Downtown Women's Center's Aging in Place Program

DWC's Aging in Place program-the first in the nation-combines a highly effective Permanent Supportive Housing (PSH) model for women experiencing homelessness with services not typically offered in PSH (e.g., a Registered Nurse and Occupational Therapy) to ensure that older adults (60% of DWC's residents) can maintain supportive housing and address chronic health conditions that threaten their stability. With support from LA2050, DWC will deepen our Aging in Place program as we expand services to new PSH sites across Los Angeles County.

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What is the primary issue area that your application will impact?

Housing and Homelessness

In which areas of Los Angeles will you be directly working?

County of Los Angeles

City of Los Angeles

In what stage of innovation is this project, program, or initiative?

Expand existing project, program, or initiative

What is your understanding of the issue that you are seeking to address?

A "Justice in Aging: Fighting Senior Poverty Through Law" 2016 Special Report shows that homeless adults aged 50+ experience chronic illness/geriatric conditions at rates similar to or exceeding those of housed adults 15 to 20 years older, including conditions believed to be limited to the elderly (i.e., falls or memory loss). Despite a rapidly aging homeless population (23% are aged 55+), Aging in Place programs are primarily designed to meet the needs of older adults within the general population, and are not refined to meet the unique needs of older adults with histories of homelessness, especially women. Further, although PSH is the leading evidence-based practice for ending chronic homelessness, there are few PSH models that support this population's geriatric needs. With the increasing number of older adults falling into homelessness, and the significant number facing geriatric chronic health conditions, DWC recognized the need to bridge these two approaches to housing stability.

Describe the project, program, or initiative this grant will support to address the issue.

DWC's Aging in Place program addresses chronic physical and mental health issues among older adults in PSH by providing a full-time Registered Nurse (RN) and access to Occupational Therapy. We couple these services with intensive case management services to ensure that our older adult residents, who represent the majority of women residing at DWC, are able to maintain supportive housing in order to safely age in place. The Aging in Place program is based on the CAPABLE model - an evidence-based practice developed by researchers at Johns Hopkins intended to support residents in nursing homes. CAPABLE relies on an interdisciplinary team consisting of an RN, Occupational Therapist (OT) and OT interns, Social Worker, Case Manager, and a Maintenance Worker to collaboratively assess and address residents' unique, holistic needs. CAPABLE seeks to address physical and mental health barriers that impact the ability to retain housing and decrease hospitalization rates, among other things, for residents in PSH. DWC was the first provider in the nation to introduce this model for PSH. All women identified as candidates are assessed by the RN and OT for chronic health, environment, and ability challenges that may threaten their ability to safely age in place. From this assessment they develop an individualized plan and are connected to appropriate resources. OT interns support with assessments and also provide life-skills workshops for residents.

Describe how Los Angeles County will be different if your work is successful.

DWC's Aging in Place program addresses barriers faced by our served population, including the lack of programs dedicated to meeting the unique needs of older adult women with histories of homelessness, as well as housing shortages and rapidly rising rental prices which are driving unprecedented numbers of Los Angeles residents out of their homes. Our vision is to expand this model for new residents moving into housing where DWC will provide supportive services and beyond; by 2025 DWC will become the service provider for 245 new units of PSH throughout Los Angeles County-a nearly 50% increase in available supportive housing for women-including 85 units set to open for occupancy by March 2024. DWC is also developing a new Aging in Place program manual, through which we will disseminate knowledge and provide technical assistance to partner PSH providers on how to develop effective, evidence-based Aging in Place services for residents, further extending our impact in Los Angeles County.

What evidence do you have that this project, program, or initiative is or will be successful, and how will you define and measure success?

The overarching goal DWC's Aging in Place program is to increase housing stability and ensure older adult residents and residents with geriatric health conditions can safely address the chronic physical and mental health challenges that threaten their stability. DWC measures program success by DWC's on-site Registered Nurse and Occupational Therapist assessing eligible and interested residents for chronic health, environment, and ability challenges that threaten stability, with the goal to connect with 70 women with histories of homelessness each year and provide support tailored to their individual needs. DWC measures qualitative success by the number of women reporting greater satisfaction with their living situation, deepened social connections through participation in enrichment workshops, and lower levels of stress. Our program has proven to be effective; of the women enrolled, 98% retained their housing in 2022, compared to Los Angeles County's average PSH retention rate of 91%.

Approximately how many people will be impacted by this project, program, or initiative?

Direct Impact: 70

Indirect Impact: 204

Downtown Women's Center

Over our 35-year history, the Downtown Women’s Center has created innovative programming focused on meeting the unique needs of homeless, formerly homeless, and extremely low-income women. When the Center first opened in 1978, it was the first and only resource for women living on Los Angeles’ Skid Row. In 1986, DWC opened the United States’ first permanent supportive housing for women, a program that has since been modeled as a national prototype. DWC now offers 119 units of permanent supportive housing among our two Residences to women who are primarily elderly, mentally ill, and/or physically disabled. More than 95% of the 500 women we have served through our Residence program have remained permanently housed. We have also scaled up our housing efforts beyond our own 119 apartments by piloting our Critical Time Intervention (CTI) model with clients housed off-site. Our CTI model, a proven evidence-based program launched in 2011, provides intensive case management for individuals transitioning out of chronic homelessness, ensuring that they have the support and access to resources they need to stay housed. DWC is also committed to sharing best practices; this April, our Director of Clinical Health Services and Lead CTI Case Manager will present DWC's CTI model at the Housing California Conference in Sacramento. As the need on Skid Row has continued to grow, DWC is grateful that we have been able to expand our programming and services, offered through our Day Center, Learning Center, two Residence locations, and on-site Medical and Mental Health Center. In 2012, DWC served 4,300 women with 90,000 meals, 23,000 showers, and 6,500 case management and counseling sessions. Along with our direct service, DWC contributes to national and local policy discussions and to best practice research in service provision for people experiencing homelessness. In 2001, DWC spearheaded the Downtown Women's Action Coalition, addressing women’s policy and research needs. The coalition has since performed several needs assessments for women on Skid Row. DWC’s well-reputed history is a testament to our mission and work in the community. DWC received a Los Angeles Office of the City Attorney Commendation in 1993, a Bank of America Neighborhood Excellence Initiative Neighborhood Builder Award in 2007, and "Organization of the Year" by the Los Angeles Business Journal in 2011. Several other organizations have utilized DWC as a prototype for creating services for homeless women, including Friends In Deed in Pasadena, and organizations in San Francisco, San Jose, Amarillo, Texas; and New Orleans. Finally, we attribute our long-term success to the overwhelming community support and volunteer efforts that allow us to make the greatest impact with limited resources. DWC has been recognized as a Blue Ribbon Service Enterprise by the state of California, and our model has been developed into a case study in best practices in nonprofit volunteer engagement.

Organization website
DowntownWomensCenter.org
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charitynavigator.org

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