State and Local Partnerships for 

Housing Stability

March 15, 2022

Webinar
Welcome

Webinar is hosted by the 

Housing and Services Resource Center

Facilitator

Lori Gerhard, Director of the Office of Interagency 

Innovation, Administration for Community Living

2
Instructions for Zoom

Audio Options

• Use your computer speakers, OR dial in using 

the phone number in your registration email.

• All participants are muted.

Questions and Comments

• Please actively use chat throughout the meeting, 

especially for your comments.

• To ask a presenter a question, please use the 

Q&A function.

Or, send your question or comment via email to 

HSRC@ACL.HHS.GOV

3

This event is being recorded.
Poll: Who Is with Us?

What sector is your organization in?

• Health or Human Service Agency

• Housing or Homelessness Services

• Health Care Provider or System

• Community Development Organization

• Association, Research, or Advocacy Organization

• Consumer

• Other

4
Challenges

Finding and Obtaining Affordable and Accessible Housing

• A 2021 report found there were only 40 affordable and available homes for 

every 100 extremely low-income renter households nationwide. 

• Under 1% of US housing stock is wheelchair accessible, and less than 5% 

can accommodate individuals with moderate mobility disabilities.

Homelessness is Growing Among People with Disabilities & Older Adults

• HUD’s 2018 Annual Homeless Assessment Report indicates that 48.5% of 

single adults and heads of households who used homeless shelters over the 

course of a year report having a disability: approximately 550,000 people.

• Per HUD’s 2018 Annual Homeless Assessment Report, the number of 

sheltered homeless aged 51–61 increased from about 216,000 in 2007 to 

249,000 in 2017.

• The number of people experiencing sheltered homelessness also rose for 

those 62 and older, from 46,000 to 76,500. Older adults now make up 23 

percent of the sheltered homeless population, up from 16.5 percent in 2007.

Finding, Navigating & Obtaining Services & Supports

5
6
Connecting the housing sector and the community 

living networks

1. Coordinate Technical Assistance

2. Facilitate Partnerships

3. Recognize and Share Innovations

4. Leverage and Align Resources

Learn more at: acl.gov/HousingAndServices

7

7
Poll Results

8
Today’s Agenda

Opening Remarks

Massachusetts 

Washington

Questions & Answers

Closing

9
Massachusetts Panel 

Presentation

• Emily Cooper, Special Advisor on Housing, 

MassHealth, Chief Housing Officer, Executive 

Office of Elder Affairs

• Susan Ciccariello, Acting Director of the Office of 

Long-Term Services and Supports, MassHealth

• Adam Schaffer, Deputy Director, Division of 

Housing Stabilization, Massachusetts Department 

of Housing and Community Development 

10
Chat #1

What is your most effective way of 

developing strong relationships with an 

organization in a different sector?

11
Transforming Lives

The slides in this section are from the Washington State Department of Social and Health Services

Braiding Programs to Serve Clients 

Whitney Joy Howard, Lead Supportive Housing Program Manager, Home and 

Community Services Division, Washington State Department of Social and Health 

Services 

Pam Parr, Executive Director of Spokane Housing Authority

Alexa Whitted, Manager of GOSH/CCG Services for Consistent Care
Vision, Mission, Values

• Vision

Seniors and people with disabilities living 

in good health, independence, dignity 

and control over decisions that affect 

their lives.

• Mission

To transform lives by promoting choice, 

independence and safety through 

innovative services.

• Values

Collaboration, Respect, Accountability, 

Compassion, Honesty and Integrity, 

Pursuit of Excellence, Open 

Communication, Diversity and Inclusion, 

Commitment to Service 

13
Philosophy

Home and 

Community 

Services

The division of Aging and LongTerm Support Administration 

(ALTSA) within DSHS that is 

responsible for promoting, 

planning, developing and 

providing long-term care services 

responsive to the needs of 

persons with disabilities and 

older adults.

14

•

Philosophy

Most people want to live as 

independently as possible for as long 

as possible.

• ALTSA embraces the belief that

individuals with high care needs can be

supported in the community in a

variety of settings by offering waiver

and state plan services that provide

alternatives to institutionalizations.

