​The U.S. Government Accountability Office (GAO) recommends that the U.S. Department of Health and Human Services (HHS) facilitate the development of a cross-agency federal strategy to ensure that federal resources for home- and community-based services for older adults are used efficiently and effectively, states a May 20, 2015, GAO report. According to the report, five federal agencies within four departments (the Administration on Aging and the Centers for Medicare and Medicaid Services within HHS, the Department of Housing and Urban Development, the Department of Transportation, and the Department of Agriculture) fund home- and community-based services and supports that older adults often require to continue living independently in their own homes; however, for the most part, these agencies do so independently. GAO visited three U.S. localities, chosen for their enhanced delivery systems of home- and community-based services, and found that local area agencies on aging, assisted by other community-based organizations, took the lead in planning and delivering services for older adults; these services were paid for with a mix of federal, state, and local funding. Several officials from two of the localities reported that flat funding of certain state funds, combined with the growing number of older adults, has resulted in waiting lists for affordable housing and in-home services, prompting GAO's recommendation for interagency collaboration. HHS agreed with the recommendation but has indicated in the past that competing priorities for its limited resources has prevented it from leading the development of such a cross-agency federal strategy.

HRC Recommends: Federal, state, and local agencies must tackle numerous and complex challenges in providing resources to effectively support housing an aging population. Studies have shown that older adults who live in subsidized housing have more chronic conditions, are more likely to be hospitalized or use the emergency department, and have higher healthcare costs than those in their community who do not require such assistance. In the aftermath of the GAO report, risk managers should encourage stakeholders in their organizations to keep abreast of any ensuing regional and local collaborative efforts to improve access to affordable housing and home and community-based healthcare services for their aging patient populations.