health and health care utilization of highly vulnerable populations. In October 2014, the Office of Special Needs Assistance Programs (SNAPS) and the Office of HIV/AIDS Housing (OHH) announced a technical assistance partnership with the US Interagency Council on Homelessness and the US Department of Health & Human Services to strengthen the connections between homeless assistance providers and mainstream healthcare services. The initiative, to be carried out through 2015, will improve access and effective utilization of Medicaid, Federally Qualified Health Centers, and other health services, thereby freeing up HUD dollars to direct towards housing. Solidifying partnerships between state housing agencies (and state Medicaid and health and human services agencies was also crucial work for the 811 Project Rental Assistance Demo in FY2014, for reaching extremely lowincome persons with disabilities requiring long term services and supports. The first participants in these units are expected in spring 2015. HUD is also developing a strategy to meet the housing choice, affordability and accessibility needs of older adults and an aging America, partnering with HHS for demonstrations and ensuring our mortgage investments support high quality facilities. In FY2014, HUD’s Section 232 nursing home portfolio maintained an average CMS Star rating of 3.2, surpassing the 2014 target and on par with the national average even with some of the riskiest credits, serving vulnerable populations. 80 Olmstead v. L.C., 57 U.S. 581 (1999) 81 The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014; reports/50-years-of-progress/index.html 82 Reducing Tobacco Use. A Report of the Surgeon General, 2000; 83 Task Force on Community Preventive Services. The Guide to Community Preventive Services: What Works to Promote Health?, 2005; www. 84 King BA, Peck RM, Babb SD. Cost Savings Associated with Prohibiting Smoking in U.S. Subsidized Housing. Am J Prev Med. 2013 Jun;44(6):631-4; Retrospective: FY 2014-2015 Agency Priority Goal End Veterans Homelessness 87

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