• Goal: Offer options to individuals

requiring long-term care services in the

least restrictive setting while honoring

client choice and preference.
High Acuity Clients are Served in All Community Settings

ADL means Activities of Daily Living:

Eating, Dressing, Moving Around, 

Toileting, etc.

HIGHER

ACUITY

GROUP 1. Extremely limited ADLs, 

often immobile

GROUP 2. Very limited ADLs, plus 

cognitive problems

GROUP 3. Moderately limited ADL, 

plus clinically complex

GROUP 4. Moderately limited ADL 

and/or behavior challenge

GROUP 5. Moderately limited ADL

Number of Clients by CARE Assessment Acuity Group

Adult Family Home

Clients

Almost 

2,000 

for 

group 1

About 

2,900 

for 

group 2

About 

1,200 

for 

group 3

About 

1,300 

for 

group 

4

About 

700 

for 

group 

5

Assisted Living Facility

Clients

Abou

t 150 

for 

group 

1

Abou

t 800 

for 

group 

2

About 

900 for 

group 

3

About 

1,600 

for 

group 

4

About 

4,000 

for 

group 

5

In-Home Clients

with Agency or Individual

Provider

About 

2,000 

for 

group 

1

About 

15,500 

for 

group 2

About 

13,700 

for 

group 

3

About 

12,200 

for 

group 

4

About 

8,900 

for 

group 

6

Source: CARE data as of June 30, 2015 snapshot, combined clients of ALTSA and DDA.

15

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000
The ALTSA Housing Team

16

Housing Team DOB: 2011 via Money 

Follows the Person Demonstration 

• Statewide team of Housing Program Managers 

who work to administer housing resources and 

Supportive Housing services to ALTSA eligible 

clients.

• Support independent housing options for 

ALTSA clients

• Focus is on subsidies and tenancy support

• Housing team acts as liaisons between field, 

various contractors and available Long-Term 

Services and Supports.

• Increase housing resources for ALTSA clients.
Housing Capacity Work

17

Part of the ALTSA Housing Team's goal is to increase housing capacity for ALTSA 

clients. In 2019 an FTE was created to focus on capacity building.

We do that through collaboration with: 

• WA State Housing Trust Fund

• WA State Housing Finance Commission

• Department of Commerce

• All 45 Public Housing Authorities throughout WA State. 

In addition, we also work with local housing developers, including non-profits, 

and property management companies. 
Building Relationships With Other Providers and 

Agencies

• Health Care Authority 

(HCA) and Managed Care 

Organizations

• Department of Commerce

• Public Housing Authorities 

• Supportive Housing 

providers

• Property Management 

Groups and Landlords
Federally Funded Voucher Opportunities

• Non-Elderly Disabled 

Vouchers

• Mainstream Vouchers

• Emergency Housing 

Vouchers

• 811 Project Based 

Vouchers
ALTSA State Funded Rental Subsidies

• ALTSA provides state-funded Emergency Rental Assistance, a one-time 

intervention to avoid eviction 

• Subsidies provide interim support between institutionalization and 

permanent, federal subsidies.

• ALTSA Rental Subsidies are funded through WA State but are modeled after 

HUD’s Section 8 Housing Choice Voucher Program.

• ALTSA subsidies are currently focused on transitioning clients out of skilled 

nursing facilities and transitioning or diverting from state psychiatric hospitals.

• Only current ALTSA clients are able to access the ALTSA Rental Subsidy, and 

clients must remain on ALTSA services in order to continue receiving the subsidy.

• ALTSA contracts with Spokane Housing Authority (SHA) to 

administer/pay ALTSA subsidies statewide.
Housing Authorities in Washington State

▪ In Washington State, there are 46 separate housing authorities. 

▪ Housing Authorities are generally quasi governmental agencies 

providing affordable housing and rental assistance to a particular 

territory. 

▪ Most housing authorities have portfolios of affordable rental units AND 

rental assistance programs that provide low-income households the 

opportunity to rent from private landlords.

21
Spokane Housing Authority

Not your average Housing Authority... 

• Innovation, collaboration, and 

flexibility

• Braiding together funding and 

programming

• Looking for loopholes

22
Why Spokane Housing?

• SHA’s Referral Voucher Program — existing partnership with ALTSA using 

the Housing Choice Voucher Program to serve ALTSA clients in SHA’s 

jurisdiction.

