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Trustees of the University of Pennsylvania

Identifying Care Costs and Interventions for Aging Homeless Adults in New York City

NYHealth awarded a grant to Penn SP2 to conduct an analysis of the health care utilization, needs, and costs of people who are homeless and ages 55 and older.

Special Projects Fund

Grantee Name

Trustees of the University of Pennsylvania

Funding Area

Special Projects Fund

Publication Date

September 2020

Grant Amount

$120,305

Grant Date:

February 2017–August 2019

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Homelessness has steadily increased in New York State, with most of the State’s homeless population residing in New York City.

People who experience homelessness often have a complex array of illnesses or other serious disabilities, which leads to high use of hospital-based care and health care costs. As the homeless adult population ages, there will be corresponding increases in health care needs and costs. Compared with people who are not homeless, studies have found that homeless people age prematurely and have very high rates of geriatric health issues at younger ages. To mitigate this potential crisis, the University of Pennsylvania School of Policy & Practice (Penn SP2) conducted a multistate, data-driven analysis of the health care utilization, needs, and costs of people who are homeless and ages 55 and older.

NYHealth awarded a grant to Penn SP2 to support New York State’s participation in this national effort.

Outcomes and Lessons Learned

  • Conducted an analysis on the health care needs and costs of aging homeless people in New York City using data from the New York City Center for Innovation through Data Intelligence (CIDI).
  • Identified the health care utilization patterns and costs of aging homeless adults in New York City and projected these costs over the next 10 to 15 years.
  • Published a New York City-specific report, “A Data-driven Re-design of Housing Supports and Services for Aging Adults who Experience Homelessness in New York City,” to complement the multisite study. Key findings include:
    • New York City could see a return on investment of up to $1.13 for every $1 spent on addressing homelessness among people ages 55 and older.
    • Between 2017 and 2030, the number of homeless adults over the age of 65 is expected to grow from 2,600 to 6,900.
    • The combined annual shelter and health care costs associated with the growing population of homeless adults over the age of 65 are projected to triple from approximately $150 million in 2011 to $461 million in 2030.
  • Developed potential intervention models that reduce both homelessness and the associated health care costs for the aging homeless population, and detailed financial projections to allow policymakers to analyze the financial viability of the proposed solutions.
  • Shared research findings widely, including through:
    • A U.S. Department of Health and Human Services convening in Washington, D.C., that engaged multiple federal, state, and city stakeholders from the health care and housing sectors;
    • An NYHealth-hosted panel discussion, featuring Steven Banks, Commissioner, New York City Human Resources Administration/Department of Social Services;
    • Coverage in a CBS 60 Minutes segment about the country’s homelessness crisis; and
    • A blog post in Health Affairs GrantWatch by NYHealth Senior Program Officer Brian Byrd.

Penn SP2 expects that a spectrum of short- or long-term rental assistance programs, combined with social services, will help homeless seniors reconnect with family, move in with a partner or roommate, or rent an apartment of their own. For the smaller group of homeless older adults whose health care and shelter needs are higher than most homeless seniors’, the study recommended more intensive permanent supportive housing interventions that include enhanced services for aging in place or palliative care.

This grant exemplifies what can be achieved through transparent collaboration between private philanthropy, academic institutions, and local government. By making its data available to Penn SP2 researchers, CIDI provided a unique opportunity to produce groundbreaking analysis. Although no specific policy changes have occurred yet, stakeholders have started the conversation about the emerging crisis of New York City’s aging homeless population. For example, Commissioner Banks has said that the study’s data and recommendations will inform all future efforts to reduce homelessness in New York.

Co-Funding and Additional Funds Leveraged: The Blue Cross Blue Shield of Massachusetts Foundation contributed $140,000 to fund the Massachusetts analysis, and the Conrad N. Hilton Foundation contributed $45,000 to fund the California analysis.

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