Congregate Housing

HUD administers the Congregate Housing Services Program (CHSP). Designed to assist older people and younger people with disabilities to live independently in their own apartments, the CHSP provides housing combined with professional service coordination and supportive services, such as housekeeping, personal care, congregate meals, and transportation. It aims to encourage maximum resident independence in a home environment, improve management's ability to assess eligible residents' service needs, and ensure delivery of needed services.

The CHSP has about one hundred sites across the United States. Some are from the original CHSP, authorized in 1978; the rest have been funded since a new version was authorized in 1990. (The new version mainly increases the amount of financial support required from the housing sponsor and community.) No new CHSP sites have been funded since 1995. CHSP participants pay 30 percent of their (adjusted) income in rent and up to 20 percent for services. HUD, state home- and community-based services programs, Medicaid, and donations cover the remaining costs.

Several studies have documented the original CHSP's overall effectiveness. The following description of the Portland, Oregon, CHSP may help illustrate the model. Four Housing Authority of Portland (HAP) apartment complexes have thirty CHSP slots each, representing about 30 percent of their total population. Each complex has an on-site service's coordinator who works with participants, CHSP staff, and local service providers to arrange and monitor services, recruit and oversee volunteers, and help participants strengthen informal supports. CHSP also employs homemakers and meal service staff. The Professional Assessment Committee, including health and social service professionals, consults with the coordinator on assessment, care planning, and troubleshooting.

Portland CHSP participants are encouraged and assisted to take an active role in advocating and caring for themselves. The program is voluntary, and participants decide what services they will use. Available services include on-site daily meals in a group setting, assistance with housekeeping and personal care, transportation, health and wellness promotion, Senior Companions, affordable foot care clinics, and daytime check-ins by CHSP staff. Trained HAP staff, contracted home health agencies, a nearby nursing school, and many volunteers provide services. Since service coordinators assign service providers to an entire site, workers often shop and do laundry for more than one person at a time, thus keeping costs low.

The Portland CHSP serves five main types of residents: frail older people who live in the CHSP building, at-risk older people from outside the CHSP complexes, deinstitutionalized people, younger people with disabilities, and people with temporary disabilities. Participants generally must be able to be on their own at night and for much of the day, and to be independent in transferring (moving from one position to another [e.g., from wheelchair to bed]) and toileting. The CHSP can often support a person who can transfer but is unstable for some tasks, or who has a temporarily higher level of need.