• BRIDGES expands the concept statewide using state funding.

• It takes lots of coordination to both utilize the flexibility of state funding 

and retain control over quality of housing and the consistency of 

payment found through HUD funded subsidies — but it WORKS!

23
What is ALTSA Supportive Housing?

Supportive housing is an evidence-based 

service that focuses on helping individuals find 

and keep housing

• Developed initially to serve homeless people with 

complex needs

• Utilized by ALTSA to serve clients with complex 

behavioral health issues 

• Great alternative to residential settings for people 

who want to live independently and need support

24
Supportive Housing: Coordinating System of Care

Supportive Housing 

Provider acts as the point 

person for the participant 

and helps to drive 

collaboration across 

systems and providers. 

HCS and AAA 

CM

Informal 

Supports

Housing

Managed Employment

Care 

Organizati

on

Outpatient 

Behavioral 

Health

Substance 

Use 

Disorder 

Services

Primary 

Care 

Physician

Who is part of System of 

Care will vary over time and 

by participant.

25

Participant

Supportive 

Housing 

Provider
What is Supportive Housing?

26

Philosophy, Program, and Evidence-Based

Provides immediate access to housing and support 

services

Keeps the individual front and center

Utilizes Harm Reduction and Proactive Engagement

Home Visits & 24/7 access to services
Supportive Housing Providers: Services

Pre-tenancy Services: 

• Develop an individual housing support plan; 

housing crisis plan. 

• Conduct search and secure affordable 

independent housing.

• Review lease and Landlord-Tenant law; being 

a housing advocate.

• Assist participant move into housing. 

• Coordinate with the participant’s care team.

27
Supportive Housing Providers: Services

Ongoing Tenancy Support Services:

• Proactively support maintenance of tenancy.

• Relationship building with landlords, property managers 

and neighbors.

• Ensure person-centered housing support and crisis plans 

are up-to-date. 

• Coordination with participant’s care team, including 

coordination of authorized LTSS.

• Activities that support community integration.

• Connection to permanent affordable housing.

28
Long-Term Services and Supports:

Community Services Supporting Housing

Services that assist secure and/or 

maintain an apartment:

• Background check

• Rental applications

• Move-in deposits

• First month’s rent

• Moving services

• Essential household items

• Other support, e.g. cell phone or bus 

pass

• Pest eradication

• Deep clean

29
Long-Term Services and Supports:

Community Services Supporting Housing

Resources to Support Tenancy

• ALTSA Housing Subsidy 

• Emergency Rental Assistance

• Community Choice Guide

Additional Services (Where Contracted):

• Behavioral Support Services

• Technical Assistance

• Professional Support Services: 

Communication Therapy, 

Dietitian/Nutritionist

30
ALTSA Resources

• For more information on ALTSA’s Braided Services, please see the Washington 

State Long-Term Care Manual

• Community Services Supporting Housing 

• Chapter 5a Washington Roads

• Chapters 7b Community First Choice (CFC) and 7d COPES

• Chapter 10 Nursing Facility Case Management and Relocation

• Specific Housing and Supportive Housing Resources 

• Chapter 5b Housing Resources for ALTSA Clients

• Chapter 30d Supportive Housing: Foundational Community Supports

• Please also check out ALTSA’s Housing Resources and Supportive Housing 

Services webpages

31
Chat #2

What new ideas did you get from the 

Massachusetts and Washington 

presenters?

32
Your Questions & Answers

33
HSRC Website

34

acl.gov/HousingAndServices
Wrap Up

• Please email us at hsrc@acl.hhs.gov

• Watch for our email when the webinar 

recording and slides are available

Questions? Ideas? 

Email us at hsrc@acl.hhs.gov

36
Acknowledgment

This presentation was supported in part by the U.S. Administration for Community 

Living through a contract with Mission Analytics Group, Inc. (Contract number 

HHSP233201500060I) which subcontracted the work to USAging. The views 

expressed do not necessarily represent the positions or policies of the 

Administration for Community Living / Department of Health and Human Services.

37